Ethical Dilemma; Utilization of Hospital Resources More Specifically Not Enough Rooms for Patients
Abstract
In a situation where a health facility is faced with an ethical dilemma, to ensure that the involved parties are all satisfied even to the affected ones, the decision-making process should be in line with the medical code of ethics—also, the professionals working as a team in finding a possible solution to prevent ethical conflicts. For a health facility with limited resources faced with an emergency can deploy these decisions as possible solutions; Admit only the severely sick and in need of urgent medication, discharge those with terminal decisions to create more hospital beds, and prioritize children over the elderly depending on factors like comorbidities.
Keywords; Decision making, Ethical dilemma, code of ethics, Ethical conflicts, solution.
Ethical Dilemma; Utilization of Hospital Resources More Specifically Not Enough Rooms for Patients
Introduction
Health care service providers are often faced with hard conflicting decisions to make in their quest for offering the best health care service to their patients. The decision-making process calls for medical practitioners to make choices that adhere to the set medical code of ethics while concurrently trying not to bring ethical conflicts between the beneficiaries. In this case, a large number of patients need to be attended to, but there are limited hospital rooms. The possible solutions this hospital can opt for include; admitting only the severely sick and in need of urgent medication, discharge those with a terminal illness to create more hospital beds, and prioritize children and elderly depending on factors like comorbidities. These decisions should all be made in line with the code of ethics to satisfy both parties and prevent ethical conflicts by the affected parties.
The three options that can be used to resolve the dilemma
Admitting only the severely sick
One of the provisions required by nurses in the administering of medical aid is that they should do it with compassion, and respect for integral human dignity. Nurses are required to have a good relationship with their patients and be honest when needed, it is their obligation, to tell the truth about situations and nature of a prevailing health condition and the basis of their decision explained (Winland-Brown et al., 2015). A health facility faced with a high number of patients coming in, yet there are limited beds. They will have to make a hard decision of admitting only those patients that are severely sick and need imminent medical attention. But this has to be communicated to the patients who might need to know, which creates a tolerable environment between the patient and the nurse.
Discharge those patients with a terminal illness
Nurses, as professions, are obligated to self-determine situations and make decisions in the best interest of the patients. In the case of a terminal illness, patients hold the right to autonomy; as a result, this gives the nurses the responsibility to relay the information regarding an illness a patient is suffering from. The nurses are required to present the information to the patients in the simplest form possible for them to understand. The decision to discharge a terminally ill patient involves consultation among medical professionals and also the patient. In the case where the patient can not comprehend things for themselves, they will require the help of a surrogate. The surrogate should go in line with the patient’s wish and will (American Nurses Association 2001). The decision to terminate medication for an incurable disease should be welcomed by the patient and his or her beneficiary. As always, respect for human dignity should be at the forefront. Economically this would save the family from incurring costly medical bills bearing in mind that the illness being attended to cannot be treated. The health facility would have met their obligation of managing the impending problem of inadequate hospital beds.
Prioritize between children and elderly depending on factors like comorbidities
Under one of the provisions of the code of ethics of nurses, in examining a health condition, they are required to prevent unwanted treatments to patients (American Nurses Association 2001). A patient with lower survival probability should not be picked over one exhibiting lower comorbidity. The decision is reached through consultation with other professions; team work is the key to success for medical practitioners. A patient exhibiting more comorbidities means they have lower chances of survival based on the medical analysis. Logically a younger patient with lower comorbidities should be opted over an elderly patient exhibiting more comorbidities, some of which are terminal. Some decisions are tough, and they might bring about ethical conflicts in line of duty. To make such decisions that solve ethical conflicts leaving all the parties satisfied. One of the techniques in solving ethical conflicts is through the deployment of procedural justice; the process should be made fair to result in a fair outcome too (Nelson PhD 2005). The medical professionals are required to share the decision openly between the parties plus the underlying reasoning behind the conclusion and following consequences clearly outlined to satisfy the beneficiaries.
