The key point of the article : The medical field encounters ethical issues and dilemmas on a daily basis. There are ethical codes that have been provided to be followed by all medical practitioners.
Summary
The dilemma in question is that of Mr. Green who shared his suicidal thoughts with the nurse under whom he was in the care of. Mr. Green, who is an end stage aggressive prostate cancer patient, expressed to the nurse in confidence about how he had thought of ending his life (Jie, 2015). He asked the nurse to keep these thoughts and feelings a secret. The ethical dilemma herein is whether the nurse should break confidentiality and tell other medical care givers about Mr. Green’s suicidal thoughts.
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Conflict raised: The conflict that this dilemma raises is a question of when nurses and other health professionals can break confidentiality. Should nurses be able to reveal information from and about their patients without their consent?
Analysis
The issue raised herein is not unique to the medical field. There are stipulated ethical principles that are required to be followed by medical caregivers hence to better solve this case; it is mandatory to consult the nurses’ code of ethics value statement, ethical principles and associated literature with regard to patient-nurse or patient-doctor confidentiality. According to the references mentioned above, the nurse or doctor is allowed to break confidentiality when the patient intends to harm himself or herself or other people. The caregiver can also break confidentiality in the event that the information is required by a court of law. The ethical solution in this case shall be having the nurse share the information with the rest of the care team so that Mr. Green can get the help that he needs. The nursing team shall then follow the self-harm and suicide protocol of the hospital strictly to provide the appropriate interventions.
Hypothetical Dilemma
Michal, a 16-year-old, was diagnosed with Hodgkin’s lymphoma and was supposed to undergo therapy because the doctors agreed it would help her recover and live longer. Michal did not like chemotherapy because it was painful. She also claimed that she felt worse after each treatment even though the doctors had informed her that chemotherapy would make her better. She refused to continue with therapy. Unlike most cases where parents sometimes force treatment procedures on their patients, her mother upheld her decision.
The issue herein is that; since Michal is a minor, her parent or guardian has legal authority to make health care decisions for her. The doctors, on the other hand have an ethical obligation to respect the patient’s self-determination, which means they can allow a patient to refuse treatment. Moreover, the caregivers are obligated ethically to make decisions that maximize the benefits for the patient and minimize risks. The hospital took Michal’s case to court. If the court revokes Michal’s mother’s decision concerning the treatment of her child, she will be taken away to a foster home or a temporary guardian and forced to undergo chemotherapy. If the court supports the decision made by Michal and her mother, there is the conflict where chemotherapy may have actually saved a Michal’s life.
Kant’s Categorical Imperative
Kantian ethics state that the categorical imperative is moral. In order for an action to be seen as a moral obligation, there is a set of requirements that must be fulfilled. First, one should behave in a way that a reasonable generalization of their actions to a universal rule will benefit all the people under this rule. Second, the pull of duty should be at the center of all actions. According to Kant, all moral actions should not be a means to an end, but an end in itself (Johnson, 2016). In this case, taking Michal away from her mother to force her to undergo treatment that is painful and she does not approve of does not fit the first principle even though it does fit the second principle. Therefore, the action according to Kant is not moral.
Aristotle’s Influence
Contrary to duty ethics, philosophers like Aristotle upheld the virtue principle. Aristotle emphasized that the morality is essential for goodness and not just for knowledge. Since human beings have character and are capable of virtue, the right thing action depends on the situation and not the application of a law. Therefore, people should do the right thing, at the right time and at the right place.
Which method is preferred and why?
Basing on the assertions of Kantian and Aristotelian ethics, I would prefer the virtue principle as opposed to the duty principle. The former recognizes that different situations require different causes of action, hence the right action is the one that leads to the highest good for all the persons involved. Kant, on the other hand, asserts that universal laws should be applied in every scenario regardless of the outcome or the impact that it shall have on the parties that are involved. Aristotle takes into consideration that a situation can turn out differently for the benefit of all people if a rule is broken. He adopts virtues such as prudence, justice, courage and temperance to inform actions. If Aristotelian ethics are applied to Michal’s case, it is possible that she can be made to undergo alternative treatment which she shall be comfortable with and that she shall not be separated from her sole caregiver. Forcing a patient to undergo unwanted treatment in the most unfriendly conditions may create another problem or aggravate the existing problem.
References
Jie, L. (2015). The patient suicide attempt – An ethical dilemma case study. International Journal of Nursing Sciences 2(4); 408-413. Retrieved from: https://www.sciencedirect.com/science/article/pii/S2352013215000149
Johnson, R. (2016). Kant’s Moral Philosophy . Retrieved from: https://plato.stanford.edu/entries/kant-moral/
