Ethical Dillemmas
Decision making is a process of choosing the best alternative to achieve individual and organizational objectives. Identifying and using the decision-making process helps healthcare professionals at all levels to make more effective decisions. The acronym “DECIDE” helps aid through the most effective decision making process used by healthcare professionals at all levels. This model is an acronym of 6 particular activities needed in the decision-making process: (1) D = define the problem, (2) E = establish the criteria, (3) C = consider all the alternatives, (4) I = identify the best alternative, (5) D = develop and implement a plan of action, and (6) E = evaluate and monitor the solution and feedback when necessary.
First of all it is important for a health care professional to define what the problem is. The following are Uustal's nine steps to ethical decision making identified in the Ethical Decision Making Lecture at Grand Canyon University (2011).
SITUATION: 85 year old Full Code living in a vegetative state, who has just been readmitted to the ICU for treatment of pneumonia; has a history of 1 CVA, 2 TIA’s; tracheostomy via ventilator dependent as a result of respiratory failure and an ejection fraction of 40%; she also receives nutrition and medications daily via PEG tube. (1) Identify the problem: 85 year old full resuscitation on a patient with no quality of life; the patient does not have a living will established and all medical decisions have been appointed by the only living known relative, the grandson who lives 700 miles from the facility. He wants to preserve her life by continuing to do everything medically possible. (2) Values and Ethical position related to the problem: understanding the family member not wanting to let go; however, in my opinion this is an irrational situation that has created an ethical dilemma in healthcare. My personal values state that this patient has endured enough suffering; my personal values are incongruent.
First of all it is important for a health care professional to define what the problem is. The following are Uustal's nine steps to ethical decision making identified in the Ethical Decision Making Lecture at Grand Canyon University (2011).
SITUATION: 85 year old Full Code living in a vegetative state, who has just been readmitted to the ICU for treatment of pneumonia; has a history of 1 CVA, 2 TIA’s; tracheostomy via ventilator dependent as a result of respiratory failure and an ejection fraction of 40%; she also receives nutrition and medications daily via PEG tube. (1) Identify the problem: 85 year old full resuscitation on a patient with no quality of life; the patient does not have a living will established and all medical decisions have been appointed by the only living known relative, the grandson who lives 700 miles from the facility. He wants to preserve her life by continuing to do everything medically possible. (2) Values and Ethical position related to the problem: understanding the family member not wanting to let go; however, in my opinion this is an irrational situation that has created an ethical dilemma in healthcare. My personal values state that this patient has endured enough suffering; my personal values are incongruent.