Question
Ethics Paper
Ethical issue presentation and paper Rubric Each student will choose an ethical situation observed or experienced in an advanced nursing practice clinical experience that lends itself to critical discussion. Often, such a situation occurs when there is a difference of opinion between patients, family members, and providers on the best course of action or treatment. At other times, situations occur in which decisions are made that conflict with respected ethical norms, values, or principles. The scholarly paper and class presentation focus on a topic or issue unrelated to paper(s) written for the Ethics course. Choose an ethical dilemma that presents itself in an APN clinical situation in women’s health, pediatrics, or obstetrics. Criteria for this course’s class presentation and scholarly paper include: Minimum 8 pages (excluding title page and references) 10% (10 points): Summarize the specific situation as encountered in advanced practice.What are the relevant medical facts and social factors of the situation? What specific ethical questions were raised in the situation? 15% (10 points): What bioethical principle (including respect of autonomy, nonmaleficence, beneficence, or justice) was deemed to be compromised in the situation? Describe the principle specifically related to this situation. 35% (35 points): Review what is written in the literature about similar situations; using the literature, critically analyze the ethical issue(s) surrounding the clinical situation observed/experienced. Discuss authority, accountability, responsibility, and practice standards. 10% (15 points): Discuss the resolution(s) and outcomes of the dilemma, including both ideal and practicalsolutions. 10% (10 points): Discuss how an understanding of this issue applies to your future decision making as an advanced practice nurse. 10% (10 points): PowerPoint presentation. PowerPoint presentation for the discussion forum should reflect the paper contents. PowerPoint presentation posted and response to student classmate PowerPoint on time/when due. 20% (10 points): Quality of the presentation and paper. Both presentation and paper are of scholarly quality. References not older than 7 years (exception – historical research or conceptual models); follows APA 7 th edition format; minimal number (no more than five) grammatical/typographical errors. Is it ethical to act on the request of a 28-year-old woman with advanced breast cancer, who has been developmentally delayed since birth, for no further cancer treatment?This was the question posed in our clinical site last year 2022. In this situation, the positive and negative arguments both had valid points related to the treatment of individuals with disabilities and decision-making capacity based on the virtue ethics principles of autonomy and beneficence. The positive position in this debate is that it is ethical for the healthcare team to act on this woman’s request for no further breast cancer treatment. Respecting autonomy means honoring a person’s right to make his or her own decisions, assuming the person exhibits the traits of an autonomous person. One of the main issues in the intellectual and developmental disabilities community has been challenging professionals who make one-sided decisions for clients about how they should live their life.A developmental delay does not necessarily exclude this woman from having the ability to understand the consequences of her decision, to use reasoning skills to make this decision, to deliberate with others and explain her choice, and to make a choice as illustrated by Applebaum in the New England Journal of Medicine. A provider’s role is to disclose accurate medical, treatment, and prognosis information and to engage in shared decision-making with the individual to empower the individual to make his or her own decision. In contrast, a provider does not have domain over an individual’s values—and by denying her wishes to stop treatment—the provider acts as if he or she does not recognize and value the individual as a person capable of making her own decisions. There are circumstances under which a provider could have cause for concern about a decision by an individual with an intellectual or developmental disability. Decisions that would cause “concern” might include refusing medication that would prevent an adverse outcome, refusing prevention or treatment that is standard of care, refusing to follow the recommended diet, refusing to follow safe sex practices, or refusal of continuous positive airway pressure. Sometimes decisions such as refusal of breast cancer treatment can be confused with cause for concern because the decision strikes an unsettling tone in health care provider’s values to ‘help’ or cure. True concerns about this woman’s decision should be addressed in a thorough investigation into her decision-making capacity, as with any individual. In conclusion, the provider should not decide what is in this woman’s best interest, given that a moral patient-provider relationship has been established and she can exhibit the traits of an autonomous person with full capacity. The negative argument is that it is not ethical for the healthcare team to act on her request for no further cancer treatment. As an adult, this woman will never recover development at her age, which means we need to adjust care processes for her while protecting her from paternalism through virtue ethics. In living memory, people with disabilities were often institutionalized en masse, experimented on without knowledge, and forced to have treatments against their will or the will of their loved ones. Recent observational studies by Tuffrey-Wijne et al. from England and Australia show that individuals with disabilities are commonly not included in discussions about their treatment options. With this knowledge, we must practice respect for autonomy—starting with learning more about her, the effect her developmental delay has on her decision-making capacity and autonomy, and her understanding of the likely impact of stopping treatment. While we can appreciate that she has communicated a choice to stop treatment, we need to understand the circumstances under which she communicated a choice to start treatment and identify if any evaluation of her capacity was completed when deciding to start treatment or since that time. We practice beneficence in this case by ensuring that she receives the greatest benefit from her treatment. Additionally, we can apply the World Health Organization bio-psycho-social model of disability that aims to address the health inequities and poorer outcomes for people with disabilities around the world as described by Arnott. Using this model, we can meet her biological needs through access to symptom management as well as her psychosocial needs of support and quality of life. Beneficence is an important strategy tosupport the greatest benefit for the population, including providing effective treatment for all people with disabilities and the population overall. Due diligence is required, however, to prevent paternalistic actions if she does have the capacity to make this choice because violating her autonomy would result in great harm to her and the provider’s virtues. After our debate, we agreed on several points including: The next step is the thorough assessment of this individual’s capacity to order a stop to cancer treatment and respect her autonomy confined to her ability to understand, reason, deliberate, and choose. Importance of learning more about her wishes and reasons for wanting to stop treatment. The need for facts related to any prior evaluation of this individual’s decision-making capacity before starting this treatment plan, or if the providers were happy to treat them so long as she agreed with the treatment plan as determined by medical experts. It is not unusual to have differences in opinion about the cause for concern or alarm for someone making the consequential decision to stop treatment for potentially life-threatening conditions or severe symptoms.
Expert Solution
The
moral inquiry presented in the high-level clinical practice was whether it is
ethical to follow up on the solicitation of a 28-year-elderly person with advanced breast malignant
growth, who has been formatively deferred since birth, for no further disease
treatment. The clinical realities of the circumstance incorporate the lady's
conclusion of advanced breast malignant growth and her formative deferral since
inception. Moreover, the ongoing norm of care for the therapy of advanced breast
cancer was thought of. Moreover, the
dynamic limit of the lady was
considered, given her inability. The moral inquiries raised by the circumstance
incorporate whether the lady has the ability to settle on an educated and
independent conclusion about her treatment plan given her handicap, whether the
lady ought to be dealt with uniquely in contrast to others in comparative
circumstances, and whether the medical services group has an obligation to give
the lady similar norm of care as they would accommodate different patients.
There is additionally whether or not the choice of the lady to not continue with
malignant growth treatment is ethically solid and sensible given the dangers
and potential advantages related to treatment. At long last, there is whether
or not the medical services group ought to regard the lady's independence by respecting
her desires in regard to her therapy.
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