Ethical Theories In Nursing (Term Paper Sample)

Evaluation of Ethical Theories and/or Principles and their Application in Critical Health and/or Social Care Setting
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Introduction
An Acute and critical clinical scenario involving life threatening conditions that require high degree of accuracy with a very small allowable error margin calls for a quick judgement and response from intellectually and emotionally prepared social care professionals (Stannard, Benner &Kyriakidis 2011 p. 1). In this situation, all the ethical principles are found to be in conflict with each other, necessitating the professional to use ethical theories to enable him/her in determining the relevant principle applicable in that particular situation through metalevel evaluation of all the possible clinical decisions with all their possible consequences and not merely on consequences only (Zygmond&Boorhem 1989 p. 5).
Critical Evaluation of Application of Ethical Principles in solving the identified ethical dilemma
According to Stannard, Benner and Kyriakidis (2011), acute and critical patient conditions demand that the social care professionals respond with thinking-in-action (clinical reasoning while on the move). All the moral problems arising out of this situation must be dealt with autonomy, justice, non-maleficence and beneficence through careful identification, analysis and resolution whilst combating the problem at hand (Mueller, Hook & Fleming 2004 p. 554). The appropriate actions to be taken should be preceded with ethical principles originating from the declaration of Helsinki that states that; in times of acute and critical conditions, the patient should be handled with respect, his/her needs coming first, be given the right to self-determination and the right to make informed decisions (Glod 2008 p.27).
* Application of the Consequentialism Principle
Hammond (1992) while quoting Sen (1987) gives an overview of Consequentialism as being the judgement of a given action as either being right/good or wrong/bad by solely basing the judgement on the resultant consequences that comes out of that action and not in the action itself or anything else (p. 12). Consequentialism, therefore, requires that all the resultant consequences be assessed first and be weighed as either being harmful or beneficial to the client while overlooking the action itself. If the beneficial consequences are found to outweigh the harmful ones, then the action is justified otherwise it should be done away with.
Consider a case where a four year old boy involved in a very fatal accident with deep cuts was brought into the hospital where I worked. In the process he lost a lot of blood through hemorrhage. The boy’s parents instructed us to do everything possible to save the life of their child, except carrying out blood transfusion on him as it went against their faith; Jehovah Witness faith and beliefs, among them forbidding blood transfusion among their faithful. I had learnt earlier that haemorrhage, frequently encountered in intensive care units and medical emergency units can lead to loss of intravascular blood resulting to decreased tissue perfusion, hemodynamic instability, organ damage, organ hypoxia and eventually death (Gutierrez, Reines & Wulf-Gutierrez 2004, p. 1). Due to my intervention, we settled at blood transfusion as our first cause of action.
According to the principle of Consequentialism, I had to weigh out all the possible consequences resultant from blood transfusion. Blood transfusion helps in replacing the red blood cells lost during the accident to aid in oxygen circulation in body which supports the normal body metabolic activities, the plasma component of blood helps in controlling haemorrhage as it contains coagulation factors, platelets forms a clot by combing with thrombin to help stop haemorrhage, sufficient white blood cells in the body helps any disease causing micro-organisms that might have entered the body through the open wounds and finally blood transfusion saves lives (Children’s Hospitals and clinics of Minnesota 2012, p. 2). On the other, blood transfusion was to put the child at risk by exposing him to haemolysis (which rarely occurs-1case in 76000 blood transfusions), cause acute lung injury to the child (which rarely occurs-one case in 1200 to 190000 blood transfusions) and cause bacterial and viral infection (Children’s Hospitals and clinics of Minnesota 2012, p. 2). Weighing the consequences of blood transfusion alone without considering any other factors, I inferred that blood transfusion was worth carrying out on the child, as the beneficial consequences of blood transfusion outweighed the harmful ones.
* Application of deontological Principle and/or Theory of Ethics in Critical Health/Social Scenarios
According to Hinman (2010), deontology is the moral obligation and duty of the doer (in this case a social worker or clinician) to act according to the rules that are justified to be right and to avoid doing otherwise as this would be wrong (Hinman 2010, p.4). According to Jones and Bartlett Publishers while quoting Beauchamp and Childress (2008) argue that the clinical professional should always respect the privacy of the patient, seek consent from patients before intervening, guard all the patients’ confidential information and in consultations with patients, to always guide them in making informed decisions (p.42). In obeying the principle of non-maleficence, which requires the clinical professional to refrain from causing harm or inflicting pain and all other evil on the patient, the clinician should under all circumstances refrain from causing suffering/pain on the patient, incapacitating the patient, depriving the patients of life’s goods, offending and even killing the patient under whichever circumstances (Jones and Bartlett Publishers p. 52).
Considering the case of the boy involved in an accident cited earlier, the principle of deontology required me to weigh all the possible actions to be taken (and not the resultant consequences that follows the execution of any given action) in order to determine the most suitable one that suits the patient’s needs. The three possible courses of action open to me at that critical moment of decision making were: carrying out blood transfusion on the boy, hearkening to the boy’s parent’s pleas or doing nothing. Under the theory of deontology, the first option was the most suitable one (as it was my professional obligation to save life) than the later two as they gave room for the occurrence of the boy’s death (contrary to my professional obligation).
* Application of the Ethical Theory of principlism in Critical Health/Social Scenarios
According to Bulger (2007), Principlism is an approach to moral ethics that is based on culturally accepted judgements as regards to respect of all persons, justice and beneficence that are particular relevance to ethics concerning biomedical practice (p. 84 ). Principlism heavily relies on the principles of autonomy, beneficence, nonmaleficence, justice, fidelity and confidentiality to determine any serious moral obligation that outweighs other obligations in deriving inferences from any given medical ethical dilemma to solve it. Bulger (2007) further argues that since principlism is consistent (and not in conflict) with theological, ethical and social principles from where it is derived, it is therefore the best approach suited in solving these problems.
In the events of action taking in the boy’s handling, I was obliged to observe all the above mentioned principles: autonomy (the patient’s informed decision was always to come first-he was a minor and critically in a condition that disabled him from normal conversation), beneficence (the chosen action must be beneficial to the patient), nonmaleficence (do not harm the patient), justice (the boy child had a right to be given an equal/fair share to life), fidelity and confidentiality. To fulfil all this, I was forced to overlook the boy’s parent’s demands and put the welfare of the patient (the boy child involved in a fatal accident) first.
* Application of Respect for Autonomy Principle and/ or Theory of Ethics in Critical Health/Social Scenarios
According to O’Neill (2001), Respect for autonomy refers to involvement of the patient by seeking the patient’s informed consent to all disclosure of personal information in relation to medical treatment, analysis and research of the patient’s condition (p. 2). It is not allowable to force an action on a patient without his/her consent (either formal/written or oral). After careful and thorough professional guidance to the patient of all the possible actions and their outcomes/consequences concerning their condition, they should be left to choose the action.
The application of the principle/theory of autonomy in the case of the boy involved in a fatal accident cited earlier, I had to give the patient a right to be informed of all the possible actions that were to be taken on him to remedy his condition with all their exhaustive advantages and disadvantages. Whichever acti...