NHS FPX 4000 Assessment 3 Applying Ethical Principles

Name

Capella university

NHS FPX 4000 Developing a Health Care Perspective

Prof. Name

Date

Applying Ethical Principles

Ethics in healthcare are fundamental to ensuring patient-centered care and guiding professionals in making morally sound decisions. They encompass principles like beneficence, nonmaleficence, autonomy, and justice, which help balance patient rights with medical responsibilities (Olejarczyk & Young, 2024). This assessment presents an ethical case study related to genetic testing and patient autonomy, applying the moral principles and decision-making model to derive a morally grounded solution. 

Ethical Case Study

Dr. Leonard Harper, a geneticist at Hillside Medical Center, faces an ethical dilemma after conducting prenatal genetic testing for Mrs. Clara Bennett, a 38-year-old expecting mother. Given her age and family history, Clara wanted to determine if her unborn child had any genetic disorders. The results indicate a high likelihood of Down syndrome. During a private consultation, Clara, visibly distressed, requests that Dr. Harper withhold the results from her husband.

Clara fears that sharing the news might cause her husband undue stress, given his demanding and dangerous job. Dr. Harper, a staunch advocate for patient autonomy, understands Clara’s desire for privacy but is also concerned about the potential strain this secrecy could place on the couple’s marriage and its impact on future medical decisions. He must carefully weigh Clara’s autonomy against the ethical obligation for transparency and open communication in family matters.

Facts of the Case Study and Peer-reviewed Literature

This case scenario presents several facts, including balancing patient autonomy and family communication. According to the literature, patient autonomy refers to their right to make healthcare decisions without providers’ influence (Olchowska-Kotala et al., 2023). It is one of the fundamental ethical principles stated by the literature supporting Clara’s right to control personal health information. However, open communication, particularly in decisions involving family dynamics, is crucial, as withholding medical information can lead to ethical dilemmas.

This communication is essential for the accurate understanding of medical information and developing collaborative decisions (Noorulhuda et al., 2023). Dr. Harper’s dilemma aligns with these findings, as Clara’s request challenges the standard practice of open communication in familial health decisions. Furthermore, the case study underscores the importance of family-centered care approaches to promote shared decision-making, potentially reducing psychological distress for all involved parties. This is particularly essential in genetic testing and disclosure scenarios, as presented in the case study, to ensure that all family members are adequately informed, involved in decision-making, and prepared for potential challenges related to the diagnosis, fostering trust and support within the family unit (Dimond et al., 2022). 

The chosen articles support the analysis by highlighting essential ethical principles and practices relevant to the case study. Olchowska-Kotala et al. (2023) provide a basis for respecting patient autonomy, emphasizing Clara’s right to control genetic test information. Meanwhile, Noorulhuda et al. (2023) underline the importance of open communication in healthcare, which is crucial when family dynamics are involved, aligning with Dr. Harper’s concern about withholding information. Dimond et al. (2022) further strengthen the analysis by advocating for a family-centered care approach in genetic testing, which promotes shared decision-making, addressing the core ethical challenges of the scenario. 

Effective and Non-effective Communication Approaches 

In the case study, Dr. Harper demonstrates professionalism by scheduling a private consultation with Clara, providing a safe environment for discussing sensitive information. Private meetings support patients’ autonomy and create an environment for the patient to express their concerns openly without any fear. Physical space for private meetings also protects patients’ confidentiality, fostering good rapport and trustworthiness (Pratiwi et al., 2022). In this scenario, this communication approach was effective as it allowed Clara to express her concerns about withholding genetic test results from her husband. 

A more effective communication approach would be to incorporate elements of a family-centered strategy. According to Dimond et al. (2022), this involves engaging all relevant family members in discussions about health-related decisions, promoting transparency, shared decision-making, and ensuring emotional support for everyone involved.  Generally, healthcare professionals should use communication approaches that emphasize empathy, clarity, and transparency while respecting patient autonomy. However, the approach to avoid includes paternalistic communication, where the provider makes decisions without patient input (Lazcano-Ponce et al., 2020). This strategy can override patient autonomy. Thus, a balanced, empathetic, and inclusive communication strategy is key to navigating ethical dilemmas in healthcare.

Ethical Decision-Making Model and Case Study

According to the literature, an ethical decision-making model has three substantial steps, including moral awareness, moral judgment, and moral behavior. The first step includes recognition of ethical issues, followed by evaluating and choosing the right course of action and implementing the decision in practice. This model guides individuals in making ethically sound decisions by systematically addressing ethical dilemmas and their implications (Lim et al., 2023). In the case study, Dr. Harper demonstrates ethical moral awareness by acknowledging the dilemma of balancing patients’ autonomy with family communication.

This action was effective in understanding the gravity of the patient’s request and comparing it with medical obligations according to what is in the best interest of the patient and her upcoming child. Furthermore, the doctor demonstrates moral judgment by weighing the ethical principles of confidentiality against the potential impact on the family’s decision-making and trust, enabling him to consider the implications of both sides. While the case study has a knowledge gap about Dr. Harper’s ethical behaviors, it is recommended, according to moral decision-making, that he must ensure that his actions align with ethical principles and support the family’s overall well-being. This approach helps navigate the complex ethical landscape and make a balanced, informed decision (Lim et al., 2023). 

