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Lecture 1

HSAD 210 Lecture Notes - Lecture 1: Farjana, Findlaw, Ethical Dilemma

Health Services Administration
Course Code
HSAD 210
Chalmers C. Clark

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Farjana Nipa
Professor Chalmers C. Clark
15 February 2018
Ethical Reasoning projects-Evaluating Controversial Ethical Issues
Ethical issue:
You are working on a care of the elderly ward. Your patient, Martha, is an 89-year-old woman
who was admitted with a chest infection. You have so far been unsuccessful in your treatment
with antibiotics and the patient is now refusing any more antibiotics. You know that without
them the patient will most likely deteriorate and succumb the infection. What is the ethical
consideration here?
Defining terms
1. Autonomy- According to Lewis Vaughn autonomy is a “person’s rational capacity for
self-governing or self-determination” (9; ch. 1). This principal clarifies that a person has
the right to make their own healthcare decision. This case doesn’t clarify if Martha is
autonomous or not. However, if she is autonomous we have to make an ethical decision
whether to respect Martha’s decision, which is to stop taking antibiotics or do what we
think is best for Martha. If Martha is autonomous she has the right to refuse treatment
under the law of informed consent, which allows the patient to freely consent or decline
treatments and has the right to be informed about the information they need to make an
informed judgment about their healthcare (9; ch. 1). However, if Martha has family

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members and she is not autonomous we have to inform her family members about her
treatment but if she doesn’t under paternalism we can override her decision for her own
good (10; ch. 1).
2. Beneficence- Vaughn describes beneficence as a way to do good to other (10; ch.1). In
healthcare, the principle of beneficence is referred to doing good for clients. Beneficence
emphasis to do more than just avoid inflicting pain and suffering (10; ch. 1). In this
particular case, we want to avoid Martha health from deteriorating. Even though the
antibiotic isn't doing much but keeping her health from getting worse, it's still is a way of
trying to do good for the patient.
3. Nonmaleficence - Even though this principle doesn’t come much into conflict with this
case. It still should be taken into consideration. In this case, it would be trying to make an
ethical decision that would do any no unnecessary harm.
4. Justice- this is another principle that doesn’t come in conflict with this case but when
evaluating this case we have to keep in mind that we have to be fair with Martha and take
into account of the opinions and feelings of Martha's family members if she has any.
Ethical dilemma
The ethical dilemma may occur when two or more pillars of medical ethics are in conflict
with one another or when personal values come into conflict with professional practice. While
making an ethical decision regarding Martha's case we have to weigh both sides of the argument.
According to the doctors and nurses, Martha needs to have antibiotic to prevent her from any
unnecessary harm which refers to the principle of nonmaleficence. Doctors and nurses has the
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