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Ethics 5

A Hispanic man was injured and found to be HIV positive. He wanted his sister's nursing care but did not want her to know his status due to stigma. The doctor must decide whether to maintain confidentiality or warn the sister of infection risk, balancing patient privacy versus the sister's health.

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Jason Roel Llena
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45 views6 pages

Ethics 5

A Hispanic man was injured and found to be HIV positive. He wanted his sister's nursing care but did not want her to know his status due to stigma. The doctor must decide whether to maintain confidentiality or warn the sister of infection risk, balancing patient privacy versus the sister's health.

Uploaded by

Jason Roel Llena
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Reason and Impartiality as requirements for Ethics

What is Reason?

 Reasoning is the ability to think clearly, understand events, and make sound
conclusions. In ethics, a rational approach guarantees that ethical decisions are
sound, intelligent, and consistent with ethical ideals.
 Reason encourages people to critically assess ethical dilemmas, consider
multiple points of view, and weigh the implications of various acts. This aids in
avoiding impulsive or emotionally charged decisions.
 Reason enables ethical standards to be applied globally. Ethical decisions based
on reason are not arbitrary or subjective; they can be justified and communicated
to others, promoting understanding and agreement.

What is Impartiality?

 Impartiality entails treating all individuals or parties equally and objectively. It


promotes the idea that everyone should be treated equally in ethical decision-
making, regardless of personal preferences, relationships, or affiliations.
 An unbiased approach takes into account the interests and well-being of all
stakeholders involved. It helps to prevent favoritism and ensures that judgments
are based on a commitment to justice and fairness.
 Impartiality is related to objectivity. Ethical decisions should not be influenced by
personal emotions, prejudices, or other influences. An impartial posture facilitates
objective appraisal of ethical quandaries. Morality necessitates an impartial
assessment of each individual's interests. For example, being partial to friends is
not morally acceptable.

Models in Ethical Decision Making


Seven Step-wise Model of Scott Rae (2009)

1. Determine the facts:


Gather Information: Obtain all essential information and facts about the ethical
issue. Make sure you have a complete understanding of the problem.
Clarify Assumptions: Identify any assumptions that may be impacting your
interpretation of the data. Examine and verify these assumptions.

2. Identify the problem.


Description: Clearly state and describe the ethical issue or dilemma you're
dealing with. Determine the essential aspects and factors involved.
Rationale: Understanding the problem is the first step toward finding a solution.
This entails understanding the ethical implications of the issue.

3. Define the ethical issues.


List Ethical Questions: Explain the ethical issues highlighted by the situation.
Determine the moral principles and values that are in tension or conflict.
Consider Perspectives: Recognize various perspectives on the ethical issues at
hand, taking into account multiple viewpoints.

4. Identify the stakeholders.


List Key Stakeholders: Identify all individuals or groups who have an interest in
the outcome of the ethical issue. Consider how the decision may affect each
stakeholder.
Rank Stakeholders: Determine the relevance of each stakeholder's interests and
rank them accordingly.

5. Consider Options:
Alternatives: Brainstorm and outline potential courses of action to address the
ethical challenges. Consider the short- and long-term repercussions.
Evaluate Consequences: Consider the potential l good and negative
outcomes of each action. Consider how each choice is consistent with ethical
standards.

6. Make a decision:
Apply Ethical Principles: Select the option that is best consistent with ethical
principles and values. Consider how this decision reflects Christian principles.
Justify Decision: Explain the reasoning for your decision, including how it
matches with ethical issues.

7. Implement the decision:


Create an Action Plan: Outline the steps needed to carry out the chosen option.
Consider the practical aspects of putting your decision into action.
Monitor and Evaluate: Continuously examine the decision's impact and make any
revisions. Consider the ethical approach for future learning.
Example Situation

A twenty-year-old Hispanic male was brought to a hospital emergency room,


having suffered abdominal injuries due to gunshot wounds obtained in gang
violence. He had no medical insurance, and his stay in the hospital was somewhat
shorter than expected due to his good recovery. Physicians attending to him felt that
he could complete his recovery at home just as easily as in the hospital and he was
released after only a few days in the hospital.

During his stay in the hospital, the patient admitted to his primary physician
that he was HIV positive, having contracted the virus that causes AIDS. This
was
confirmed by a blood test administered while he was hospitalized. When he was
discharged from the hospital, the physician recommended that a professional nurse
visit him regularly at home in order to change the bandages on his still substantial
wounds and to insure that an infection did not develop.

