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NRS 433V Nursing Research: Role of the Hospital Administrator

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Questions:

Your health care team is presented with the following case:

A 6-year-old develops a high fever accompanied by violent vomiting and convulsions while at school. The child is rushed to a nearby hospital. The attending physician makes a diagnosis of meningitis and requests permission from the parents to initiate treatment. Both parents are Christian Scientists, and they insist that no medical treatment be given to the child. The physician initiates treatment anyway, and the parents later sue the physician and the hospital.

In a formal, written paper, provide the following:

1. Summarize potentially conflicting values and principles that exist in this case based upon ethical theories and principles you have learned in this course.

2. Assuming the role of the hospital administrator, provide a solution to resolve the identified ethical dilemma in this case.

Answers:

1.

The case study is related to case of a six year old who was diagnosed with meningitis after heavy fever and convulsion at school. Ethical issue arose after the attending physician initiated treatment without the permission of the child’s parents. In this case, conflict and dilemma is seen between the principles of autonomy and beneficence in health care. Firstly, the principle of autonomy is an important value in health care which gives the power to patients or their family members to take their own decisions regarding receiving treatment or denying it. However, challenges to autonomy in health care have arose in the scenario because the child’s treatment was initiated without the permission of parents. Autonomy in health care emphasized that decision maker must be competent enough to make decisions (Holmes, 2016).  However, the parents might not understand the graveness of the situation and the ill-effect of delaying treatment. On the other hand, the physician decided to continue with treatment because they preferred the value of beneficence over the value of autonomy. The principle of beneficence explains the primary obligation of the health care staff in preventing harm to patient and improving their situation by valid actions (Beauchamp, 2016). Hence, due to this expectation from the health care staff, the physician might have proceeded with the treatment. In the case scenario, the patient’s autonomous decision has conflicted with clinician’s beneficent duty to prevent harm to patient.

2.

As a health care administrator, the ethical dilemma in the can be solved by balancing autonomy and beneficence. Although autonomy is central to medical ethics, it is necessary to understand and judge that patient’s decision may not always be right in particular situations. In the case scenario, the parent’s decision of not initiating the treatment is not rationally correct because meningitis is a medical emergency in which prompt antibiotic treatment is necessary. Evidence also proves that timing of initiation of antibiotic therapy is crucial in preventing unfavorable outcomes in patients (Bodilsen, 2016). Therefore, the clinician’s decision to prefer beneficence over autonomy is correct in this situation because the patient or family member’s were not competent enough to understand the consequences of delay in treatment. The parent’s may be convinced with adequate evidence regarding the benefit of prompt treatment for their child and the reason for going against their wish. With this approach, the conflict between beneficence and autonomy could be resolved.

References

Beauchamp, T. L. (2016). Principlism in Bioethics. In Bioethical Decision Making and Argumentation (pp. 1-16). Springer International Publishing.

Bodilsen, J., Dalager-Pedersen, M., Schønheyder, H. C., & Nielsen, H. (2016). Time to antibiotic therapy and outcome in bacterial meningitis: a Danish population-based cohort study. BMC infectious diseases, 16(1), 392.

Holmes, D. (2016). Critical interventions in the ethics of healthcare: Challenging the principle of autonomy in bioethics. Routledge.

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