Introduction
The modern healthcare environment could be characterized by numerous challenges specialists should face delivering care. The appearance of these problems is preconditioned by the increased complexity of the majority of health issues and patients diverse needs. The scope of nursing practice includes close cooperation between all actors to acquire an improved understanding of every case and select the most appropriate treatment. However, it also means that numerous ethical dilemmas could occur because of radical differences in peoples mentalities, cultures, and worldviews. The unsolved conflict might have a pernicious impact on results by deteriorating care and decreasing the level of trust between a nurse and a patient. In this regard, the primary aim of this paper is to investigate an ethical dilemma that occurred in the real healthcare setting. The comprehensive analysis of this issue will help to understand the causes of conflicts that might be observed in actual practice. Additionally, the work offers ethical principles, barriers, and theories that could be used when solving the dilemmas of this sort.
Clinical Situation
The hospital environment suggests numerous cases that could be used for the investigation as there are multiple patients with different needs and demands. The following clinical situation is used in the paper. A family addresses a local health care unit because of the significant deterioration of their sons state. A patient, an eight-year male Joshua, has leukemia. He is Caucasian. He has a traditional family. Joshua’s parents are Jehovahs Witnesses. At the moment, the state of the patient’s case is critical. He has already experienced chemotherapy and now suffers from its myelosuppressive effects. The level of blood plates and red blood cells is extremely shallow. Additionally, there is a tendency towards the further deterioration of the situation. Radical alterations of Joshuas blood composition might result in fatal consequences and the patients death. For this reason, a blood transfusion is prescribed as emergent treatment. In general, it remains one of the most frequently used approaches to support patients suffering from this disease and restore the level of blood plastids (Hoffman, 2014).
For this reason, donated blood should be transfused to guarantee the improvement of Joshuas state. The application of this method can guarantee the patients recovery (Adams, 2014). However, the ethical dilemma appears. As stated above, Joshuas parents belong to Jehovah’s Witnesses. The given millenarian restorationist Christian denomination strictly prohibits blood transfusions (Hoffman, 2014). That is why parents do not accept the suggested treatment and insist on looking for alternatives. On the contrary, healthcare specialists insist on using the prescribed treatment as the best and the most efficient method. The given ethical dilemma becomes central to the case as it might result in the further deterioration of the situation and the patients death. The case involves the following actors: an oncologist and a nurse who are responsible for the delivery of care, the patient, and his parents. The situation is complicated because of chemotherapy and its effects. Consequently, Joshua dies from anemia.
Ethical Characteristics
The given case demonstrates the critical importance of ethical dilemmas in the healthcare setting. The inability to make a compromise and find the most appropriate solution results in Joshuas death. Regarding the fatal outcomes of the case, the comprehensive investigation of the central ethical characteristics of the dilemma should be performed. First of all, it could be considered a religious issue. There are numerous cases when Jehovah’s Witnesses refuse from medical treatment and blood transfusions because of the nature of their beliefs (“Leukemia in children, “n.d). A significant number of deaths are preconditioned by this fact. For this reason, the problem remains crucial for healthcare. As for the case, the inability of parties to communicate and make a compromise results in the significant deterioration of the patients state.
That is why it could be considered a communication problem complicated by religious issues. Specialists cannot suggest alternatives because of the complexity of the health issue and disease. Moreover, there is another important factor. Joshua is under age which means that he is not able to make decisions on his own. His parents become responsible for his health as they have the right to accept or refuse the proposed treatment. For this reason, caregivers primary task is to persuade the patients parents and attain their informed consent related to the case. However, they fail to do it.
Ethical Principles
Like other ethical dilemmas, the given case includes several moral principles. First of all, health workers acted in respecting patients’ autonomy. It is one of the leading ethical principles that are used in the healthcare setting. Respect for autonomy means that every individual has the right to act as a free agent (Adams, 2014). People can make decisions related to their lives as long as they do not deteriorate other individuals lives. As for the case, the patients parents can manage their health; however, their right to deprive Joshua of the needed health care remains doubtful. They gave him birth and are responsible for him; however, there is another ethical principle stating that peoples lives are priceless and no one is allowed to harm them. This principle is violated. Joshua dies because his parents are not able to abandon their religious beliefs and save their son. They broke one of the main ethical principles and preferred to ignore the existing threat.
Barriers
Revolving around the case, it is also possible to note several ethical barriers that appear. The nature of the clinical situation presupposes that the patient is not able to make decisions on his own. For this reason, his parents become the main actors who should be persuaded and demonstrated the fundamental role of the blood transfusion. Specialists are not able to communicate with Joshua directly which means that the life of a patient does not depend on his desires and intentions. Second, the parents religious beliefs become another significant barrier that should be eliminated to deliver the needed care. The fact is that there are numerous cases of refusals to accept the required needed care because of the peculiarities of faith (Adams, 2014). This problem is not new to healthcare and is considered one of the main obstacles a specialist faces.
Ethical Theory
Therefore, several ethical theories could be applied to the case. The parents attitude could be described as a categorical imperative. In other words, their moral rules do not admit exceptions. They are not ready to make terms with specialists and let them perform the blood transfusion. However, this approach preconditions crucial results. For this reason, consequentialism could have served as a guide to a better outcome. It states that the correct moral response is preconditioned by consequences (“Treatment & support,” n.d). In other words, only actions that promote the patients recovery and improvement of his state could be considered moral. Using the given ethical theory, specialists should use blood transfusion and improve Joshuas state. The same could also be applied to his parents point of view on the situation. As far as there are no alternatives, the suggested treatment should be accepted.
Self-Assessment
In general, recalling this case, I should say that I feel regret because of the outcomes. Unfortunately, religious issues have always been a problem for caregivers as it is almost impossible to provide the needed care because of numerous limits. Joshua dies because of his parents inability to understand the nature of the health problem and follow health workers pieces of advice. The given outcome is not surprising regarding the nature of the disease (Griffiths & Danbury, 2015). However, the use of the blood transfusion demonstrates appropriate results if to initiate treatment in time (Griffiths & Danbury, 2015). That is why I am sure that religious issues should be disregarded when delivering care to patients in critical states. It is crucial to save the life of a person and guarantee his/her recovery. This task acquires the top priority, and if people are not able to understand it, their instructions should be ignored.
Conclusion
Altogether, the given paper provides a detailed description of the ethical dilemma that occurred in the healthcare setting. The patients parents are not able to accept the proposed treatment because of their religious beliefs. That is why their son Joshua dies from anemia which develops after the chemotherapy. There are numerous ethical concerns related to the issue. The adherence to the wrong principles preconditions the disastrous final result. For this reason, it is essential to understand the most important aspects of the case to be able to act under these conditions and make the right decisions.
References
Adams, R. (2014). Prevention of stroke in sickle cell anemia. The Journal of Law, Medicine & Ethics, 42(2), 135-138. Web.
Griffiths, S., & Danbury, C. (2015). Medico-legal issues for intensivists caring for children in a District General Hospital. Journal of the Intensive Care Society, 16(2), 137-141. Web.
Hoffman, A. (2014). Jehovah’s Witness parents’ refusal of blood transfusions: Ethical considerations for psychologists. Journal of Health Psychology, 21(8), 1556-1565. Web.
Leukemia in children. (n.d.). Web.
Treatment & support. (n.d.). Web.