The identified case involves a patient who has a “Do Not Resuscitate” tattoo. The 70-year old individual has a history of atrial fibrillation, diabetes mellitus, and obstructive pulmonary disease. The efforts practitioners undertook to increase his consciousness level were unsuccessful, thereby being unable to engage in meaningful discussions regarding the most appropriate health practices to meet his needs. This paper examines and addresses this ethical dilemma using the principles and process of ethical decision-making.
Applying the Principles of Ethical Decision-Making
The professionals providing medical support to the presented patient had to make complex choices in an attempt to meet his needs. Unfortunately, the individual was incapacitated and incapable of engaging in meaningful discussions. This situation explains why the practitioners initially pursued the “principle of not choosing an irreversible path when faced with uncertainty” (Holt, Sarmento, Kett, & Goodman, 2017, p. 2192). With this kind of understanding, the practitioners chose to ignore the tattoo and identify evidence-based approaches to address the patient’s medical demands.
The second principle discussed in the presented case study is that of authentic preference. Although there were inadequate laws and policies capable of supporting the concept of patient-centered care, the ethics consultant proposed that there was a need for the team to respect the man’s interests and expectations. The DNR order obtained from the Florida Department of Health was following the individual’s tattoo. However, past literature revealed that there was a specific case whereby the person’s DNR tattoo was not a reflection of his current expectations (Holt et al., 2017). These aspects explain why the issue presents a major ethical dilemma for clinicians, policymakers, and family members.
With these aspects, practitioners can consider the above two principles and go further to examine issues of unfounded beliefs and legality. This means that they will embrace the irreversible path when a patient uses a tattoo to convey a specific message. They can also focus on authentic preference and involve different stakeholders before making the final decision (Utkualp, 2015). This case also supports the importance of informed consent and pursuing what is ethically and legally right.
This case becomes a powerful model that clinicians and medical professionals should always consider whenever they encounter similar dilemmas. I would have examined several issues before identifying the best approach to meet this patient’s health needs (Zubović, 2018). The most important thing is to focus on the issues discussed below.
Dimensions of Ethical Dilemma
The nature of the presented case indicates that there are specific dimensions that medical experts should take into consideration. The first one is that of professional practice. Caregivers and clinicians should use their competencies to do what is right and maximize the health outcomes of the identified patient (Zubović, 2018). They should also pursue the ideologies of informed consent and autonomy. The second dimension is that of institutional practices.
The specific facility has guidelines and frameworks for ensuring that ethical issues received evidence-based solutions (Holt et al., 2017). This case means that the consultation team will be involved to provide the best insights. The third one is that of local and political interface whereby practitioners will focus on the outlined guidelines and cultural aspects of the people before making the most appropriate decision. The outcome is that those involved will have to monitor the rights and expectations of the individual.
As a practitioner addressing this case, it would be necessary to consider or consult various organizational policies. For instance, the existing code of ethics will guide professionals to address specific issues associated with various ethical dilemmas. The caregiver will identify the presented approaches for providing support to persons who are unable to make meaningful decisions or be part of the process. Another issue to consider is the role of consultancy when faced with complex scenarios (Utkualp, 2015). The involvement of leaders and team members can ensure that meaningful decisions are made. The ultimate objective is to provide superior medical services to the patient while at the same time supporting his needs. The best action plan is to obey the individual’s DNR tattoo.
These core health care ethical principles are essential whenever planning to address dilemmas in medical practice: justice, benevolence, nonmaleficence, and autonomy. The idea of justice guides practitioners to treat others properly and equally. The principle of nonmaleficence guides experts to not harm their patients whenever providing medical services. The concept of benevolence empowers practitioners to provide services that will benefit the identified individual (Utkualp, 2015). Autonomy is a situation whereby individuals should be free to make their unique choices. These attributes will guide me throughout the ethical decision-making process.
With these principles, caregivers will have to put the rights and needs of the patient first. Since the individual is not in a stable state, it can be necessary to involve family members or relatives. There is a need to consult the patient’s past medical reports to examine if his current needs resonate with the DNR tattoo. The next strategy is doing what is right in an equal and fair manner (Zubović, 2018). The involvement of different stakeholders and consultants can ensure that appropriate decisions are made to address this ethical dilemma.
Ethical Decision-Making Process
With the above concepts and ideas, it can be possible to offer evidence-based guidelines for guiding the clinical staff in this scenario to make an ethical decision and meet the unique health demands of this patient. The first phase of the model will entail gathering all information and facts (Holt et al., 2017). The members of staff can consult family members, examine past medical records, and monitor the patient’s documented wishes. The second phase is predicting the most probable decision or outcome. The team will consider the needs of this patient and the best approaches to fulfill them.
The third stage is that of making informed consultations. During this phase, the group members can consider their feelings and philosophies to inform the most appropriate action plan. The fourth stage is monitoring and ascertaining the appropriateness of the decision. With these steps, the clinical staff will identify the needs of the patient, consult documented materials, and focus on the individual’s wishes. Since this is an ethical issue, the most important thing is to protect the patient’s rights while at the same not harm him (Holt et al., 2017). The team will ensure that the tattoo becomes a guiding factor to address this individual’s health needs.
The above discussion has revealed that medical practitioners encounter difficult situations that call for evidence-based decision-making approaches. The studied case can guide health professionals to consider the role of the principles of health care and the process of ethical decision-making to deliver exemplary medical support to different patients. Such aspects will empower them to consider the rights, expectations, and needs of people with similar tattoos.
Holt, G. E., Sarmento, B., Kett, D., & Goodman, K. W. (2017). An unconscious patient with a DNR tattoo. The New England Journal of Medicine, 377, 2192-2193. Web.
Utkualp, N. (2015). Ethical issues and dilemmas encountered in nursing practice in Turkey. International Journal of Caring Sciences, 8(3), 830-836.
Zubović, S. (2018). Ethical dilemmas of nurses and physicians in the primary health care setting. Hospice & Palliative Medicine International Journal, 2(5), 280-284. Web.