The option that will produce the most good and do the least harm (The Utilitarian Approach)
Every patient has the right to get the best medical care available when in need. But in the case of an influx of patients with limited resources, prioritizing those patients in need of urgent medical attention over the rest doesn.t do much of harm as the critically ill will be attended to, and later these other can have their chance. The utilitarian approach advocates for choosing the action with the greatest benefit (Velasquez et al., 2015). In this case, the benefits are that the critically ill with more risk of loss of life will be attended. Although there is little harm to those who will have to be attended to later, the damage pending isn’t that much compared to assuming to prioritize the critically ill.
The option that best respects the rights of all who have a stake? (The Rights Approach)
The rights approach champions for the right to be told the truth, the right to privacy, and the right to not being exposed to deliberate injury (Velasquez et al., 2015). For a hospital in need of more hospital beds in times of a crisis, the decision to discharge the terminally ill after having informed them and their beneficiaries in the most appropriate way is a respect to the terminally ill, the next patient in need of the occupied bed and the hospital at large. The family of the terminally ill are satisfied after admitting their moral rights were observed. Also, they will be saved from the continuously accumulating hospital bills over a disease that’s incurable. On the other hand, the hospital will be offered the moral right to exercise its duty of saving the lives of a patient whose condition can be managed back to normal.
The option that treats people equally or proportionately (The Justice Approach)
The Aristotle’s justice approach discredits giving favoritism to individuals that do not rightfully deserve it and without a reasonable reason (Velasquez et al., 2015). In a situation where medical professionals are tied down by limited resources, a decision to chose to attend to a younger patient with lesser medical complications sounds better. It is best when the other party is fully aware and is in terms of the decision. These benefits both parties in such a way that the patient with a better survival rate is attended to, and the other patient is saved from unwanted treatment due to comorbidities.
The option that best serves the community as a whole, not just some members (The Common Good Approach)
The Common Good Approach is inclined towards having a society whose individuals strive to ensure that they all benefit from the available social resources (Velasquez et al., 2015). Choosing to attend to the severely sick in an emergency situation characterized by limited resources is a just approach to society as a whole. The health facility will ultimately attend to all the patients entitled to the service but by first serving those who need an imminent cure. The harm would be a little bit of delayed attendance to those not critically ill, but in the end, all the patients would be attended to. This procedure done in a professional way by availing all the logic behind the decision to the affected parties solves any arising conflict.
The option that leads me to act as the sort of person I want to be (The Virtue Approach).
The virtue approach holds the belief that with deep reflection, individuals are able to realize their best ability as human beings given a chance, this can only be achieved through cultivating the best virtues that can bring out the potential version of an individual (Velasquez et al., 2015). The decision by a nurse under their code of ethics, talking to an elderly patient or their surrogate, and giving frank and logical reasons to prioritize treatment of a child showing fewer commodities over their own is an act of selfless. The patient with more severe illness accepts the reality and paves the way for a younger patient with chances of survival would mean a lot to the well being of both patients and the health facility at large Such acts promote the development of character within a society.
The option that best addresses the situation
Basing a decision making process in an emergency situation using The Rights Approach to choose to respect the moral rights of a terminally ill patient and discharge them with their consent, to create more room for treatable patients best describes the solution to an ethical dilemma in question. The underlying harm to the affected patient is fully informed to them plus the benefits of accepting the decision to get them discharged. This aids the medical officers in getting a possible answer to a conflicting situation.
Conclusion
Health facilities and their staff will often find themselves in situations that require making tough decisions that might be conflicting. To address such problems, reasoning as a team and trying to get solutions observing the set code ethics offers a better solution at the end. This reduces the burden of decision making in dilemma situations.
References
American Nurses Association Silver Spring Maryland; Code of Ethics of Nurses with Interpretive Statements (2001).
Nelson, W. A. Ph.D. (2005). An Organizational Ethics Decision-Making Process
Velasquez, M., Andre, C., Shanks, T and Meyer., M. J. (2015). The Markkula Centre for Applied Ethics at Santa Clara University, Thinking Ethically
Winland-Brown, J., Lachman, V D., Swanson, E O (2015). Ethics, Law, and Policy, The New ‘Code of Ethics for Nurses with Interpretive Statements’: Practical Clinical Application, Part I