Assignment: Ethical Decision Making Essay

Assignment: Ethical Decision Making Essay

Assignment  Ethical Decision Making Essay


Ethical practices of the medical professionals often call on them to involve the patients in decision making regarding the mode of treatment that would be ideal for their patients. Consequently, patients have the right to be informed of the possible options of treating their conditions and the results that they would benefit from based on such engagement. According to De Roubaix (2011), the four core moral principles include respect for autonomy, justice, nonmaleficence and beneficence. The ethical principles and provisions need to be looked into when making decision of the treatment process that is ideal for the patient. This paper discusses ethical decision making for clinicians based on a case study titled “An Unconscious Patient with a DNR Tattoo.”

Dimensions of the Ethical Dilemma

The clinicians need to work together with the patient and acknowledge that the patient does not want resuscitation (his autonomy). However, the doctor needs to conduct advanced airway management to save his life (beneficence). Though the patient is unconscious and does not consent to the treatment chosen, intravenous fluid resuscitation and issuance of empirical antibiotics are granted against his wish (nonmaleficence).

The critical dimension of ethical dilemma is derived from the need to respect the advance directive that has been issued by a patient regarding the type of care that needs to be advanced to him or her. An advanced directive is a legal document that medical professionals have to honour. Any adult has the right of coming up with his or her advance directive to serve the purpose of guiding orders for end of life including the appointment of his or her surrogate. Failure to honour the ethical directive by the patient would often call for the ethics committee to review the decisions of the medical professional and where necessary reprimand them for not acknowledging the wishes and rights of the patient. The other dimension of ethical decision making is adherence to HIPAA regulations and patient confidentiality.

Assignment  Ethical Decision Making Essay

Potential Organizational Policies

The ethical policies of a health institution are an ideal point of reference whenever a moral dilemma faces healthcare professionals.

Assignment Ethical Decision Making Essay
Assignment Ethical Decision Making Essay

The policies establish an ethical review committee within the facilities. The medics have the role of reporting their ethical dilemmas to the committee and await the directive of the committee before proceeding with their decision. The ethical policy provision for justice, the balance of risk and benefits and patient consent are some of the measures that clinicians need to consider in when referring to the moral principles. However, where the wish of the patient is contrary to the procedure that the clinicians would want to issue, the contrary opinion of the patient has to be legal and abiding by the ethical principles of clinical practice.

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Four core health care ethical principles and the process of ethical decision making


The respect for autonomy affirms that any patient has the right of deciding on the type or nature of treatment that he or she wants. The ethical principles are the basis upon which informed consent is revered within the health settings. The healthcare settings need to eliminate the factors that would either coerce or lead the patient to decide their free and voluntary acts (De Roubaix, 2011). The principle also calls upon the medics to issue all the information regarding the possible treatment methods and the side effects that could result to the patient when either of the treatment options is decided upon by the patient. However, based on the case study, the patient has been brought into the hospital when he is unconscious. Therefore, he is not in a position to comprehend the treatment methods that would not be ideal for him nor can be taken and sign an informed consent for the advanced airway management to be conducted by the medics. Such would lead to the consideration of the principle of justice


The principle of justice establishes that all patients have a right to care. There is a need to provide healthcare services equally to all despite their economic, racial or cultural backgrounds (De Roubaix, 2011). Both the conscious and the unconscious patients, therefore, have the right to access quality medical care that would be of benefit to their developmental processes. The medics have an ethical duty to serve the patient despite him being unconscious when taking the principle to the context of the case study. Admission of the patient, diagnosing the issue and owing the willingness to assist in the treatment of the patient is ethical conduct on the part of the patients, which would then serve to facilitate his access to medical care.


The third principle is that of beneficence. The medical professions have to act in a manner that would bring out positive outcomes to the medical condition of the patients. Therefore, the action of the medical professionals, despite the choices that the patient makes, should be aimed at improving the overall patient outcome and contribute to making the patient feel better (De Roubaix, 2011). This principle has been applied in the case study. Despite the patient not being capable of finding informed consent for the advanced airway management, it will be critical to access, the issuance of intravenous fluid resuscitation and issuance of empirical antibiotics when waiting for the result from the ethics review committee is part of the ethical considerations of the doctors and nurses handling the case.


The principle of nonmaleficence has also been utilized by the physicians handling the case of the client. The policy provides that medics should act in a manner that is of benefit to the patient and eliminate the incidences of harm that could be posed to the patient in the course of the treatment (De Roubaix, 2011). Taking up the issue as an emergency and finding out the ideal procedures, committing the patient to treatment as sending the patient case for review is the commitment of the patient to the principle of nonmaleficence.

The assistance to the clinical staff, based on the information on the case study, is to recognize that tattoos do not meet the threshold that is needed for advance directives. Therefore, it will be ideal for the clinicians to proceed with the emergency treatment that gears towards the saving of the life of the patient. Maintaining the treatment methods or de-escalation of the treatment procedures can be done when written documentation on the preferred patient model of care or patient consent can be enforced when the patient is out of danger. Such would mean that the clinicians would need to impose the principle of beneficence while at the emergency room.


In the healthcare setting, it is essential to recognize that the preferences of an end of care and tattoos would often change based on the changing preferences of the patients. Therefore, only where there is legal and written documentation that expressly state that a given form of care is not ideal for the patient, the clinicians must impose the principles of nonmaleficence, beneficence and justice in the issuance of care and medication to the patient. The tattoos tend not to offer strong medication on what the clinicians would need not to do. While the clinicians have to respect the wishes of their patients, it is essential to receive proper guidance to the clinicians. Where the instructions are vague as is the case of the tattoo, it would be ideal to ignore such until sufficient information is existent. The term “DO NOT RESUSCITATE” does not specify what or what not to do. Within the medical profession, clinicians may not guess informed decision making of the patient.

Write a 1,250-1,500 word paper in which you explore decision making methods that can be used to resolve an ethical dilemma using the scenario provided in the assigned reading, \”An Unconscious Patient With a DNR Tattoo.\” Describe how to use the principles of ethical decision making (reviewed in this topic) to help resolve this ethical dilemma. Address the scenario to generate your conclusions about how you would proceed.

What are the dimensions of the ethical dilemma?
What are the potential organizational policies to which you will refer?
Apply the four core health care ethical principles and the process of ethical decision making in formulating your assistance to the clinical staff.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.