Application of Ethical Principles Assignment 3

Shawna Coronel

Capella University

Developing a health care perspective

La Tonya Fore Williams

February, 2024
 Case Study: End-of-Life Care for a Minor

In this case study, Timothy Collins, a 16-year-old minor, has aggressive leukemia. The

treatment process has been complicated for Timothy, and a little bit of research has led him to

consider hospice care and discontinue treatment. On the contrary, his parents want to save his life

and have expressed their wishes to pursue new experimental treatments overseas. Dr. Angela

Foster, the oncologist, is at a crossroads and faced with the ethical dilemma of beneficence and

autonomy towards the patients and the conflicting wishes of the parents since Timothy is a

minor. This is a big issue for healthcare professionals since their decisions can shape healthcare

outcomes. Three parties are involved in this case. First, Timothy Collins, the minor patient who

wants to discontinue treatment and pursue hospice care. Second, the parents, Mr. Robert Collins

and Mrs. Lydia Collins, believe that their son can be cured through new overseas treatments. The

last party is Dr. Angela Foster, Timothy's oncologist, who must act in the patient's best interest.

Ethical Decision-Making Model

The ethical issues in the case study can be explored through moral awareness, moral

judgment, and ethical behavior. The oncologist understands the discord between Timothy's

autonomy and his parent's need for care. Autonomy is an ethical principle that supports a

patient’s rights to make medical decisions without influence from care providers or guardians

(Varkey, 2021). However, research has also indicated that healthcare professionals must disclose

treatment options or medical information to allow the patient to exercise self-determination in

the care process (Varkey, 2021). Dr. Foster recognizes the impact of Timothy's decision on Mr.

Robert Collins and Mrs. Lydia Collins's emotional agony and takes into account their need to

explore alternative treatment. The moral judgment arises when Dr. Foster is forced to weigh the

code of ethics of beneficence and the patient's autonomy while empathizing with his parent's
desire to save their only child. Lastly, ethical behavior involves Dr. Foster's ability to go through

the case by ensuring that she respects the patient's wishes in their care while also addressing the

needs and desires of parents. Therefore, the physician must integrate open communication,

transparency, and compassion while handling the case.

The ethical dilemma stems from Timothy's aggressive terminal illness, which has prompted

him to consider hospice care. The parents also escalate the problem and need to seek alternative

overseas treatment to cure their child, which goes against Timothy's wishes. Lastly, the physician

must accommodate and respect the wishes of Timothy and his parents. One of the main ethical

principles in nursing is beneficence, which requires physicians and other care workers to act in

the best interest of patients. Research has shown that efficient implementation of beneficence

leads to better health outcomes and promotes the well-being of patients (Cheraghi et al., 2023).

Thus, Dr. Foster has to prioritize the interests of the patients while navigating the ethical

dilemma. These factors complicate the case further.

Effectiveness of the Communication Approach

The primary effective communication strategies utilized by the healthcare professional in

the case study include transparency, open communication, and empathy. Dr. Foster was

transparent and communicated openly with Timothy and the parents regarding the illnesses. The

parties understood the illness's nature, the failure of current treatments, and alternative

treatments. The information was crucial in decision-making for both parties, indicating instances

where the professional communicated effectively. Dr. Foster should maintain transparency and

open communication, especially when addressing the conflict between Timothy and the parents

regarding their wishes for care. If the healthcare professional does not adhere to transparency and
open communication, it could breach patient autonomy and disregard patients' concerns,

negatively affecting the health outcome.

Effective Approach to Address Ethical Dilemma

The healthcare professional employed several actions to address the ethical dilemma. Dr.

Foster opted for effective discussions where all the parties expressed interest in the care process.

She emphasized open communication, respect, and empathy. Respect was crucial as it enabled

the health professional to recognize and acknowledge the patient's desire for hospice care.

Perspectives from parental figures or guardians in the cases of minors are sufficient, especially if

an individual is deemed incapable of making choices (Paron & Kutsar, 2023). Thus, the

professional applied empathy to understand the parents and address their concerns about seeking

new experimental treatments. As things stand in the case study, the health professional manages

the ethical dilemma by respecting Timothy's decision for hospice care but showing support and

empathy to the parents. Dr. Foster acted in the patient's best interest, which was demonstrated

through adherence to beneficence and autonomy. The case study emphasizes the need for

healthcare professionals to respect patient autonomy and beneficence. These ethical principles

ensure that physicians and other care providers work towards meeting people's interests. It is also

crucial to integrate open communication transparency and consider the interests of all parties

involved. This can help address conflicts and ensure the patient receives the best care.

Application to Ethical Principle

The healthcare professional respected the patient's autonomy. The best solution in this case

study is to facilitate a meeting with all the parties: Timothy, his parent, Dr. Foster, and other

healthcare professionals. The focus priority of the meeting would be to discuss crucial

information on Timothy's hospice care by addressing Timothy's preferences and the parents'
concerns. They can also discuss newer or alternative treatments and how they may be helpful in

Timothy's case. The approach largely makes the approach effective in building relationships

across the organization. It applies a patient-centered approach, which involves meeting the needs

of an individual and prioritizing quality care (Edgman-Levitan & Schoenbaum, 2021). Thus, the

professional can collaborate with the family and other care professionals like nurses, palliative

care specialists, or social workers. These working relationships can enhance trust and teamwork

throughout the organization. In addition, it promotes collaborative decision-making, open

communication, shared commitment, and mutual respect to provide quality care to Timothy. This

can lead to effective professional collaboration across the healthcare organization.

References

Cheraghi, R., Valizadeh, L., Zamanzadeh, V., Hassankhani, H., & Jafarzadeh, A. (2023).

Clarification of ethical principle of the beneficence in nursing care: an integrative

review. BMC nursing, 22(1), 1-9. https://doi.org/10.1186%2Fs12912-023-01246-4.

Edgman-Levitan, S., & Schoenbaum, S. C. (2021). Patient-centered care: achieving higher

quality by designing care through the patient’s eyes. Israel Journal of Health Policy

Research, 10, 1-5. https://doi.org/10.1186%2Fs13584-021-00459-9.

Paron, K., & Kutsar, D. (2023). Creation of child-patient’s autonomy in a

child-parent-doctor relationship: Medical doctors’ perspectives. Childhood, 30(2),

145-160. https://doi.org/10.1177/09075682231169615.

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical

Principles and Practice, 30(1), 17-28. https://doi.org/10.1159%2F000509119.