Ethical values are critical in the healthcare sector. They provide a practical rationale for identifying the actions that are highly valued. Ethics guide healthcare providers on how to conduct themselves and make sound judgments. However, healthcare providers still face ethical dilemmas that can conflict with their values or the code of ethics.
A Do Not Resuscitate (DNR) order states that CPR should not be performed on a patient. A Cardiopulmonary Resuscitation (CPR) is an emergency technique performed by either essential heart compressions and ventilation or the use of medicines (Vranick et al., 2020). The main objective of this technique is to preserve intact brain function before other medical procedures are taken to restore blood circulation. A DNR order gives a physician free and informed consent to refuse treatment in a situation where permission cannot be obtained. A patient can also appoint a surrogate to oversee the enforcement of their wishes.
The occurrence of ethical dilemmas in the workplace requires one to weigh interests and values against each other. Such circumstances require the use of different theories to judge such ethical dilemmas. For instance, utilitarianism examines the good consequences of an action while deontological theories determine if the action is either right or wrong, irrespective of the results. The theories are founded on the four nursing ethical principles: justice, autonomy, beneficence, and non-maleficence (Kaya & Boz, 2019). The suspension of a DNR order to suit a family’s wishes does not respect the patient’s autonomous decision. A DNR order provides an accurate reflection of the patient’s desires and hence should be respected. A physician should not dictate care but rather exercise the course of action as conveyed by the patient.
The American Nurses Association (2020) position statement on DNR provision 1.4 states that patients have the right to self-determination and recognition of specific rights. The statement further outlines that a patient has the right to refuse or terminate treatment. Thus, physicians have the ethical obligation to uphold a patient’s decision even if it violates other ethical principles such as non-maleficence and beneficence.
Consolidation of guidelines in the clinical practice requires full participation from the healthcare stakeholders. There is a need to have ethical discourse for the development of ethical competence in the medical field. Additionally, healthcare providers should ensure that their actions reflect ethical considerations by adhering to clinical guidelines.
References
American Nurses Association. 2020. Nursing care and do not resuscitate (DNR) decisions. Revised position statement. Center for Ethics and Human Rights. https://www.nursingworld.org/~494a87/globalassets/practiceandpolicy/nursing-excellence/ana-position-statements/social-causes-and-health-care/nursing-care-and-do-not-resuscitate-dnr-decisions-final-nursingworld.pdf
Kaya, A., & Boz, İ. (2019). The development of the professional values model in nursing. Nursing Ethics, 26(3), 914-923.
Vranick, J., Sanghavi, D., Torp, K. D., & Stanton, M. (2020). Do Not Resuscitate. StatPearls [Internet].
Response
It is pretty common to see expedited care provided to a VIP at the expense of other patients. One typical instance is jumping the queue or preferential treatment that is different from what an average patient would receive. Patients might face undesired consequences such as restricted and controlled access to certain areas of the medical facility. VIP preferential treatment compromises the quality of care and violates ethical principles such as fairness and social justice. Medical treatment should be prioritized based on a first-come, first-served basis or the severity of the illness.
The notion that a patient’s social status will significantly impact a medical facility is often farfetched and misguided. Hence hospital administrators should stop systematic prioritization of VIPS and focus on providing equal treatment. Additionally, the healthcare system is already flooded with disparities, and VIP preferential treatment will burden the healthcare system.
