Healthcare Ethical Issues Case Study

Healthcare Ethical Issues Case Study

Healthcare Ethical Issues Case Study

In healthcare industry, ethics is fundamental in making decisions. According to Amer (2019), ethics is a collection of moral principles aimed at guiding people in knowing what is right or wrong. Healthcare practitioners in charging professional duties apply principles and codes in behavior management and decision-making process.  Notably, ethical principles are parts of a given ethical theory that help in defending or justifying a moral rule or judgment.  In regard, Hawk et al. (2017) explain ethical principle as a general judgment that serves as a fundamental basis for ethical prescription and evaluation of health activities. Consequently, the application of different principles in health industry is likely to result in ethical dilemmas. or in other words, ethical challenges. In analyzing ethical issues, the current essay analyzes a given case study to explain ethical dilemmas in a health care setting. Further, the essay discusses the social problems realized in the case study and the involved stakeholders. More so, based on the case study, the author summarizes the definition and application of ethical principles and theories and concludes by offering recommendations.

Overview of a Case Study

The case study is a local agency that offers foster care to children who have been neglected and abused. The agency also offers family preservation services such as counseling, educational services, and parental classes to both the parents and the children under foster care. The stakeholders include the executive director, psychologists, teachers, and social workers. Other stakeholders include nurses such as Janet from the outpatient that collaborates with the agency to offer health services to the fostered parents and children. Jasmine is one of the clients in the agency and has a two years daughter who is placed under foster care. In addition to attending the usual therapeutic sessions, Jasmine uses glucometer and frequently tests her glucose levels by pricking her finger since she has Type II diabetes. However, although the social workers in the agency are aware of Jasmine’s diabetic condition, they do not know that she is HIV positive. Ann, one of the agency social worker and Jasmine’s therapeutic attendant, learns about Jasmine HIV status from the conversation with Janet. Further Mary, the executive director also gets to know about Jasmine status from other sources. According to the director, Jasmine puts the clients and staff at risk of contracting HIV when testing her glucose level. In regard, the director argues that either Jasmine or Ann should disclose the patient’s private information. Notably, Mary, he director, is not a trained social worker or a counselor and according to her informing others about Jasmine’s HIV status would mitigate the contracting risk.

Social Problem

Akujobi and Jack (2017) explain social problem as a condition or behavior that is capable of disrupting or damaging society’s well-being. Drawing from the case study, child abuse or child neglect is realized as a major social problem in the society. In effect, the agency offers foster care services to the children who have been neglected and abused. The parents to the fostered children are also counselled and other family preservation services. They are also given a court order that they have to complete the treatment program before regaining the custody of their children.   

Ethical Dilemma and the Stakeholders

Ethical dilemma is one of the significant challenges facing healthcare practitioners. Monrouxe and Rees (2017) explain ethical dilemma as a situation involving conflicting moral principles. Based on the case study, Ann, a social worker, is in an ethical dilemma. Mary, an executive director of the same organization, directs Ann to speak to Jasmine privately to disclose her human immunodeficiency virus (HIV) positive status. According to Mary, Jasmine places staff and other clients at risk of being infected during finger pricking to test her glucose level. Notably, Mary asserts that if Jasmine fails to mention her HIV-positive status publicly, the obligation will be pegged on Ann as the social worker.  However, Ann is not the primary care provider to Jasmine, which gives a professional mandate to know such private and confidential information. More so, unlike Mary, Ann is a trained counsellor and social worker and hence may find it unprofessional to disclose patient’s private information.  

In the case study, there are several primary stakeholders. According to Kumar et al. (2018), a stakeholder is a person or organization affected by or affects the attached organization’s decisions. Thus, stakeholders can either be direct or indirect depending on their relationship with the agency. In the case study, direct stakeholders include social workers such as Ann, executive director, psychologist, and teachers. The indirect stakeholders include nurses from the health scare that collaborates with the agency to offer health services and the clients (both children and parents). Ann is a licensed social worker at a local child protective service agency. On the other hand, Mary is the executive director at the child protective service agency. In regard, the two are direct stakeholders to the agency. Janet is a nurse practitioner at Rose Memorial Hospital and provides primary care to Jasmine and hence an indirect stakeholder to the agency. Additionally, Jasmine and her daughter are indirect stakeholders as they represent the clients that are offered services by the agency.

