Capella FPX 4000 Assessment 3

Capella FPX 4000 Assessment 3

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Capella University

NURS-FPX4000 Developing a Nursing Perspective

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Applying Ethical Principles

Ethical dilemmas are inherent in healthcare, requiring professionals to navigate complex situations where competing values and principles come into play. Such cases require consideration of autonomy, beneficence, non-maleficence, and justice principles to reach a decision that will retain the ethical face of patient care. In this paper, we examine an unethical scenario from Hillside Medical Center and analyze the case based on the principles of moral theory and code of ethics.

Overview of the Case Study

This case focuses on Dr. Leonard Harper, a geneticist, who faces an ethical dilemma involving patient autonomy and family communication. Mrs. Clara Bennett is a 38-year-old woman who has just learned that her prenatal genetic test reveals that her baby has a high risk of being born with Down syndrome. Clara specifically asks Dr. Harper not to tell her husband, Lt. Jack Bennett, a naval officer currently working overseas, about the results, as it may complicate the pressure in his line of work. This situation put Dr. Harper in a dilemma about respecting the patient’s autonomy of self-governance and upholding patient confidentiality or maintaining transparency in family decision-making, especially given the potential impact on their marriage and the child’s future medical care.

Analysis of Ethical Issues in the Case Study

In this ethical dilemma about Dr. Harper and Mrs. Clara Bennett, there are facts related to autonomy, beneficence, and nonmaleficence. Peer-reviewed literature offers the moral and practical considerations derived from research findings. Varkey (2021) shows that to promote autonomy is a patient’s right to control personal health information and make decisions about their healthcare processes. Clara’s request correlates with this principle as she insisted on keeping the results of the genetic tests hidden from her husband.

However, according to the article by Cheraghi et al. (2023), beneficence dictates that the clinicians’ actions must conduce to patients’ benefit and well-being. Therefore, the transparency of the baby’s health issues can be helpful for Clara, her husband, and their child, as they can be emotionally prepared for any decision. In addition, nonmaleficence requires healthcare workers to refrain from any action or utterance that will cause harm to the patients (Cheraghi et al., 2023). In this case, Dr. Harper should weigh the risks: what negative effects an inability to share this information can have for the Bennetts as a couple and their child’s care.

The selected articles supplement the argument by presenting the authors’ viewpoints on autonomy, beneficence, and nonmaleficence principles. Varkey (2021) emphasizes that patient self-determination (autonomy), relating to Clara’s right to self-governance, should have been respected to make decisions regarding her baby’s health and what to disclose. Cheraghi et al. (2023) stated that the principle of beneficence enhances welfare by mainly elucidating how the transparency of and discussing the possible challenges that Clara, her husband, and their child may encounter. Furthermore, the same study emphasizes nonmaleficence and directs healthcare providers to avoid harm, relational pressure, or lack of support. Such understandings support the ethical approach that Dr. Harper applies to solve this challenging problem.

Using the Ethical Decision-Making Model to Analyze the Case Study 

Analysis of how Dr. Harper responded to Clara Bennett’s request shows the implementation of an ethical decision-making model. The model has three steps: identification/evaluation of the moral issue, assessment/supervision of correcting actions, and ethical actions (Banks et al., 2022). The healthcare professional presents moral awareness by acknowledging an ethical consideration between the patient’s autonomy and the possible harm of not disclosing information to the husband. This awareness reflects his understanding of the competing ethical principles, including autonomy, beneficence, and nonmaleficence. After weighing all the ethical principles, ethical judgment determines the best course of action.

Ethical decision-making considers the consequences of the decision for both parties of the conflict (Banks et al., 2022). Hence, Dr. Harper understands Clara’s right to privacy by establishing autonomy as a primary governing principle. However, his judgment has to consider the rest of the picture regarding the family and the negative consequences of leaving Jack out of major decisions. The resolution’s ethical courses of action (moral behaviors) depend on whether Dr. Harper can act on his judgment. This step will enable the healthcare professional to look more ethically at the solution and the policy of guided disclosure and make the environment favorable for Clara to explain the results to Jack. This makes it easy for the two parties to have information and the ability to make cooperative decisions.

Effective, ethical approaches build trust, promote patient-centered care, and conform to professional practice best practices for positive patient outcomes (Varkey, 2021). In contrast, non-ethical results in ignoring autonomy or transparency, resulting in mistrust, family- dissents, and cases of distress. For Dr. Harper, the right thing to do and do well would be to maintain Clara’s capacity and facilitate the family to encourage guided conversations involving the patient. On the other hand, unethical behavior, such as revealing information to Jack without further compunction, can lead to distrust, tension in their relationship, and psychological effects. Using an interesting ethical decision-making model, Dr. Harper can solve the conflict in a way that will not harm any participants.

