In pediatrics, there is the need for a unique parent-physician relationship. The connection between the two helps make sure that the two are involved in making ethical medical decisions regarding the children. Nonetheless, there are situations when the two parties fail to agree on certain issues. For instance, the two fail to agree on the best medical care for the children, the physicians are compelled to make ethical decisions that will help save a child’s life. In this scenario, a six-year-old child was diagnosed with meningitis, which is a life-threatening condition. The physicians informed the parents seeking permission to treat the children. The parents are Christian Scientists and do not believe that their children needed any form of treatment. In such a dire situation, the physician ignored the parents’ directive by going ahead and initiating the treatment. Feeling that their directive was violated, the parents went ahead to sue the physician and the hospital. A critical analysis of this situation reveals that the action taken by the physician was informed by his/her ethical decision-making. To understand this, the paper analyzes the ethical decision particular to this case by using Uustal's "Ethical Decision-Making Model”.
The Ethical Dilemma in the Case and the Use of Uustal's Ethical Decision-Making Model
According to Uustal's ethical decision-making model, physicians have concrete steps, which they need to follow in making sure they arrive at morally acceptable decisions (Uustal, 1990). The essence of the model is that it is used when physicians are faced with ethical dilemmas. In this case, the ethical dilemma was to obey the parents’ directive of not treating the child and let him die or violate their decision and save the child’s life. Primarily, Uustal’s model dictates that physicians are responsible for making sure they accord their patients with the best care, particularly when they have permission. This means that the patients have the right to accept or reject medical care, for reasons only known them (Katz, Webb, & Committee on Bioethics, 2016). Considering that children are under the care of parents, they are responsible for making decisions on their behalf. For instance, the parents had the mandate to decide what they believe is best for their child. In the case of an ethical dilemma, the situation is undeniably problematic since, in the caring process, there are possible conflicts that may exist between physicians and their patients. Despite the conflicts limiting the physician to care for the patients, if the situation is wanting, they are forced to make decisions that contradict the patient’s instructions.
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In handling this case, the question that arises is in reference to whether the physician was right to continue with the treatment despite the parents refusing to permit the operation. According to Uustal's ethical decision-making model, action by the health care provider is agreeably morally right since meningitis is a life-threatening condition to a child (Uustal, 1990). Therefore, despite a child needing guidance from the parents in every aspect of their life, there are points when their influence is conflicted, particularly if the situation may lead to their demise. First, Uustal's ethical decision-making model views the parents’ action as being influential in the child’s treatment process since their decision was informed by their religious belief, which dictated that they do not need medical attention for them to be healed. Regardless of their beliefs limiting the physician to not treat the child, his moral obligations dictate that he has to save the baby’s life and beat all the odds, even if they do not have the permission to do so (Rainer, Schneider, & Lorenz, 2018). Conclusively, though the physician’s actions may have been unprofessional since they failed to act based on the parents’ instruction, their ethical decision was morally upright since it helped save a child’s life.
The Perspectives, Needs, and Expectations of Stakeholders
Before the situation, the child was living a normal life, which is why the parents had the expectations of their child living the same others. However, with the current situation, the child’s life is in grave condition since he is suffering from meningitis. Directed by the ethical practices of a physician, the health care provider is compelled to make sure they do all they can do to save the child’s life, even if their actions do not coincide with the parents’ directives. The perspective, particular to the child is that they act as the object disagreement between the parent’s autonomy in decision-making and beneficence (Glover & Nwomeh, 2016). On a more general approach, the perspectives of all parties listed herein, the child, parent, physician, hospital, attorney, administrator, and health care staff, is for the child to recover. However, there are some controversies in how the involved individuals believe the child should recover. That is, the ethical dilemma particular to this case is that to the pediatricians, consent is subjective since the six-year-old child may not have given their opinion, and the treatment was dependent on the parent’s decision.