Ethical Concerns

In healthcare practice, it is unethical to share patients’ information without their consent. According to Amer (2019), sharing patient’s information without consent is a violation of privacy and confidentiality rights.  In the case study, Janet discloses Jasmine’s HIV positive to Ann without consent from Jasmine. The practice is unethical and suable in a court of law. It is also an ethical concern that healthcare professionals should exercise self-control and prudence (Hawk et al., 2017).  In regard, the executive director should not have been offended by Ann’s decision of not sharing Jasmine’s HIV-positive status. Instead, Mary (the director) should have handled the issue cautiously and adopt self-control. 

In addition, it is ethical for the primary care provider to discuss with patients disclosing health status. Amer (2019) asserts that primary caregivers have practice responsibility in advising patients to disclose health status like HIV to family members and other people. In the case study, Ann, who is not a primary care provider, is directed by Mary to privately approach Jasmine to disclose her HIV status to group members. However, Janet as the primary care provider should be the right person to advise Jasmine in sharing her health status. In regard, the right channel will give Jasmine the confidence to share her health status with group members. Moreover, it is unethical to discriminate against a person based on healthcare conditions. Monrouxe and Rees (2017) opine that health conditions should not be grounds for discriminative statements and unjust treatments. The executive director claims that Jasmine’s condition is placing staff and group members at risk for contracting HIV. Most importantly, healthcare practitioners should take precautions when dealing with infectious diseases.

Furthermore, ethical codes and standards demand responsibility, fairness, and love in delivering care services. According to Hawk et al. (2017), discharging clinical duties goes beyond professionalism to include fairness and love. Based on the director’s assertion, it is the social worker’s obligation if the patient fails to disclose health status. In essence, it reflects that the director is unfair to the social worker and has no empathy for Jasmine’s health situation. Therefore, Mary should treat Jasmine and Ann with love and fairness. Finally, it is ethical to train healthcare staff on to treat patients. According to Monrouxe and Rees (2017), practical training is necessary for all workers in health organizations. Referring to the dilemma, the director made ethical errors due to lack of training on counseling and ethical dilemma situations. However, such errors can be mitigated through practical staff training on ethical handling of patients in healthcare setting.

Ethical Principles and Theories

Ethical Principles

In health setting, ethical principles form guidelines for professional duty execution. According to Rajani (2013), an ethical principle is a standard theoretical framework that enhances the analysis of ethical situations in the health industry. Based on the case study, principle of truthfulness and confidentiality is evidenced. According to the ethical principle, a patient has a right to know the truth about a medical condition. For instance, if a person is tested for HIV, the patient is entitled to the test result, negative or positive.

On the other hand, the healthcare clinician should keep such information secret. However, according to Hawk et al. (2017), private and confidential information can only be shared with the patient’s consent.  In the case study, the primary caregiver gave the patient information about HIV status but disclosed the test result to another caregiver without the patient’s consent.

Additionally, principle of justice is evidenced in the case study. The ethical principle emphasizes fairness, impartiality, and equality (Rajani, 2013).  In healthcare, a patient has equitable accessibility, participation, and equal treatment rights. Drawing from the case study, Jasmine had access to counseling and medical services. However, upon discovering Jasmine’s HIV-positive status, the director thinks Jasmine should not interact freely with colleagues. In essence, it is a violation of distributive and social justice.

Ethical Theories

In health industry, ethical theories are utilized. Hawk et al. (2017) define ethical theory as a formal statement of what to be done in scenarios of ethical dilemmas. Based on the case study, there is a theory of utilitarianism. According to the theory, an action or decision is morally right if the attached consequences are suitable to most of society (Tannsjo, 2019). However, utilitarianism ignores individual rights but values the satisfaction of a larger group. Drawing from the case study, the director depicted theory based on fears that Jasmine may infect the treatment team and even entire staff with HIV. Therefore, Jasmine should readily disclose her health status to colleagues attending group sessions through the social worker.

