Healthcare Values & Ethics: Course of Action 1 - Follow Bashir's Wishes

University of Washington Paradigm Template
Using the scenario, complete the four template pages for each of the following courses of action:
* course of action 1: Follow Bashir’s wishes (page 2)
* course of action 2: Refuse to follow Bashir’s wishes (page 6)
* course of action 3: Briefly delay the decision to gather additional information and other perspectives (page 10)
Answer the questions in complete sentences. If a question is not applicable for a given course of action, explain why it is not applicable, using complete sentences.
Note: The completed “University of Washington Paradigm Template” should be included as an attachment to your task submission rather than in the body of the essay itself.
Course of Action 1: Follow Bashir’s Wishes
right13335MEDICAL INDICATIONSThe Principles of Beneficence and NonmaleficenceWhat is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal? The problem of Jamilah is chronic. To support this it has been stated in the scenario she has chronic obstructive pulmonary disease and chronic adult onset diabetes mellitus. It has also been stated that she has been in the care facility since her husband died meaning the problem has been there for quite some time. The problem of Jamilah is also acute and emergent because if she receives no medical care she is likely to die.What are the goals of treatment? The goals of treatment are to cure the patient from the disease he or she is ailing from and also to relieve pain caused by some diseases so that they can live a normal life.In what circumstances are medical treatments not indicated? The medical treatments are sometimes not indicated to prevent the harm they would cause the patient for example children with viral infections should not be provided with aspirin due to the danger of Reye’s syndrome.What are the probabilities of success of various treatment options? The probability of success of various treatment options is always high because the healthcare providers thoroughly analyze the options and they always settle on the best treatment. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided? Jamilah will benefit from medical care because she will probably not succumb to her illnesses because care will be administered. 00MEDICAL INDICATIONSThe Principles of Beneficence and NonmaleficenceWhat is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal? The problem of Jamilah is chronic. To support this it has been stated in the scenario she has chronic obstructive pulmonary disease and chronic adult onset diabetes mellitus. It has also been stated that she has been in the care facility since her husband died meaning the problem has been there for quite some time. The problem of Jamilah is also acute and emergent because if she receives no medical care she is likely to die.What are the goals of treatment? The goals of treatment are to cure the patient from the disease he or she is ailing from and also to relieve pain caused by some diseases so that they can live a normal life.In what circumstances are medical treatments not indicated? The medical treatments are sometimes not indicated to prevent the harm they would cause the patient for example children with viral infections should not be provided with aspirin due to the danger of Reye’s syndrome.What are the probabilities of success of various treatment options? The probability of success of various treatment options is always high because the healthcare providers thoroughly analyze the options and they always settle on the best treatment. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided? Jamilah will benefit from medical care because she will probably not succumb to her illnesses because care will be administered.
left8890PATIENT PREFERENCESThe Principle of Respect for AutonomyHas the patient been informed of benefits and risks, understood this information, and given consent? The question is not applicable because Jamilah was not informed of any medical treatment benefits and risks, as she was not supposed to receive any treatment. Is the patient mentally capable and legally competent, and is there evidence of incapacity? Jamilah is mentally and legally competent however, there is an evidence of incapacity because she cannot be able to communicate appropriately.If mentally capable, what preferences about treatment is the patient stating? The question is not applicable for the course of action because Jamilah did not tell anyone the specific medical treatment she would prefer. If incapacitated, has the patient expressed prior preferences? The question is not applicable for the course of action because earlier Jamilah had only stated she needed help but she was not specific about the kind of treatment she wanted. Who is the appropriate surrogate to make decisions for the incapacitated patient? The appropriate surrogate to make the decisions for Jamila is her eldest son and not Bashir. Is the patient unwilling or unable to cooperate with medical treatment? If so, why? Jamilah is not unwilling to cooperate with medical treatment because she had earlier declared that she needed help because she desired to stay alive. 00PATIENT PREFERENCESThe Principle of Respect for AutonomyHas the patient been informed of benefits and risks, understood this information, and given consent? The question is not applicable because Jamilah was not informed of any medical treatment benefits and risks, as she was not supposed to receive any treatment. Is the patient mentally capable and legally competent, and is there evidence of incapacity? Jamilah is mentally and legally competent however, there is an evidence of incapacity because she cannot be able to communicate appropriately.If mentally capable, what preferences about treatment is the patient stating? The question is not applicable for the course of action because Jamilah did not tell anyone the specific medical treatment she would prefer. If incapacitated, has the patient expressed prior preferences? The question is not applicable for the course of action because earlier Jamilah had only stated she needed help but she was not specific about the kind of treatment she wanted. Who is the appropriate surrogate to make decisions for the incapacitated patient? The appropriate surrogate to make the decisions for Jamila is her eldest son and not Bashir. Is the patient unwilling or unable to cooperate with medical treatment? If so, why? Jamilah is not unwilling to cooperate with medical treatment because she had earlier declared that she needed help because she desired to stay alive.
