Table of Contents
- Decision-making Model
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- Physician: Hello. May I speak to Mr. Jones, please?
- Jones: Hello. This is Jones
- Jones: Yes. How is everything now?
- Jones: Okay
- Kate: Go ahead
- Kate: I agree
- Kate: Of course, I have his best interests
- Jones: How do we determine that, doctor?
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An ethical dilemma is a situation that appears when equally compelling standpoints arise for and against a particular course of action (Benjamin & Curtis, 2010). Ethical dilemmas in the medical field emerge when personal beliefs and values conflict with recommended medical decisions and practices. It is important for professionals to have a decision-making ability in order to resolve such matters by balancing medical interests with both ethical and legal responsibilities (Timby, 2009).
In the case scenario, the physician is encountering an ethical dilemma according to which he must choose between failing to administer medical treatment to the 6-year-old patient for religious reasons as insisted by the mother who has custody, and administering the treatment as directed by the biological father. Therefore, the dilemma involves the determination of the rights of parents in making choices on the child’s treatment versus the physician actions in providing necessary treatment.
When faced with an ethical dilemma, rational and fact-based decision-making is critical. There are several different ways in which medical professionals can reach sensible decisions. One way is by using the six-step decision-making process, based on considering, comparing, and evaluating various alternatives for a problem (Benjamin & Curtis, 2010). The first step towards decision-making process is to define the problem, where the physician is required to gather all the relevant information regarding the situation, paying critical attention to its details. These details include distinguishing the clinical, legal, and ethical content of the situation.
The second step demands physicians to establish the problem criteria. It involves identifying the type of ethical problems the situation presents and determining if the situation is appropriately authorized by valid orders when necessary and by the current policies and procedures. Physicians should search for clarification of the orders when needed. The next step aims to make the comparisons between the alternatives and their consequences, as well as allocating weights to the established criteria. At this stage, physicians are required to analyze the problem using ethics theories and approaches as the tools of analysis. They should determine whether the problem was supported with positive and conclusive data from nursing literature or research. Also, it is essential for them to determine whether any nursing organization has issued a position statement, guideline, or standard on the problem (Benjamin & Curtis, 2010).
Consequently, the physician should analyze the practical alternatives and select the most implementable one. Physicians should focus on realistic options that have ethically appropriate actions. In making the decision regarding the solution, it should be considered if they possess the current clinical competence so as to perform the action safely with the knowledge acquired from education programs. The next step involves designing and implementing an action plan for the decision and requires a definitive action. The final step of this decision-making process evaluates the decision’s results. In this step, physicians reflect on the ethical decisions, actions, and their outcomes while paying attention to the lessons they can learn and apply in future situations (Benjamin & Curtis, 2010).
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The physician should utilize the six-step approach to examine the best course of action following the two conflicting positions taken by the child’s parents. Normally, the decision-making authority concerning a child’s health care is the parents’ prerogative. In this case, there is a conflict between the mother’s beliefs and values and the physician’s recommended treatment plan, which is supported by the father. Although the decision-making authority lies with the mother, it is apparent that her stand is not in the best interest of the child. Moreover, the opinion of a physician from a different center confirmed the importance of proceeding with the treatment. Consequently, if the confrontation persists, the physician could request for help from an ethics consultant or ethics committee, since the mother’s decision is clearly inconsistent with the child’s best interests. Another alternative would be to contact the child services department and the legal system, as the physician has a duty to ensure that the child’s best interests are given the major priority (Harrison, 2004).
Following the conflicting standpoints regarding the child’s treatment, the physician may decide to offer an explanation to the parents and involve the child’s father by making a call.
Physician: Hello. May I speak to Mr. Jones, please?
Jones: Hello. This is Jones
Physician: This is Greg of Medan Medical. I believe we had spoken earlier.
Jones: Yes. How is everything now?
Physician: I believe it is alright. I have Kate in my office at the moment and would like to offer an explanation to both of you regarding the decision taken by the institution’s ethics committee
Kate: Go ahead
Physician: First, parents have the primary authority and responsibility for making medical decisions on behalf of the child.
Kate: I agree
Physician: Parents as primary caregivers should always be guided by the best interests of the child.
Kate: Of course, I have his best interests
Jones: How do we determine that, doctor?
Physician: I do not deny that, Kate, but let me answer Jones’ question first. Medical professionals have a legal and ethical obligation to promote the best course of action concerning children’s health. Although the institution respects parents’ personal beliefs, we may have to disregard your position in this case.
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Kate: But it is my child!
Physician: I agree. Nonetheless, I did not reach this decision by myself. After the diagnosis another physician confirmed my position on the treatment. The institution also has an ethics committee, which has deliberated on the issue and unanimously agreed that the treatment should commence.
Jones: Oh, well. Let us go ahead.
Physician: This is the best course of action, and I am certain we will offer Lloyd the best medical care in treating his ailment.
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