WRITE ABOUT ETHICAL DECISION MAKING MODEL
Case 1
An ethics consultation was called for assistance in the case of a nine-year old girl with a two-year history of AIDS. At the time of the consultation, her disease had progressed, and it was the opinion of her physicians that she would probably die within the next six months. During the previous two years, she had multiple hospital admissions for treatment of various infections and for poor growth. In addition, she had developed chronic lung disease and required intravenous fluids for nutritional support. More recently, she had developed AIDS nephropathy that had progressed to end stage renal failure requiring daily peritoneal dialysis. She developed pneumonia and was hospitalized with hypoxia that was compounded by the other aspects of her disease process. At the time of admission, her grandmother (guardian) requested that the patient not be told about the diagnosis of HIV or AIDS, and that information about the predicted terminal course of her disease be withheld from her. Members of the health care team were uncomfortable with this request and asked for an ethics consultation. How would you work through this dilemma if you were a member of the Ethics Committee?
Worksheet: Ethical Decision Making Model
Step 1
Is this an ethical dilemma? Describe the ethical issue in this case. Pick two ethical values in the CNO Ethics Standard which are in conflict or relate the most to the case. Also identify the two ethical principles (from LHO) that relate to this case study. Describe how each value or principles applies to the case study. Ensure that you have selected 4 different values / principles.
Step 2
Step 2a: Gather all relevant information. Identify known and unknown facts and evidence. Consider medical indications, client capacity and preferences, quality of life and client safety, social, legal and economic factors.
Step 2b: Consider policies, guidelines, professional standards, code of ethics and relevant legislation which relate to this case study (support with evidence of research).
Step 3
Step 3a: Identify and Evaluate Stakeholders Responsibilities & Perspectives
Complete the chart below by considering the following for each identified stakeholder:
o What are their responsibilities (roles, duties or obligations) in this situation?
o Which of their values, beliefs, goals or assumptions will affect this decision?
| Responsibilities
(Roles/Duties/Obligations) |
Values
(Beliefs/Goals/Assumptions) |
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| Stakeholder: |
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| Stakeholder: |
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| Stakeholder: |
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Step 3b: Identify where conflicts exist by reflecting on the following questions:
o Do the responsibilities of one stakeholder conflict with others’ responsibilities or perspectives?
o Do the values, beliefs or goals of one stakeholder conflict with other’s responsibilities or perspectives?
o Do any stakeholders’ perspectives hold greater weight/priority? Why?
Step 4
Examine and determine your own values on the issues presented in the case, and how that might impact your ethical perspective?
Step 5
Write out the issue/problem – clear, simple statement. Ensure that you identify the problem in terms of ethical values/principles
Step 6
Brainstorm all possible options or courses of action. For each identify the Pros/Benefits and the Negatives/Consequences. Consider the stakeholders when considering all of the options.
| Option | Benefits | Consequences |
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Step 7
Make or recommend a decision and provide the justification/rationale. Based on the full analysis of the options, determine which option best addresses the situation.
Ethical Case Study
Purpose: To analyze an ethical dilemma using an ethical decision making framework.
Method: Choose a case study from those provided below. Use the Worksheet: Ethical Decision Making Model to work through the dilemma. (The Content covered in week 5 & 6 will be very helpful in completing this assignment). You will take on the role of an Ethics Consultant/Committee, and use this process to identify at least 3 different, realistic options to solve this ethical dilemma.
Requirements:
Complete each step, answering the questions in full.
Except in the charts, the answers are to be in paragraph form. The charts may be point form. (Steps 3 & 6 only)
Support your work with research/evidence, particularly in Step 2 & 7.
Include a title page and reference page which conform to the guideline in the Program Guide and APA Guidelines. APA guidelines must be used throughout the entire assignment.
Maximum total page length is 14 pages.
The paper must be your own, original work. Your paper will be submitted to Turnitin automatically upon submission.
Avoid plagiarism and APA Guide
See the information
http://owl.english.purdue.edu/owl/resource/589/01/
http://www.indiana.edu/~wts/pamphlets/plagiarism.shtml
|
CRITERIA |
EXEMPLARY |
ACCOMPLISHED |
DEVELOPING |
BEGINNING |
MARK |
| ETHICAL PRINCIPLES & VALUES
(10%) |
The ethical issue is described in accurate detail & the ethical principles/values in conflict are correctly described and justified. Four ethical values / principles are applied to the case.