NHS FPX 4000 Assessment 3 Applying Ethical Principles

Using ethical decision-making in healthcare promotes trust, respect, and effective patient-provider relationships. It ensures that decisions are made transparently, with consideration of patient autonomy and informed consent. Ethical practices lead to better patient outcomes, increased satisfaction, and stronger patient-provider relationships (Olejarczyk & Young, 2024). They help in fostering an environment where patients feel valued and understood, which can also enhance adherence to treatment plans and improve overall care quality.

In contrast, unethical approaches, such as paternalistic approaches and ignoring patient preferences, can have detrimental effects. These actions may erode trust, lead to patient dissatisfaction, and potentially compromise care quality (Lazcano-Ponce et al., 2020). They can result in emotional distress, poor decision-making, and conflicts within families. Finally, nonethical practices may also lead to legal consequences and damage the reputation of healthcare providers and institutions, ultimately undermining the integrity of the healthcare system.

Ethical Solution 

A possible ethical solution involves that Dr. Harper should encourage Mrs. Clara Bennett to have an open discussion with her husband about the prenatal genetic test results. The doctor should explain to her the benefits of sharing results with her husband. This will foster a supportive and united approach to the child’s care, enhancing informed decision-making and preventing potential emotional and relational strain that might arise from withholding critical information. This solution aligns with several ethical principles:

1. Respect for Autonomy: While patients’ autonomy is crucial, it is also essential to respect their family’s right to be informed about significant health information that affects their family dynamics. Encouraging transparency respects both partners’ autonomy in making informed decisions together (Dimond et al., 2022).
2. Beneficence: This principle obligates healthcare providers to act in the best interest of the patient and family (Varkey, 2021). By facilitating open communication, Dr. Harper helps ensure that both Clara and her husband can make informed decisions about their child’s care, fostering mutual support and preparation.
3. Nonmaleficence: This principle focuses on preventing harm. It prevents withholding crucial information, which can later create emotional and relational disadvantages. Open discussion helps avoid potential conflict and distress, supporting the family’s well-being.
4. Justice: Ensuring that both parents are equally informed respects the principle of fairness, allowing them to address the diagnosis together and equitably share the responsibilities and decisions regarding their child’s care (Mestre et al., 2024). 

Conclusion 

In conclusion, the case scenario presents a complex ethical dilemma involving the balance between respecting patients’ autonomy and the necessity of transparent family communication. Using appropriate communication approaches and ethical decision-making models, healthcare providers can navigate ethical situations effectively. The solution for this particular case study involves Dr. Harper encouraging the patient to discuss the prenatal genetic test results with her husband, aligning with ethical principles of autonomy, beneficence, nonmaleficence, and justice. This approach supports informed decision-making and maintains family trust, ultimately promoting well-being and ensuring comprehensive and ethical patient care. 

References

Dimond, R., Doheny, S., Ballard, L., & Clarke, A. (2022). Genetic testing and family entanglements. Social Science & Medicine, 298, 114857. https://doi.org/10.1016/j.socscimed.2022.114857 

Lazcano-Ponce, E., Angeles-Llerenas, A., Rodríguez-Valentín, R., Salvador-Carulla, L., Domínguez-Esponda, R., Astudillo-García, C. I., Madrigal-de León, E., & Katz, G. (2020). Communication patterns in the doctor-patient relationship: Evaluating determinants associated with low paternalism in Mexico. BMC Medical Ethics, 21(125). https://doi.org/10.1186/s12910-020-00566-3

NHS FPX 4000 Assessment 3 Applying Ethical Principles

Lim, W. M., O’Connor, P., Nair, S., Soleimani, S., & Rasul, T. (2023). A foundational theory of ethical decision-making: The case of marketing professionals. Journal of Business Research, 158, 113579. https://doi.org/10.1016/j.jbusres.2022.113579 

Mestre, T. D., Lopes, M. J., Mestre, D. M., Ferreira, R. F., Costa, A. P., & Caldeira, E. V. (2024). Impact of family-centered care in families with children with intellectual disability: A systematic review. Heliyon, 10(7), e28241–e28241. https://doi.org/10.1016/j.heliyon.2024.e28241 

Noorulhuda, M., Grady, C., Wakim, P., Bernhard, T., Cho, H. L., & Danis, M. (2023). Communication of patients’ and family members’ ethical concerns to their healthcare providers. BMC Medical Ethics, 24(1). https://doi.org/10.1186/s12910-023-00932-x 

Olchowska-Kotala, A., Strządała, A., & Barański, J. (2023). Patients’ Values and Desire for Autonomy: An Empirical Study from Poland. Journal of Bioethical Inquiry, 20, 409–419. https://doi.org/10.1007/s11673-023-10241-y 

Olejarczyk, J., & Young, M. (2024). Patient rights and ethics. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538279/ 

Pratiwi, A. B., Padmawati, R. S., & Willems, D. L. (2022). Behind open doors: Patient privacy and the impact of design in primary health care, a qualitative study in Indonesia. Frontiers in Medicine, 9. https://doi.org/10.3389/fmed.2022.915237 

NHS FPX 4000 Assessment 3 Applying Ethical Principles

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119