Introduction
The four topics approach is used in ethical decision-making in the healthcare industry. Ethical issues can be especially challenging in the medical field since a person in an ethical situation is both a subject and object of moral behavior, which can be difficult for healthcare professionals (Gray, 2021). The four topics model can be applied to different medical cases to help nurses and clinicians make ethical decisions.
Medical Indications: The Principles of Beneficence and Nonmaleficence
The patient who had been newly diagnosed with severe kidney failure, which was an acute health problem, required immediate medical treatment. The healthcare team working with that patient wanted to help them while considering clinical ethics, which includes the principles of beneficence and nonmaleficence (Toh et al., 2018). The patient could benefit from medical and nursing care and avoid harm by applying dialysis as soon as possible.
Patient Preferences: The Principle of Respect for Autonomy
The risks and benefits of the treatment were explained to the patient and his family, and the patient was mentally capable and legally competent. However, the patient refused treatment even after being referred to the specialist, which was the initial reason why a challenging ethical situation occurred. It was unclear why the patient was unwilling to cooperate with the healthcare team and the proposed medical treatment.
Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy
Although the patient refused to receive the required medical treatment, they insisted on staying full code. In other words, the patient wanted the healthcare team to provide any necessary resuscitation procedures to keep them alive in case their heartbeat or breathing stopped. The patient lasted four months without dialysis and was placed on life support in the ED, but it was insufficient to save the patient.
Contextual Features: The Principles of Justice and Fairness
Professional, interprofessional, or business interests were not involved in the medical case, which is why no conflicts of interests arose. However, the patient’s family members represented a third party interested in the clinical decisions and the corresponding procedures, though they did not impose any limits on patient confidentiality. There were no other contextual features that could influence clinical decisions regarding the principles of justice and fairness.
Conclusion
Overall, applying the principles of the four topics approach did not shape the decision-making since the model is overly specific. It can be used as a set of guidelines, but the questions do not pertain to any ethical situations in medical care as they are often unnecessary or redundant. Therefore, applying the four topics approach does not seem valid as it is effective but not efficient.
References
Gray, C. (2021). Two aspects of the ethical situation. In Humanism in the contemporary era (pp. 87–101). De Gruyter Mouton. Web.
Toh, H. J., Low, J. A., Lim, Z. Y., Lim, Y., Siddiqui, S., & Tan, L. (2018). Jonsen’s four topics approach as a framework for clinical ethics consultation. Asian Bioethics Review, 10(1), 37-51. Web.