Ethical Issues
When making a decision about pursuing a medical career, an individual is to take full responsibility for one’s actions due to their major and direct impact on other people’s life expectancies and health. Thus, it goes without saying that medical employees are to preserve some moral obligations when dealing with the treatment process. According to Almoallem et al. (2020), the most common problems medical personnel faces are disagreement with treatment, conflicts with relatives, conflicts with administration policy, and making decisions about do-not-resuscitate or life-sustaining treatment. In the discussed case, Dr. Ricketson violated the hospital’s policy and did not check if the titanium rods were ready for implantation. Additionally, he made the decision towards a dangerous treatment instead without consulting with colleagues. Finally, the surgeon failed to inform the patient and his relatives about the mistake. In other words, Dr. Ricketson was negligent before the operation and tried to cover the negligence by ignoring the principle of non-malfeasance and failing to inform all the stakeholders about the incident.
Ethical Theories
All ethical theories, including utilitarianism, rights-based ethics, duty-based ethics, justice-based ethics, and virtue-based ethics result in reaching a decision based on various approaches to the same issue. The perception of these decisions is often modified when experienced in terms of some stressful situations that require immediate action (O’Mathúna et al., 2018). Hence, while some of the theories are used in favor of the ones who bring the most benefit to society in general, others are based upon the fact that every human being was born as an individual with exclusive rights to live a long and happy life. Whereas all of the theories might contradict each other at some point of discussion, all of them help practitioners justify their decisions through the prism of causal connection.
However, when any of the theories are applied to the Iturralde v. HMC case, it becomes clear that all of the basic human rights were neglected by the healthcare practitioner. The patient, as a human being in the first place, was entitled to receive proper medical aid regardless of his virtue or social benefit. According to the primary sociology patterns, such behavior would only be appropriate in cases when many lives are simultaneously at stake, making it mandatory to choose the ones who deserve to be saved more than others, still regarding this behavioral pattern as dehumanizing. Hence, when there is no major need to choose people according to their theoretical efficiency in society, the rights-based theory is the most suitable foundation to resolve the situation. The surgery held by the practitioner was primarily aimed at preserving one’s health, making it a major goal to justify the fundamental human privilege to live. In terms of the rights-based theory, hence, it was the surgeon’s task to ensure one’s life duration instead of searching for an immediate situation outcome.
Shared Decision-Making Model
Over the past years, the issue of interpersonal communication in terms of the treatment process has become a subject for continuous discussion due to the dissonance in the process of patients advising on their treatment. Whereas many practitioners still tend to avoid discussing the details of the treatment plan with individuals, researchers have been actively trying to define the most beneficial model of shared decision-making in order to involve patients in the process to an extent safe for their physical and mental health. Agency for Healthcare Research and Quality (AHRQ, 2020) recommends a coherent shared decision-making model named SHARE. The model is based upon five steps: seeking the patient’s participation, helping the patient to understand possible treatments, assessing values and preferences, reaching a decision with the patient, and evaluating the patient’s decision (AHRQ, 2020).
The negative consequences of implanting a screwdriver shaft instead of a titanium rod were obvious. Therefore, Dr. Ricketson should have followed the five steps described above to decrease associated risks and enable papatientarticipation in selecting a treatment instead of trying to conceal the fact of malpractice. Implementing SHARE is associated with increased patient satisfaction and decreased will to bring care providers to court (AHRQ, 2020). At the same time, Dr. Ricketson should have considered the cultural differences and tried to involve the family in the decision-making process to avoid language barrier problems. Rosalinda could have been of great help during treatment, as she would explain to her brother all the options and helped the care providers avoid being sued for malpractice.
Proposing and Defending Ethical Guidelines
Ethical guidelines should focus on four basic principles of health care are autonomy, beneficence, non-maleficence, and justice. Thus, healthcare organizations muste ethical guidelines for malpractice cases based on these principles (Gilman & Bedigian, LLC). First, such guidelines should insist on immediate disclosure of the case of malpractice to the patient and other central stakeholders, as this promotes autonomy. Second, these guidelines should include exploring the options with the patient for further treatment and selecting, as it also promotes autonomy. Third, after the patient selects the desired option, care providers should assess it in terms of possible harms and benefits to promote beneficence over maleficence. Fourth, the option should be assessed for any legal issues to promote justice. Finally, all the crucial stakeholders, including families and caregivers are to be consulted to confirm that the selected options suit everyone. These simple guidelines promote all four general principles of healthcare ethics and decrease the chances of malpractice trials.
References
Agency for Healthcare Research and Quality. (2020). The SHARE approach — Essential steps of shared decisionmaking: Expanded reference guide with sample conversation starters. Web.
Almoallem, A. M., Almudayfir, M. A., Al-Jahdail, Y. H., Ahmed, A. E., Al-Shaikh, A., Baharoon, S.,… & Al-Jahdali, H. (2020). Top Ethical Issues Concerning Healthcare Providers Working in Saudi Arabia. Journal of Epidemiology and Global Health, 10(2), 143-152.
Gilman & Bedigian, LLC. (n.d.). The ethics of medical malpractice. Web.
Iturralde v. Hilo Medical Center USA. [2012]. No. 28792.
O’Mathúna, D., Dranseika, V., & Gordijn, B. (2018). Disasters: core concepts and ethical theories. Springer.