Discussion of Making Moral Decisions

Almost every day each person faces ethical dilemmas. Doctors and nurses are in the group of higher risk as they must follow the Hippocrates’ oath and do their best to provide their patients with quality services. Any healthcare giver must take care of a patient, provide a patient with a safe environment, prevent and remove harms. Moreover, their obligation is to promote the welfare of patients and maintain the privacy of a patient.

Gerontology medical workers and physicians at oncological clinics observe how their patients meet their deaths through the pain and suffer. Dying is a terrible event of a lifetime, many of them ask to assist them with a suicide which is still forbidden in many countries. Suicide shows immorality and the weakness of a human being. Killing oneself is against nature. However, recently there have been studies and acts claiming the legacy of assisted suicide because it is immoral to remain a patient suffering. It is an intentional death of a patient with the aid of a doctor, a nurse practitioner, or a family member.

While studying professional ethics in the educational establishment, each student learns how to describe and distinguish critical ethical concepts, including concepts such as good, right, permissible, free will, pluralism, universality, reason, relativism, absolutism, obligation, virtue, prima facie, duty, action, intention, and others. They discuss core ethical problems, such as are people free to make choices, what is justice, how can they know what is right or wrong, etc. Moreover, the students distinguish the fundamental ethical theories and approach applying them to practical solvation problems in ethics, including euthanasia and other related problems.

Gerontology nurses often face various ethical dilemmas as their patients often suffer from chronical diseases and sharp pain. A case study with a 75 years old lady named Kathy was selected for discussion. in this case, a physician had faced an ethical dilemma when his patient refused to eat even though she realized that food was the primary source of energy for the human body. The patient displayed severe health issues. Kathy had dementia, and she was almost bedridden. Problems with speech were observed. Kathy’s physician could follow one of the two ethical theories: autonomy or beneficence.

According to the autonomy theory, the patient has a right to decide for him/herself. “Autonomy is the personal rule of the self that is free from both controlling interferences by others and from personal limitations that prevent meaningful choice” (Pantilat, 2008). In this case, a physician accepts any patient’s decision related to his/her health based on informed concern. A physician respects a patient’s right to self-determination and creates conditions needed for the autonomous choice. “Respect for autonomy also includes confidentiality, seeking consent for medical treatment and procedures, disclosing information about their medical condition to patients, and maintaining privacy” (Pantilat, 2008).

Autonomy for Kathy has its positive and negative aspects. On the one hand, the denial of food consumption would be the informed choice of a patient. The nurses and the doctor would have to provide the patient with the necessary information and make sure that Kathy understands it adequately. Moreover, they would be able to “calm emotions and address fears that interfere with a patient’s ability to make decisions” (Pantilat, 2008). On the other hand, the medical worker and the relatives would have to observe how Kathy is dying slowly.

Beneficence theory claims that medical workers and relatives have a right to choose what is more beneficial for the patient. “Beneficence is an action that is done for the benefits of others. Beneficent actions can be taken to help prevent or remove harms or to simply improve the situation of others” (Pantilat, 2008). In many cases, the generosity of the closest people makes them spend much time and efforts to support the sick family member. “Beneficence can also include protecting and defending the rights of others, rescuing persons who are in danger, and helping individuals with disabilities” (Pantilat, 2008). Thus, they often sacrifice themselves to create the most favorable environment for the patient at any cost. Such people put themselves in the last place forgetting about their own lives and interests. In many cases, gerontology nurses display extreme generosity acts or try to benefit others at any cost and in any possible occasion. People with large hearts cannot indifferently observe the sufferings of old people. They try to help and provide maximum support. This often leads to negative outcomes for generous nurses and relatives.

Beneficence theory application in Kathy’s case has it positive and negative aspects. On the one hand, a person “with dementia need help to compensate for declining abilities. In dementia care as in all health care, the principle of beneficence is the primary obligation” (Smebye, Kirkevold, Engedal, 2016). The constant support of a nurse makes sure that safety is guaranteed. Thus, Kathy’s lifespan is prolonged. On the other hand, Kathy would feel that her autonomy is not provided. Moreover, she gets physical and psychological harm because of being force-fed.

When discussing Kathy’s case, different people would probably select different approaches to problem salvation. Actions to be taken towards the particular person can vary significantly. In this case, since the old lady does not take food, her caregivers (relatives, social workers) will be notified. They will be asked to communicate and try to make the woman eat. Kathy will be educated regarding her illness and possible outcomes of starvation. She will be suggested to get alternative means of food delivery. If no actions are successful, she will be force-fed via vain. In such a way, she will think that she is provided with autonomy, but the physician will make sure that she is fed anyway. Of course, many people would view such methods as barbarian as they are based on lying the patient for her good. Some people would probably identify the problem that third persons decide what is right for Kathy. Of course, Kathy might experience some psychological issues as she does not feel herself a full-fledged person because of being weak, old and sick. Thus, psychological support will also be provided.

All in all, the ethical dilemma is the most challenging part of any physician’s practice. “The Physician should respect the patient’s decisions even while trying to convince the patient otherwise” (Pantilat, 2008). Physicians must calm down their emotions while treating patients. They must provide the patients with safety, and comfortable conditions along with education about their illnesses and diseases. Supporting the patient to potential recovery and assisting him/her to relief from pain is the duty of a doctor and a nurse. Making a moral decision must be based on the fact what is best for the patient. The doctors and the patients must make sure that no other final consequence is expectable prior to making any decision.

References

Athens-Clarke County. (2016). Georgia Medical Consent Law. Web. Retrieved from https://www.athensclarkecounty.com/1121/Georgia-Medical-Consent-Law

Government of Canada (2017). Medical Assistance in Dying. Web. Retrieved from https://www.canada.ca/en/health-canada/services/medical-assistance-dying.htm

Pantilat, S. (2008). Autonomy vs. Beneficence. UCSF School of Medicine. Retrieved from http://missinglink.ucsf.edu/lm/ethics/content%20pages/fast_fact_auton_bene.htm

Schadenberg, A. (2017). Canada reports nearly 2,000 assisted suicide deaths in the first year of legalization. Web. Retrieved from https://www.lifesitenews.com/opinion/canada-reports-nearly-2000-assisted-suicide-deaths-in-first-year-of-legaliz

Smebye, K.L., Kirkevold, M., Engedal, K. (2016). Ethical dilemmas concerning autonomy when persons with dementia wish to live at home: a qualitative, hermeneutic study. BMC Health Serv Res. 2016; 16: 21. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717656/

The terms offer and acceptance. (2016, May 17). Retrieved from

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[Accessed: May 6, 2021]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: May 6, 2021]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: May 6, 2021]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: May 6, 2021]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: May 6, 2021]
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