Since he had no health insurance he was dependent on Medicaid, a


government program that pays for necessary medical care for those who cannot
afford it. However, Medicaid refused to pay for home nursing care since there was
someone already in the home who was capable of providing the necessary care.
That person was the patient's twenty-two-year-old sister, who was willing to take
care of her brother until he was fully recovered. Their mother had died years ago and
the sister was accustomed to providing care for her younger siblings
A twenty-year-old Hispanic male was brought to a hospital emergency room, having
suffered abdominal injuries due to gunshot wounds obtained in gang violence. He had
no medical insurance, and his stay in the hospital was somewhat shorter than expected
due to his good recovery. Physicians attending to him felt that he could complete his
recovery at home just as easily as in the hospital and he was released after only a few
days in the hospital.

During his stay in the hospital, the patient admitted to his primary physician that he was
HIV positive, having contracted the virus that causes AIDS. This was confirmed by a
blood test administered while he was hospitalized. When he was discharged from the
hospital, the physician recommended that a professional nurse visit him regularly at
home in order to change the bandages on his still substantial wounds and to insure that
an infection did not develop.

Since he had no health insurance he was dependent on Medicaid, a government


program that pays for necessary medical care for those who cannot afford it. However,
Medicaid refused to pay for home nursing care since there was someone already in the
home who was capable of providing the necessary care. That person was the patient's
twenty-two-year-old sister, who was willing to take care of her brother until he was fully
recovered. Their mother had died years ago and the sister was accustomed to providing
care for her younger siblings

The patient had no objection to his sister providing this care, but he insisted that she not
be told that he had tested HIV positive. Though he had always had a good relationship
with his sister, she did not know that he was an active homosexual. His even greater
fear was that his father would hear of his homosexual orientation and lifestyle.
Homosexuality is generally looked upon with extreme disfavor among Hispanics.

The patient's physician is bound by his code of ethics that places a very high priority on
keeping confidentiality. That is, information about someone's medical condition that he
or she does not want known cannot be divulged by the physician. Some would argue
that the responsibility of confidentiality is even greater with HIV/AIDS since disclosure of
someone's homosexuality normally carries devastating personal consequences for the
individual who is forced "out of the closet."

On the other hand, the patient's sister is putting herself at risk by providing nursing care
for him. Doesn't she have a right to know the risks to which she is subjecting herself,
especially since she willingly volunteered to take care of her brother?

If you were the physician, what would you do in this case? Would you breach the norm
of confidentiality to protect the patient's sister, or would you keep confidentiality in order
to protect the patient from harm that would come to him from his other family members,
especially his father?

Gather the Facts:

 A guy suffering a gunshot wound


 Recovered well so he was sent home
 He confessed to the doctor that he has HIV/AIDS
 He insist that his HIV/AIDS remain confidential
 Being gay/homosexual is frowned upon in Hispanic Cultures
 He is afraid that his fellow gang members will harm him after knowing his sexual
orientation
 Since he is poor and has no insurance, he is using Medicaid, a healthcare
service, but it refuses to pay for him a professional nursing care
 He is okay with this because his sister is already accustomed to taking care of
her little brothers
 The patient does not want his sister to know that he is HIV positive and a
homosexual
 The patient’s sister is at risk of being infected of HIV as she is going to be in
contact with his wounds as well as his blood when she is changing the
bandages.

Identify the Problem

 Should you respect the wish of the patient to confidentiality or should you warn
the patient’s sister about the possible risk of infection to HIV?
 This is a problem between patient confidentiality vs. the right to know of a patient
to possible infection.

Define Ethical Issues

 The ethical issues in this problem are all about the duty of a medical practitioner
to be compassionate. The problem however is who should you be
compassionate to? The patient or the patient’s sister?
 The patient’s side is all about confidentiality because of the compassion to help
him hide from the possible effects of his homosexuality being revealed and the
patient’s sister’s side is all about the compassion or duty to warn someone of
imminent or severe harm

Identify the Stakeholders

 The 1st stakeholder here is the patient. When you reveal his secret, he might be
targeted by the gang members and killed.
 The 2nd stakeholder is the patient’s sister, if you do not reveal the secret, she
might be infected with HIV.

Consider Options:

 1st option is to uphold confidentiality


 2nd option is to violate confidentiality and let the sister know of the possible risk.
 3rd option is to generally warn the sister about possible infections (e.g. wear
gloves, use masks, etc.)
 4th option is to make the patient tell the sister himself about the HIV and ask her
to keep it a secret. If he refuse, tell the patient that you will tell the sister yourself.
Make a Decision

 Make a decision no matter how uncomfortable.

Implement the Decision

 Carry out the decision.

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