left10160QUALITY OF LIFEThe Principles of Beneficence, Nonmaleficence, and Respect for AutonomyWhat are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds? According to Jamilah she hopes that she will receive treatment so that she can continue living a normal life and that she can no longer experience the pain she was feeling. The question on the physical mental and social deficits the patient might experience even if treatment succeeds is not applicable for the course of action because Jamilah would receive any medical treatment.On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment? One can judge that some quality of life would be undesirable for a patient who cannot express such a judgment when they realize that the patient state of health will not improve but rather it will deteriorate.Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life? Examples of biases that might prejudice the providers evaluation of the patients quality of life include age, ethnicity, and gender identity.What ethical issues arise concerning improving or enhancing a patient’s quality of life? Some ethical issues that arise concerning improving or enhancing a patient’s quality of life include conflicts between the relatives of the patient and the health care provider whereby the relatives of the patients claim that the quality of life of the patient is desirable and therefore no need for its enhancement or improvement. However, the health care provider is suggesting for an improvement because the quality of life is not desirable.Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment? When the quality of life of an individual is assessed and it established that it is undesirable change in treatment plans such as forgoing life-sustaining treatment can take place because in some cases it is assumed that the life sustaining treatment has adverse effects that are making the quality of life of the patient undesirable.What are plans and rationale to forgo life-sustaining treatment? The goals behind forgoing a life sustaining treatment in some cases is to cut on costs because even though the treatment will be administered the patient will eventually die and to also reduce the effects the long sustaining treatment maybe causing. The action is justifiable because there is no need of going on with the medical treatment and high medical expenses be incurred and the patient will eventually die. What is the legal and ethical status of suicide? It is illegal to commit suicide as it considered a sin and those who attempt suicide are jailed. Suicide is considered wrong and health care providers have the obligation of ensuring that a patient does not commit suicide. The health care providers should not sacrifice beneficence for autonomy. 00QUALITY OF LIFEThe Principles of Beneficence, Nonmaleficence, and Respect for AutonomyWhat are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds? According to Jamilah she hopes that she will receive treatment so that she can continue living a normal life and that she can no longer experience the pain she was feeling. The question on the physical mental and social deficits the patient might experience even if treatment succeeds is not applicable for the course of action because Jamilah would receive any medical treatment.On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment? One can judge that some quality of life would be undesirable for a patient who cannot express such a judgment when they realize that the patient state of health will not improve but rather it will deteriorate.Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life? Examples of biases that might prejudice the providers evaluation of the patients quality of life include age, ethnicity, and gender identity.What ethical issues arise concerning improving or enhancing a patient’s quality of life? Some ethical issues that arise concerning improving or enhancing a patient’s quality of life include conflicts between the relatives of the patient and the health care provider whereby the relatives of the patients claim that the quality of life of the patient is desirable and therefore no need for its enhancement or improvement. However, the health care provider is suggesting for an improvement because the quality of life is not desirable.Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment? When the quality of life of an individual is assessed and it established that it is undesirable change in treatment plans such as forgoing life-sustaining treatment can take place because in some cases it is assumed that the life sustaining treatment has adverse effects that are making the quality of life of the patient undesirable.What are plans and rationale to forgo life-sustaining treatment? The goals behind forgoing a life sustaining treatment in some cases is to cut on costs because even though the treatment will be administered the patient will eventually die and to also reduce the effects the long sustaining treatment maybe causing. The action is justifiable because there is no need of going on with the medical treatment and high medical expenses be incurred and the patient will eventually die. What is the legal and ethical status of suicide? It is illegal to commit suicide as it considered a sin and those who attempt suicide are jailed. Suicide is considered wrong and health care providers have the obligation of ensuring that a patient does not commit suicide. The health care providers should not sacrifice beneficence for autonomy.