Outline and Application of Ethical Decision-Making Process

In healthcare industry, ethical dilemmas call for ethical decision-making. According Grote and Berens (2020), decision making is a systematic and starts by problem definition. Based on the dilemma, the ethical issue is telling Jasmine to disclose her HIV status. The decision-making process if followed by definition of stakeholders (Monrouxe and Rees, 2017). Based on the scenario, key stakeholders include Jasmine, the social worker, the executive director, the primary care provider, and Jasmine’s colleagues. Subsequently, there should be a definition of consequences. In other words, the impacts of Jasmine disclosing her HIV status on her and other primary stakeholders. 

In addition, decision-making calls for identification of obligations. Based on the case study, should take the rights and principles of critical stakeholders into consideration.  Moreover, according to Grote and Berens (2020), the ethical decision process should include organizational integrity and character. Based on the attached case, institutional values and operational ethics of local child protective service agency. Furthermore, there is an evaluation of potential actions (Hawk et al., 2017).  The agency leaders should apply the best approach based on potential impacts on parties involved. Finally, the process should be concluded with consent-based and mutual solutions.

Missing Information

Drawing from the scenario, significant information to improve decision-making missing. Information on Jasmine’s consent to the primary care provider to disclose her HIV status to the secondary caregiver is not captured. In addition, the information on ethical codes and standards of the local agency is lacking. Therefore, it forms the basis for demanding patients to disclose health status to colleagues. Moreover, the executive director’s role in training and awareness of ethical issues and dilemmas is missing. Finally, the resources available to help in training and adopting the right policies that encourage privacy, rights, and participation.

Recommendations

Based on the case study, the patient’s health status should be coded with ethical privacy and confidentiality. Therefore, disclosing the HIV status should be based on informed consent. In addition, the primary care provider should be the right person to seek the patient’s view on the importance of publicly sharing about the health condition (Amer, 2019). Significantly, it implies that the social worker should not talk privately to the patient. However, the discussion should be between the primary caregiver and the patient. Finally, the local agency staff should be trained on counselling and ethical principles and theories (Rodger and Blackshaw, 2017). Consequently, practical training results in rational approaches to ethical dilemmas.

Conclusion

Ethics is essential in making decisions. In healthcare setting, ethical principles and theories help in defending or justifying a moral rule or judgment in cases of moral dilemmas. Based on the case study, child abuse was identified as a significant social problem. Additionally, the patient disclosing the health status was the primary ethical dilemma. It is also worth noting that major stakeholders included Jasmine, the executive director, primary caregiver, social worker, and other clients. Referring to the case study, principles and theories were identified and applied. The principles noticed in the scenario were truthfulness and confidentiality, and justice. Notably, utilitarianism was the evidenced ethical theory in the case study.

Moreover, an effective ethical decision-making process includes an ethical issue, primary stakeholders, consequences, obligations, and potential impacts. Finally, healthcare practitioners should apply ethical privacy and confidentiality in dealing with patient information. In essence, professional operations in healthcare industry call for ethically approved decisions and services. 

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References

Akujobi, C. T., & Jack, J. T. (2017). Social change and social problems. Major themes in sociology: An introductory text, 491-526.

Amer, A. B. (2019). Understanding the Ethical Theories in Medical Practice. Open Journal of Nursing9(02), 188.

Grote, T., & Berens, P. (2020). On the ethics of algorithmic decision-making in healthcare. Journal of medical ethics, 46(3), 205-211.

Hawk, M., Coulter, R. W., Egan, J. E., Fisk, S., Friedman, M. R., Tula, M., & Kinsky, S. (2017). Harm reduction principles for healthcare settings. Harm reduction journal14(1), 1-9.

Kumar, T., Ramani, V., Ahmad, I., Braeken, A., Harjula, E., & Ylianttila, M. (2018, September). Blockchain utilization in healthcare: Key requirements and challenges. In 2018 IEEE 20th International Conference on e-Health Networking, Applications and Services (Healthcom) (pp. 1-7). IEEE.

Monrouxe, L. V., & Rees, C. E. (2017)Healthcare professionalism: improving practice through reflections on workplace dilemmas. John Wiley & Sons.

Rajani, S. (2013). Compare & contrast the four principles of healthcare ethics. International Journal of Innovative Research and Development2(8).

Rodger, D., & Blackshaw, B. (2017). An introduction to ethical theory for healthcare assistants. British Journal of Healthcare Assistants11(11), 556-561.

Tannsjo, T. (2019). Setting Healthcare Priorities: What Ethical Theories Tell Us. Oxford University Press, USA.