Effectiveness of Communication Approaches in the Case Study

In the case study, Dr. Harper talked to Clara professionally and privately and did not disclose any information to third parties without her consent. Confidential communication is highlighted by the research as essential in fostering trust between healthcare providers and patients (Semyonov-Tal, 2024). This enables honest and open discussions about sensitive matters while ensuring the patient feels respected and supported. Although this approach served Clara well by maintaining her emotional state and trust, the approach cornered her husband, Jack, out of the family’s major decision-making processes, meaning less open and collaborative.

Simultaneously, Dr. Harper ensured teamwork by showing Clara understanding and allowing her to speak what she wanted. Nevertheless, he failed to use words to elicit conversation about future family interactions and the consequences of the lack of disclosure related to communication. It also shall be noted that the failure to incorporate this transforms interactions between Clara and Jack into a relational strain.  The strategies that should be utilized include empathic listening and motivational interviewing. According to the literature, these approaches are effective communication strategies that enhance patient-provider relationships by fostering trust, understanding, and collaboration (Cole et al., 2023).

These approaches encourage patients to share their concerns openly and help healthcare providers guide patients toward informed, patient-centered decisions. These strategies will help Clara make decisions while also allowing her to examine the different ramifications of that decision. However, two approaches that should be avoided throughout the case include ignorance of secrecy and unilateral disclosure without Clara’s consent because they can harm the relationship and erode trust. If communication is effective, it leads to confidence, cooperation, and emotional readiness of all involved individuals. On the other hand, ineffective interactions may lead to misunderstandings, ruin relations between patients and providers (Kwame & Petrucka, 2021), harm family integration, and impede patients’ safety. 

Resolving the Ethical Dilemma by Applying Ethical Principles 

One of the potential solutions that can be offered to Dr. Harper’s ethical problem is to launch a mediated disclosure model. It is essential to respect Clara’s autonomous decision and, at the same time, maintain direct communication with her husband, Jack, under the supervision of a professional. The solution complies with ethical principles and respects an individual’s and the family’s rights. Dr. Harper listens to her decisions and emotions; he tries to help her calm down. In this way, Clara’s autonomy stays at the center of the solution when she participates in the disclosure planning.

According to Cheraghi et al. (2023), beneficence is used to benefit concerning parties. In helping Clara explain the results of the genetic test, Dr. Harper creates an enabling platform for parents to comprehend emotionally and practically their child’s needs in the future. This action promotes positive results for the family. Potential harm is also managed in nonmaleficence (Cheraghi et al., 2023). The culture of keeping secrets could detract from the relationship between Clara and Jack, and breaking confidentiality is detrimental to Clara’s trust in her healthcare provider. A mediated disclosure reduces these risks to a certain extent due to the provided institutional setting. Justice is highlighted in the factor that the rights of both parents are taken into account. Despite Clara’s confidentiality agreement, having Jack involved in decisions concerning their child is also more fitting. This proposed solution is firmly anchored on ethical imperatives and is humane, fair, and professionally palatable as a solution to the dilemma.

Conclusion 

In conclusion, addressing the ethical dilemma involving Dr. Harper and Clara Bennett and applying moral principles ensures a balanced and compassionate resolution. Respecting Clara’s autonomy while encouraging open communication through mediated disclosure aligns with beneficence, nonmaleficence, and justice. Ethical solutions prioritize patient-centered care while reducing potential harm and ensuring fair and professional outcomes. This case highlights the significance of moral reasoning and effective communication in resolving complex healthcare dilemmas, building trust, and promoting the well-being of all parties involved. 

References

Banks, G. C., Knapp, D. J., Lin, L., Sanders, C. S., & Grand, J. A. (2022). Ethical decision making in the 21st century: A useful framework for industrial-organizational psychologists. Industrial and Organizational Psychology, 15(2), 220–235. https://doi.org/10.1017/iop.2021.143 

Cheraghi, R., Valizadeh, L., Zamanzadeh, V., Hassankhani, H., & Jafarzadeh, A. (2023). Clarification of ethical principle of the beneficence in nursing care: An integrative review. BMC Nursing, 22(89). https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-023-01246-4 

Capella FPX 4000 Assessment 3

Cole, S., Sannidhi, D., Jadotte, Y., & Rozanski, A. (2023). Using motivational interviewing and brief action planning for adopting and maintaining positive health behaviors. Progress in Cardiovascular Diseases, 77(1), 86–94. https://doi.org/10.1016/j.pcad.2023.02.003 

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(158). https://doi.org/10.1186/s12912-021-00684-2 

Semyonov-Tal, K. (2024). Keeping medical information safe and confidential: A qualitative study on perceptions of Israeli physicians. Israel Journal of Health Policy Research, 13(1). https://doi.org/10.1186/s13584-024-00641-9 

Capella FPX 4000 Assessment 3

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119