October 25, 2011
Ethical Decision Making Paper
A health care case in need of evaluation using the steps to ethical decision making is described in Ethical Dimensions in the Health Professions by Ruth B. Purtilo and Regina F. Doherty. According to the book, a student named Andrea was working in the outpatient clinic one morning when she saw someone she knew. Her father’s business partner, Mr. Brown, whose health was failing and interfering with his earnings according to her father, was sitting in the waiting area chatting with another man. The man was young and very different from Mr. Brown, wearing a torn leather jacket. Andrea did not think anything of it at the time because she remembered her father admiring the fact that Mr. Brown has the ability to have friends in all walks of life. After hanging up her coat, Andrea returns and notices the other man is gone. She now is supposed to take Mr. Brown’s clinical history and prepare him for his tests. After Andrea leads Mr. Brown to the changing room, she notices he dropped something out of his pocket outside of the room. When she picks up the brown bag, she finds a syringe and a small plastic bag of white powder labeled “Brown, $450” (Purtilo and Doherty 131). Andrea needs to use the six step method to decision making that Purtilo and Doherty lay out in Ethical Dimensions in the Health Professions to help solve her predicament. Gather Relevant Information
Step one of the decision making process is to gather relevant information. In this situation, not a lot of information is known. As far as clinical information, all Andrea knows is that he is there for some tests, what she learned from asking him his history, and according to her father, Mr. Brown’s health is failing. Andrea does not know for sure what the bag contains, although it is easy to guess being that there is a syringe with the powder, and it was labeled as four hundred and fifty dollars. She does not know for sure if he has used drugs before or if he has just bought them for the first time. Andrea has not yet told Mr. Brown of her discovery, and he has not been given a chance to defend himself. What Andrea does know is that Mr. Brown is possibly harming himself, and if he were to stop doing drugs and get clean, his quality of life may improve, and the “failing health” her father talked about would not be an issue for his career any longer. The last of any relevant information that can be obtained from the case study as it is written in the book is that the outpatient clinic Andrea works in probably has some kind of policy regarding drugs and that there are serious legal implications depending on which action Andrea takes. Identify Type of Ethical Problem
Now that all relevant information has been gathered, Andrea needs to complete step two by identifying the type of ethical problem this situation represents. The three types of ethical problems are ethical dilemmas (when two courses diverge and one right choice is picked while the other choice which is also right is not), locus of authority problem (when it is undeterminable who should have the authority to make an important ethical decision), and moral distress (when one cannot do what they know is right) (Purtilo and Doherty 53). Andrea’s situation would be described as moral distress. According to Ann Gallagher in an article she wrote called “Moral Distress and Moral Courage in Everyday Nursing Practice”, moral distress is described as feelings that are painful, and as a psychological imbalance or disequilibrium that occurs when nurses find themselves in situations where they feel unable to do the right thing. Andrea knows what the right thing to do is, but she is blocked from doing it because she knows Mr. Brown personally (or at least through her father), and if she reports him for having the drugs, she could destroy his life which in turn could destroy her own father’s business. Since the powder she found...
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