Cancer Patient Treatment Ethical Dilemma

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ethical dilemma
31.08.2023
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In the medical profession, there are work-related scenarios that create paradoxes that cannot be easily solved through ethical means. Ethics is a code of morals governing a particular career, while ethical reasoning refers to a professional’s ability to solve ethical issues through rationalization while carrying out their day-to-day duties (Dutelle & Taylor, 2018; Navari, 2013). Therefore, an ethical dilemma is a conflict between moral imperatives, and neither of the two is acceptable from an ethical standpoint but can be solved using ethical reasoning to produce an optimal solution. Although ethical dilemmas contain no clear resolution, the underlying philosophical principles guiding the moral and ethical reflections that aid in making a decision are the same (Smeltzer, Bare, Hinkle, & Cheever, 2010). In resolving ethical dilemmas, the identification of moral, ethical, and legal values enables a person to create and apply an ethical decision-making model (Allen, 2012). The values that guide a professional is crucial in solving an ethical dilemma, and the framework and model selected not only validate the end result but also defend and justify a position in moral reasoning.

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Values

Values are ideals that an individual feels their worth and aspires to achieve (Dolgoff, Lowenberg, & Harrington, 2009). It is essential that personal values align with the professional conduct that guides a person’s career (Allen, 2012). Therefore, the values that govern an individual’s perception should not conflict with the professional outlook and ideologies, and they should also correspond with the ethical considerations guiding a profession. In resolving a dilemma in the medical field, the value-based concepts of non-maleficence (not doing any harm), beneficence (aiming at doing good), veracity, justice, fidelity, and autonomy need to be applied (Smeltzer et al., 2010). Conclusively, the professional and personal values amalgamate to form an ideology used in solving an ethical dilemma in the medical field.

Respecting Patient’s Autonomy

The concept of respecting a patient’s autonomy through the provision of information in an understandable manner, assessment of comprehension, and giving them the right to choose without manipulation or coercion is not only an ethical value but also a legal issue (Hall, Prochazka, & Fink, 2012). The judgment that results from a decision should be free from biases on a physician’s side while incorporating shared decision-making that depends on a patient’s comprehensibility, autonomy, and ability to insist on a particular way of handling their decision (Hall et al., 2012). Therefore, the ability to respect a patient’s decision is one of the guiding personal and professional values that should take precedence.

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Promoting the Patient’s Best Interest

Helping a patient in making the best-informed decision and supporting the choice in the medical field is essential in a physician-patient relationship. A patient’s care provider should help deliberate, make recommendations, and try to persuade to pursue the best course of action by utilizing the best available knowledge (Lo, 2015). Additionally, the medical practitioner should help a patient in clarifying whether to accept the natural course of their condition rather than the adverse effects associated with medical interventions or prevent the pending complication related to such decision (Lo, 2015). The ability to promote the best patient’s interest without taking their right to autonomy is a valuable value in a personal and professional setting.

Financial and Care Consequences

The value of empathy towards a person is crucial in not only understanding the struggles a patient is passing through and acting on reducing them, but it also expands perception by determining the best course of actions in ethical reasoning. One way to understand the case study is through examining the financial and care strain that may cause the terminally ill woman to consider halting medication. A patient’s decision to stop treatment, leading to earlier death, may occur due to the financial burden and medical care associated with terminally ill cancer patients. Firstly, the increased financial burden attributed to cancer care costs, including life extension drugs, is the most significant contributor to poor quality of life among the cancer patients (Fenn et al., 2014). The patient’s caregivers are prone to depression, and financial problems and lack of family support may lead to a deterioration in the patient’s quality of life (Song, 2011). Such factors may be one of the most significant contributors to her decision, and understanding of what the patient may be going through is a value crucial to a professional.

Ethical Decision-Making Model/ Framework

The dilemma involves a request made by a 41-year-old patient facing terminal breast cancer to forego further cancer treatment. In resolving a case study, there is a need to establish a theoretical model. An ethical model is a theoretical founded decision-making framework that integrates several perspectives from academic sources and relevant ethics literature (Ling & Hauck, 2016). The advantages of establishing the model include efficient decision-making, consistency in systematic outputs, emotional goodwill towards the participants, and self-respect emanating from making the right judgment. In the current study, the ethical decision-making framework is utilitarianism. It is one of the branches of normative ethics that expounds on the morality of actions as a framework for moral decisions and dilemmas (Driver, 2014). Utilitarianism concerns itself with maximizing the overall good to all involved persons.

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Ethical Dilemma Solution

As a moral model, utilitarianism examines and encourages the solution to incorporate the best outcome for all participants involved in the case. Firstly, if the treatment is withheld from the patient, the cancerous tumor would spread faster, hence resulting in the disease being the primary cause of her early death. However, a professional should respect the patient’s autonomy, with the understanding that she knows the consequence of such an action, and she believes that it would result in the best decision for her. In her view, she trusts that the outcome of withdrawing from the treatment is the greater good, even though she knows the full extent of her actions. Therefore, considering the law that requires an unbiased decision by the medical practitioner on the patient’s choice and also through promoting the patient’s best interest, the best course of action would be to adhere to her wishes.

Additionally, given the significant level of financial and care needed to sustain her, withdrawing her from medicine would produce the greatest good than prolonging her life further and resulting in a higher financial burden and adverse effect associated with caring for a terminally ill patient. Conclusively, the best course of action for the patient is adhering to her request in regard to the professional, legal, and ethical standpoint.

Conclusion

In resolving an ethical dilemma, the establishment of a particular framework helps in determining a pattern and justifies it even in times when the course of action is not apparent. Additionally, it also prevents a professional from making subjective decisions while helping in adhering to the ethics and regulations at the workplace. Resolving an ethical dilemma in a personal and professional capacity using a value-based system enables an individual to focus on a customer’s need in achieving a solution. Through using utilitarianism as an ethical model, it is clear that the best course of action is to adhere to the patient’s request, as it is the one that would produce the maximum good in this case. In resolving the ethical dilemma, the best course of action is to fulfill the woman’s request, as it would bring the greatest good to everyone involved.

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