Personal Support workers are among the groups of individuals who are constantly faced with different ethical dilemmas. Without applying ideal problem-solving strategies, PSW may engage in activities that may lead to poor patient outcomes. During my placement, I came across an ethical dilemma that I believe will lay a foundation for improving my skills as a PSW. I will use the Gibbs Reflective cycle in evaluating my feelings and thoughts. The reflective cycle will also help me come up with an ideal action plan that would help me do things differently in case I come across a similar situation in the future. According to the professional code of conduct in healthcare, it is essential to maintain patient confidentiality (Scott, 2017). As a result, to fulfill this reflective exercise, the patient will be called “Naya.”
Naya is a 53-year-old African American lady who has been on chemotherapy for the past six months. Naya had been diagnosed with cervical cancer; as a result, chemotherapy was the only option of trying to prevent cancer from progressing to another stage. Before beginning the chemotherapy, all the possible options for its failure were discussed. However, Naya was positive that the treatment would work on her and agreed to start immediately. After the treatment was commenced, Naya stayed motivated and positive with life since she noted that soon she would be okay. Chemotherapy has various side effects, including nausea and vomiting, loss of appetite, mouth sores, and shortness of breath due to reduced red blood cells and tiredness. During the treatment process, Naya started developing some of the side effects, including fatigue. The emergence of such side effects indicated that Naya was not progressing well with the treatment hence the need to conduct further investigations.
While one of the nurses was talking to Naya, one of the physicians walked in and called me aside. The physician informed me that since Naya was not responding well to treatment, would it be possible to withhold this information since it would make her worried. However, since this was not my area of expertise, I explained to the physician that he should consult the nurse managing Naya’s situation. After the test results were back, I was established that Naya was not responding well to the chemotherapy. Although the physician knew the right thing to do, he colluded with the nurse handling Naya’s case to withhold this information.
Analysis
In healthcare settings, physicians are not encouraged to withhold information from a patient when they have their decision-making capabilities. However, physicians can withhold information in emergencies but reveal it to a patient once the emergency has been addressed (Scott, 2017). When communicating truthfully about a patient’s situation, it does not mean all information should be communicated immediately; instead, physicians can be communicated in bits until when all the sensitive information has been conveyed (Scott, 2017). Based on the stipulated ethical principles, I felt that the physician and the nurse were wrong by withholding Naya’s test results. Since Naya still had his decision-making capabilities, I felt that informing her about the prognosis would have helped create a suitable treatment plan. Assuming I was in Naya’s position, I am sure I would have wanted to know the progress after conducting the investigations. Since I am constantly involved in interacting with my patients, I would not have had peace interacting with Naya, knowing that some crucial information had been withheld from him. I felt that I needed to develop a good relationship with Naya to ensure that I knew what he wanted. Additionally, since cancer is a terminal illness, I felt that the physicians and nurses denied her the opportunity of making an informed decision concerning her end of life.
Naya’s case is complex and involves an array of ethical dilemmas. Healthcare providers are tasked with providing holistic care that would lead to positive outcomes. When analyzing the situation, I may have been too judgmental because I did not consider holistic approaches to providing care. When providing holistic care, healthcare providers need to ensure that they consider the psychological, emotional, and spiritual aspects of a patient. As a result, the physicians withholding information from Naya put into consideration the psychological and emotional effects that would have emerged after disclosing the information.
New Perspective
Patient autonomy is a crucial aspect that health care providers should always embrace. When patients can make their decisions, physicians should ensure that they give care based on a patient’s wishes (Kilbride & Joffe, (2018). Additionally, autonomous patients need to be told about their medical progress and the treatment options that would have improved their condition. However, when handling cancer cases, healthcare providers face ethical dilemmas regarding disclosing or withholding certain information from their patients. Personal Support workers are required to serve as patient advocates; as a result, it is their responsibility to collaborate with physicians and nurses in ensuring that everything is done correctly (Kilbride & Joffe, 2018). However, most terminally ill patients require reassurance and hope. As a result, giving them negative information about their progress may be heartbreaking, hence predisposing them to suffer from depression and other mental health illnesses.
In conclusion, assuming I encountered a similar situation in the future, I would have consulted different members to ensure that the correct thing was done. Additionally, embracing good communication and listening skills would have helped me understand the consequences of given actions. Since Naya’s case involves making end-of-life decisions, I would also withhold information from her. By doing this, I would give her hope to continue fighting for her life.
References
Kilbride, M. K., & Joffe, S. (2018). The new age of patient autonomy: implications for the patient-physician relationship. Jama, 320(19), 1973-1974.
Scott, P. A. (2017). Ethical principles in healthcare research. In Key Concepts and Issues in Nursing Ethics (pp. 191-205). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-319-49250-6_14.
