Aside from having tough therapy decisions, healthcare practices often involve cases which require practitioners to make difficult non-therapy related decisions. As these ethical difficulties arise, practitioners may use several approaches to make decisions. In most cases, there is an approach that is better suited for a particular scenario.
In the first case, the patient, a young boy, comes in with his mother. The patient, who is sick, also has bruises due to an unconventional procedure. As the medical practitioner, the main challenge is ensuring that the patient’s well-being is upheld, which would be challenging if the mother continues practicing strange remedial procedures on the patient. The ethical challenge, in this case, is whether reporting the parent to Child Protection Services would be the right thing to do, with the well-being of the child being the main determinant.
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The utilitarian approach tries to create the least amount of harm and suffering for all parties. Under this approach, the best option is the one that has the best balance of benefits over harm. Under this approach, the best option would not be to report the parent to Child Protection Services but also advise her against it since it causes suffering for the child. This is because only the outcomes are considered and the outcome, in this case, would be that the child and the mother would suffer should the CPS take him away from her.
With the Virtue approach, the decision is made while considering our virtuous qualities, or our ‘higher selves’. The case in this model would need to consider whether the mother’s therapy is valuable to the boy. Since I would not recommend that treatment, the right thing to do would be to call the CPS, because the mother’s actions are detrimental to the child’s wellbeing.
Using the justice approach, the main consideration would be the benefit of all the parties in the case. Based on this approach, it would be unfair to turn the mother into the CPS, since she is not treating her child differently but fairly and according to the dictates of her culture. The common good approach is concerned with the outcomes of action on the common good of the stakeholders or community. This approach vouches for stability and using this model, then the mother should not be turned because that would disrupt the welfare of her life as well as her child’s.
The rights approach focuses on our ability to choose freely and respect other people’s choices. Under this model, I would respect the mother’s cultural practices and not question what she is doing to her child since that is infringing. Additionally, the parent assumes responsibility for the child till he is an adult with the right to choose ( Diekema, 2019 ).
I think the best course of action would be to desist from reporting the mother. However, I would also advise her against it since it harms the child rather than alleviate pain. I feel this is the best approach since reporting the mother would not only be risking her child, it would also destroy her confidence in physicians and hospital care ( Stanford, 2019 ). This may mean that she would need to continue her cultural practices to alleviate pain in the future.
In the second case, an asthmatic patient is brought in by his mother during an attack. The patient lacks medical insurance due to his parent’s financial position. The situation becomes even more concerning when they report to the hospital with the same condition. The main challenge, in this case, is determining what step should be taken in light of this information. This is because of the asthmatic condition which may mean that the parent might be surprised by a situation that would need a lot of finances.
Using the utilitarian approach, I would not suggest that the mother should enroll in an insurance plan. This is because this model is concerned with the consequences and if the parent is more comfortable with out-of-pocket payments, they should not increase their financial burden. The virtue approach seeks the best alternative according to our highest values. Using the justice approach, I would go for the fairest alternative. Using this model I would not propose enrolling in an insurance program since this would further stretch the parents’ finances. Considering the rights approach, the parent’s payment decision should be respected and I would not suggest enrolling for a cover program ( Stanford, 2019 ). The common good model would suggest that the parents enroll in an insurance program since the insurance would offer better conditions for all the stakeholders themselves included.
I would take the common good approach and suggest that the child and the parents would enjoy better peace of mind considering the repetitiveness of the asthmatic attack. Additionally, the approach would be better for the treatment since the child would be able to access better quality care due to the cover (Trotochaud, 2006).
References
Trotochaud, K. (2006). Ethical issues and access to healthcare. Journal of Infusion Nursing , 29 (3), 165-171.
Diekema, D. (2019). Parental Decision Making | UW Department of Bioethics & Humanities. Retrieved 3 November 2019, from https://depts.washington.edu/bhdept/ethics-medicine/bioethics-topics/detail/72
SCU. (2019). A Framework for Ethical Decision Making. Retrieved 3 November 2019, from https://www.scu.edu/ethics/ethics-resources/ethical-decision-making/a-framework-for-ethical-decision-making/
Stanford. (2019). Medical Ethics 101. Retrieved 3 November 2019, from http://web.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/EthicVoc.htm