8572557150CONTEXTUAL FEATURESThe Principles of Justice and FairnessAre there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients? Business interests might create a conflict of interest in the clinical treatment of patients because the clinical setting maybe concerned about making high profits and therefore recommend a treatment that is expensive but the patients argue that that is not fair to them because the treatment will not be affordable.Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions? Family members of the patients have interests in the clinical decisions because in most cases the family members are the most concerned parties about the welfare of the patient.What are the limits imposed on patient confidentiality by the legitimate interests of third parties? Limits imposed on patient confidentiality by the legitimate interests of third parties include disclosure of the sensitive personal information of the patients whereby the information is needed for an important decision need to be made.Are there financial factors that create conflicts of interest in clinical decisions? The presence of financial factors for example in the case where a clinical setting wants to make high profits after a medical treatment and the patient want to pay as little amount as possible because they do not have enough financial resources creates conflicts of interest because every party want a decision that will benefit them. Are there problems of allocation of scarce health resources that might affect clinical decisions? Problems of allocation of scarce health resources in clinical settings might impact clinical decisions because the health care providers must ensure that they do not go against the principle of justice that state equal distribution of resources even though the resources are scarce. Are there religious issues that might affect clinical decisions? Some religious issues might impact clinical decisions. For example, when a patient believes that it is unreligious to take medicine, the health care provider may find it difficult to make a decision. The health care provider may find it difficult to make a decision because they know the medicines will be of benefit to the patient but he does want to coerce the patient into making a particular decision because he would be going against the principle of respect for autonomy. What are the legal issues that might affect clinical decisions? Legal issues that might affect clinical decisions include HIPAA and data breaches, antitrust issues and ACOs and co management arrangements.Are there considerations of clinical research and education that might affect clinical decisions? Considerations of clinical research and education influence the clinical decisions by making the clinical decisions more effective because they will act as sources of knowledge that will be used in finding solutions to clinical problems. Are there issues of public health and safety that affect clinical decisions? Issues of public health and safety that influence clinical decisions include workplace temperatures and staffing levels.Are there conflicts of interest within institutions or organizations (e.g. hospitals) that may affect clinical decisions and patient welfare? An example of a conflict of interest within hospitals that may affect clinical decisions and patients’ welfare include organization charging high prices for the care they providing to the patients. The decision will however not be favorable to the patients and therefore they will raise questions because most of them find it very difficult to pay for even the very little charged prices. 00CONTEXTUAL FEATURESThe Principles of Justice and FairnessAre there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients? Business interests might create a conflict of interest in the clinical treatment of patients because the clinical setting maybe concerned about making high profits and therefore recommend a treatment that is expensive but the patients argue that that is not fair to them because the treatment will not be affordable.Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions? Family members of the patients have interests in the clinical decisions because in most cases the family members are the most concerned parties about the welfare of the patient.What are the limits imposed on patient confidentiality by the legitimate interests of third parties? Limits imposed on patient confidentiality by the legitimate interests of third parties include disclosure of the sensitive personal information of the patients whereby the information is needed for an important decision need to be made.Are there financial factors that create conflicts of interest in clinical decisions? The presence of financial factors for example in the case where a clinical setting wants to make high profits after a medical treatment and the patient want to pay as little amount as possible because they do not have enough financial resources creates conflicts of interest because every party want a decision that will benefit them. Are there problems of allocation of scarce health resources that might affect clinical decisions? Problems of allocation of scarce health resources in clinical settings might impact clinical decisions because the health care providers must ensure that they do not go against the principle of justice that state equal distribution of resources even though the resources are scarce. Are there religious issues that might affect clinical decisions? Some religious issues might impact clinical decisions. For example, when a patient believes that it is unreligious to take medicine, the health care provider may find it difficult to make a decision. The health care provider may find it difficult to make a decision because they know the medicines will be of benefit to the patient but he does want to coerce the patient into making a particular decision because he would be going against the principle of respect for autonomy. What are the legal issues that might affect clinical decisions? Legal issues that might affect clinical decisions include HIPAA and data breaches, antitrust issues and ACOs and co management arrangements.Are there considerations of clinical research and education that might affect clinical decisions? Considerations of clinical research and education influence the clinical decisions by making the clinical decisions more effective because they will act as sources of knowledge that will be used in finding solutions to clinical problems. Are there issues of public health and safety that affect clinical decisions? Issues of public health and safety that influence clinical decisions include workplace temperatures and staffing levels.Are there conflicts of interest within institutions or organizations (e.g. hospitals) that may affect clinical decisions and patient welfare? An example of a conflict of interest within hospitals that may affect clinical decisions and patients’ welfare include organization charging high prices for the care they providing to the patients. The decision will however not be favorable to the patients and therefore they will raise questions because most of them find it very difficult to pay for even the very little charged prices.
Course of Action 2: Refuse to Follow Bashir’s Wishes
right13335MEDICAL INDICATIONSThe Principles of Beneficence and NonmaleficenceWhat is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal? The problem of Jamilah is chronic. To support this it has been stated in the scenario she has chronic obstructive pulmonary disease and chronic adult onset diabetes mellitus. It has also been stated that she has been in the care facility since her husband died meaning the problem has been there for quite some time. The problem of Jamilah is also acute and emergent because if she receives no medical care she is likely to die.What are the goals of treatment? The goals of treatment include curing someone from a specific disease and preventing someone from further complications.In what circumstances are medical treatments not indicated? Medical treatments are not always indicated in cases where they can cause further complications What are the probabilities of success of various treatment options? The probability of success of various treatment options is not always certain because some treatments work and others do not work.In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided? Jamilah will benefit from medical care by being cured from her illnesses and therefore she will be able to live a normal and she will not die. Harm can be avoided by failing to follow Bashir’s wishes where it will become feasible for her to be provided with medical care 00MEDICAL INDICATIONSThe Principles of Beneficence and NonmaleficenceWhat is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal? The problem of Jamilah is chronic. To support this it has been stated in the scenario she has chronic obstructive pulmonary disease and chronic adult onset diabetes mellitus. It has also been stated that she has been in the care facility since her husband died meaning the problem has been there for quite some time. The problem of Jamilah is also acute ...