Iturralde v. Hilo Medical Center in the Context of Medical Ethics
Certain ethical principles and values support the work of medical professionals. Iturralde v. Hilo Medical Center, USA (2012) represents a violation of ethical medical standards. During spinal fusion surgery, Dr. Ricketson improvised due to the unexpected lack of titanium rods required for such an intervention. As a result, the surgeon put the rods made from stainless steel surgical screwdriver, which later broke, leading to complications and the patient’s death. Although there are many ambiguities and gray areas in ethics, as this case demonstrates, failure to follow ethics can lead to severe problems in patient safety.
Ethical Issues
Ethics should guide medical professionals in difficult situations of their practice, but in the case in question, the doctor did not follow moral standards. Specialists must comply with four principles of clinical practice: justice, autonomy, nonmaleficence, and beneficence (Varkey, 2021). Justice was violated as Iturralde did not receive a high standard of treatment, as he should have.
The violation of nonmaleficence and beneficence manifested in the fact that the surgeon did not act for the patient’s benefit and caused harm using an disapproved treatment. Autonomy supposes the patients’ right to choose what to do with their bodies and entails personnel reporting the truth, obtaining informed consent, and maintaining confidentiality (Varkey, 2021). The surgeon did not give the patient a choice in treatment, did not obtain consent, and used an unapproved method without telling the truth (Iturralde v. Hilo Medical Center, USA, 2012). Consequently, ethical issues arose since Dr. Ricketson violated all clinical ethics principles and did not follow the standards of practice.
Ethical Theory
Applying duty-based ethics would help Dr. Ricketson avoid harming the patient’s health. This theory suggests that the duty includes the universality of actions concerning patients and that the specialist should act similarly in similar circumstances (Fremgen, 2019). This approach is called deontology and concentrates on the responsibilities and principles guiding people in different cases (Hindocha & Badea, 2022). If Dr. Ricketson had followed the principles of clinical ethics and standards of care and used approved intervention methods following duty-based ethics, the situation’s outcome would be different. For example, following the principle of autonomy, obtaining the patient’s consent for a non-standard intervention, and reporting the truth about the problems that arose during surgery were necessary.
Physician-Patient Shared Decision-Making Model
Specialists should involve patients in the process of treatment and make decisions together. Various shared decision-making models exist and can be determined by the features of the physician-patient relationship (Marinkovic et al., 2022). In the case of Dr. Ricketson and patient Iturralde, the most appropriate model to support the safety and quality of treatment is the informative model of care.
It assumes that the physician is a technical expert and provides the patient with details on intervention options, describing their advantages and risks. In contrast, the patient decides on the treatment course (Marinkovic et al., 2022). Such a model would support the ethics of treatment and protect the patient since he would know all the risks associated with his condition.
Ethical Guidelines
Following ethical principles and deontological theory as guidance would help prevent the discussed incident and the repetition of such problems. According to the duty-based theory, all medical professionals would follow ethical principles in their actions in the described situation. The team had to check the surgical kit before starting the intervention to make sure the process was safe and to guarantee nonmaleficence and beneficence. After detecting the absence of rods, the principles prescribe stopping or delaying the operation until the rods are received to avoid using the disapproved method. Such measures are necessary for justice, nonmaleficence, and beneficence.
Applying new treatment approaches is required due to circumstances that must be coordinated with the patient. Moreover, the patient must have complete information about his condition to comply with the principle of autonomy. After the changes in the surgery process, the specialists needed to decide about further treatment together with the patients and obtain consent for any procedures.
Notably, compliance with ethical principles is necessary at the individual level of specialists and at the level of organizations. For the safety and ethics of the practice, the hospital needed to make sure Dr. Ricketson had the relevant competencies and qualifications to work. In this way, ethical guidance would improve patient safety and the quality of services.
Ethical Guidelines and Accountability
The proposed ethical guidance can also help providers remain accountable. For instance, after testing the experience and competence of the doctors, the organization can confidently assert that they are sufficiently qualified and reliable to perform interventions. Following clear standards of practice and ethics will help the care team be accountable through the transparency of their actions and the ability to argue that they have responsibly fulfilled their duties.
Understanding ethical standards and guidance is necessary for specialists to analyze the incident. Such a measure will help in accountability when errors are considered and help find ways to improve practice. Consequently, providers will be able to be accountable to their patients and the profession’s requirements. They will also support the trust received from society through improvement, reliability, and readiness to take responsibility.
References
Fremgen, B. F. (2019). Medical law and ethics (6th ed.). Pearson.
Hindocha, S., & Badea, C. (2022). Moral exemplars for the virtuous machine: The clinician’s role in ethical artificial intelligence for healthcare. AI and Ethics, 2(1), 167-175. Web.
Iturralde V. Hilo Medical Center USA, No. 28792 (3rd Cir. 2012). Web.
Marinkovic, V., Rogers, H. L., Lewandowski, R. A., & Stevic, I. (2022). Shared decision making. In: D. Kriksciuniene & V. Sakalauskas (Eds.), Intelligent systems for sustainable person-centered healthcare (pp. 71–90). Springer. Cham. Web.
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. Web.