The perspective of the physician, based on the fact that they went ahead to treat the child against the parents’ directives, was that they were focused on the child’s best interest. This applies to the perspective of the hospital and all other medical staff since they are all obliged to make sure that their actions are all about caring for the patients (Rainer, Schneider, & Lorenz, 2018). Considering that the parents are suing the hospital and the physician for not following their instructions, the attorney’s perspective in this is to rule out whether the doctor was morally correct in treating the child. The roles of an attorney, in this case, are purely lawful; therefore, their decisions will consider the issue from a legal perspective. In particular, the attorney believes that the parent’s consent is the legal abiding factor that decides whether a child is to be treated or not, and this means that they are most likely to favor the parents’ choice of not treating. An analysis of the perspectives and consequences of every stakeholder shows that the issue of contention is whether the physician was right to treat the child or not. The bigger picture in this is that the child was treated and it is now everybody’s role in ensuring that the values and principles pertinent to this case are clear.
Conflicting Values and Principles
Based on what has been learned in this course, it is apparent that the conflicting principles and values, in this case, are about the physician going against the parents’ decision. The basics of this case are that the values and principles are involved with ensuring that the child is accorded the best care since he is suffering from a life-threatening ailment, meningitis. The conflict, therefore, was because the parents’ Christian Scientist beliefs restricted them from allowing the child to have any form of medical attention. On the contrary, the physician and the hospital believes that treating the child is the best option to save the child’s life, more so because their actions will not cause him any harm (Rainer, Schneider, & Lorenz, 2018). The physician, thus, acts by preserving the child’s best interest in being healthy, which is why he opted to treat him. The dreadful reaction of meningitis to the boy is nothing any physician can ignore since the symptoms of vomiting violently and convulsions are a clear indication that the condition was fatal. Based on the virtue theory, the physician has the ethical obligation of making sure that their actions are defined by the core principles and values of giving every patient the best care. The specifics of virtue ethics view the physician as an individual that exhibits the attributes of ethical thinking rather than one that is about following rules if the consequences will help save a life.
The Role of the Hospital Administrator
As the hospital administrator, I must engage the parents in a way that they understand the magnitude of how dire the situation was and why the taken actions were the best for the child. In particular, the primary objective is to convince the parents that the action by the physician and the hospital was not presumptuous disrespect of their decisions. First, I will have to explain to the parents that the action to treat the child by the physician was characteristically an ethical dilemma, where the hospital was struggling with whether to let the child die or save him and violate their instructions. For instance, to let them understand the magnitude of the child’s ailment, a clear outline of the symptoms the child exhibited as being fatal may help get the significance of our action (Glover & Nwomeh, 2016). If they will buy into this idea, the next step will be to explain to them that the physician wronged them when he failed to adhere to their instructions, but again acted in the child’s best interest of making sure their life is saved. There will also be the need to explain to the parents that physicians are obliged to act based on oaths of saving patients’ lives even if they are not permitted to. However, since all the explanation tends to support our decision, to achieve the parents’ satisfaction, we will also indicate that the physician will be suspended for failure to obey their instructions, and the hospital will make sure that, in the future, it acts based on the patient or caregiver’s permit to treat.
References
Glover, J. J., & Nwomeh, B. C. (2016). Ethical considerations in pediatric surgery. Pediatric Surgery , 1-16. https://www :1016/s0899-5885(18)30803-7:10.1007/978-3-642-38482- 0_34-1
Katz, A., Webb, S., & Committee on Bioethics. (2016). Informed consent in decision-making in pediatric practice. Pediatrics , 138 (2), e20161484. h ttps://www :1016/s0899-5 885(18)30803-7:10.1542/peds.2016-1484
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing , 27 (19-20), 3446-3461. https://www :1016/s0899- 5885(18)30803-7:10.1111/jocn.14542
Uustal, D. B. (1990). Enhancing your ethical reasoning. Critical Care Nursing Clinics of North America , 2 (3), 437-442. https://www :10.1016/s08995885(18)30803-7