(10) |
The ethical issue is not accurately described OR the ethical values OR ethical principles in conflict are not sufficiently described or justified. Only 3 ethical values / principles are applied to the case.
(7.5) |
The ethical issue is not accurately described, OR the conflicting ethical principles /values are not accurately described; at least one of these is missing. Only 2 ethical values / principles are applied to the case.
(5) |
The ethical issue, values and principles are not addressed or accurately described in the required detail (or missing). Less than two ethical values / principles are applied to the case.
(2.5) |
|
| EVIDENCE (20%) |
All known facts are stated accurately. At least 3 very relevant resources are extensively considered. (ONLY ONE OF THESE IS A CNO DOCUMENT). Student applies professional standards, legislation, and other relevant policies to this specific situation when considering the ethical issue.
(20) |
All known facts are stated accurately, and at least 3 relevant resources are considered and applied to this specific ethical issue.
(15) |
All known facts are not stated, OR 2 relevant resources are considered OR 3 resources are briefly considered (or irrelevant).
(10) |
All known facts are not described accurately, OR only 1 relevant resource is considered appropriately, OR 2-3 resources are very briefly considered (or irrelevant).
(5) |
|
| STAKEHOLDERS
(10%) |
All stakeholder roles and responsibilities are considered; indicated questions are also considered in full.
(10) |
All stakeholder roles and responsibilities are considered; indicated questions are considered in part.
(7.5) |
Easily identified stakeholder roles are not considered, or most of the indicated questions are not considered.
(5) |
Easily identified stakeholder roles are not considered, and most of the indicated questions are not considered.
(2.5) |
|
| SELF-REFLECTION
(10%) |
Your values are described and you have deeply considered how your values may impact your ethical perspective as a nurse.
(10) |
Your values are described, you have given some consideration to how your values may impact your ethical perspective.
(7.5) |
Your values are not described, OR you have not considered how your values may impact your ethical perspective.
(5) |
Your values are not described, and you have not considered how your values may impact your ethical perspective.
(2.5) |
|
| DEFINE THE ISSUE
(5%) |
The problem is clearly identified and described, incorporating ethical principles and values.
(5) |
The problem is identified and described incorporating ethical values / principles.
(3.75) |
The problem is identified, but not described, or the case study details are reiterated without consideration of the ethical values / principles
(2.5) |
The problem is not accurately identified or described.
(1.25) |
|
| OPTIONS
(15%) |
At least 3 distinct, realistic options are considered, including benefits and consequences of each; all stakeholders are considered.
(15) |
3 different possible options are considered, with some benefits and consequences and stakeholders are considered.
(11.25) |
2 different possible options are considered, with some benefits and consequences considered.
(7.5) |
1-2 possible options are briefly considered.
(3.75) |
|
| RECOMMENDATION
(10%) |
One identified option is clearly recommended, including rationale (supported by research and references) for why that option is the best choice.
(10) |
One option is clearly recommended with some rationale (supported by research and references) discussed.
(7.5) |
One option is recommended with minimal discussion of rationale, OR more than one option is recommended. The option is not supported by research and references.
(5) |
One of the defined options is not recommended, or there is no rationale for choosing this option.
(2.5) |
|
| SPELLING/GRAMMAR
(10%)
|
Writing is clear, concise and free from spelling or grammar errors
(10) |
There are a few minor spelling or grammar errors, though writing is overall clear and concise
(7.5) |
There are multiple spelling or grammar errors, or significant errors impacting clarity of the message
(5) |
There are substantial spelling or grammar errors which impede the ability to read or understand content
(2.5) |
|
| APA FORMAT
(10%) |
Title Page, Reference list and in-text citationss are complete and accurate, using current APA Guidelines and PN Program Guide. Follows assignment instructions thoroughly.
(10) |
Title page, Reference list and in-text citations are mostly complete and accurate. Follows most assignment instructions.
(7.5) |
There are multiple errors in APA Format of title page, Reference list, and in-text citations. Does not follow assignment instructions.
(5) |
Title page, reference list are incomplete or inaccurate, OR reference list does not included all resources, OR all resources are not cited. Assignment does not follow written instructions.
(2.5) |
|
Total /100
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