Ethical Dilemma – Case Study

Ethical Dilemma – Case Study
Executive Summary: Ethical Dilemma
As an application exercise, identify a specific ethical dilemma
related to the health care needs of patients or populations in the
community. This application exercise is a case study of a
situation of which you are professionally involved or one in which
you are an observer currently occurring. Assess, apply ethical
analysis and clinical reasoning. Discuss interventions. If the issue
has been resolved, discuss your thoughts regarding the outcome.
If the issue is yet to be resolved discuss possible outcomes and
your thoughts. Include the use of supportive technologies used to
assess, intervene and evaluate (HIT, monitoring devices, etc).
Content: Reference List, Content – excluding Title Page and
Reference List 500 – 1000 Words.
APA 7th ed
Must use US based hospitals and data/resources for examples
and references
SBAR Report: Moral Courage
Identify and analyze an act of moral courage in which you have
been a participant or have observed. Use an exemplar from your
current or past work setting.
Develop strategies that could be used by nurse executives to
create an organizational climate of support to acts of moral
*Create a report utilizing the the SBAR Communication Tool
SBAR is a communication tool often used in clinical care of
patients among inter-disciplinary teams. It is frequently used to
share information between nurses and physicians related to
changes in patient conditions. It can also be a powerful tool in
management and administration providing succinct information
related to recommendations for improved processes.
Using the SBAR Communication Tool, identify and analyze moral
distress and an act of moral courage. Include
S – Situation (include the act of moral courage in this section). 20
B – Background (include precipitating moral distress in this
section). 20 Points
A – Assessment (include leadership responsibility). 20 Points
R – Recommendations (include strategies to create an
organizational climate in support of acts of moral courage. 20
Must use US based hospitals, data/references for examples and
APA 7th ed Formating and Organization – 10 Points
Include References (Minimum – 2). Content: 500 – 1000 Words.

SBAR Report
Institutional Affiliation
Moral Courage Nursing Case
The role of Advanced Practising Nursing (APN) became precise after watching a nurse working with a certain geriatrician within a long-term care facility. Nurses at the facility always felt that the latter was an overly cautious individual who did not permit extensive care o the patients within the nursing home setting. However, for this particular nurse, a moment of crisis did arrive where she needed to stand up to the geriatrician in support fo t for the principle on the dignity of life.
At this moment, a patient who will be called Nelly suddenly stopped breathing. The nursing staff provided life-saving measures while the nurse went to call emergency response services. The geriatrician pulled the nurse to the side and told her that it was best that one avoided heroic measures within the nursing home settings. The physician suggested not calling for emergency care even when they thought Nelly had a heart attack. After the nurse finally understood that they were letting the patient die, the nurse retorted and told the physician that she would have to call for emergency care. The emergency medical services arrived and provided care, but the patient did die before being transferred to the ambulance. It would be determined that Nelly died from a massive heart attack. While Nelly had dementia, she had no other chronic health conditions and seemed to live a satisfying life within the nursing home.
The moral distress in this situation was the nurse’s ethical dilemma of whether to follow the physician’s orders and not make the phone call since they can all see that the patient is dying. Conversely, the nurse could choose to do the right thing and call Emergency Medical Services to provide the proper care regarding what Nelly was experiencing. This moral distress would quickly lead to poor patient care, diminished job satisfaction, greater burnout, and more attrition from nurses and other providers. As the nurse looked on with the other nurses during Nelly’s emergency care by EMS, the nurse thought of the value of each person’s life. It did occur to the nurses that she could not live with herself if she failed to call EMS. Furthermore, Nelly did not have any do not resuscitate order in her chart, nor had her family decided against not extending the life-saving measures. While the outcome was not the desired one, it became clear that any moral distress related to this require the nurses to care for everyone accordingly with compassion and respect to their wishes.
This experience also demonstrated the need to question orders given by respective leaders or supervisors. Generally, these individuals have grown to have the skill and expertise that brought them to that position. Therefore, it is possible to completely trust the decisions they give even when there are individual concerns. To this effect, nurses are responsible for airing out any concerns, especially when decisions seem to go against their moral obligations. On the other hand, leaders must listen to their work teams and choose the right path even when it seems futile or considered a waste of time. Nurses’ ethic of care is not about following the hard and fast rules but practicing based on love, compassion, and confidence./
To develop moral courage, workplaces must set up education programs where all healthcare professionals are mentored on developing moral courage. This could be learned through case scenarios with ethical dilemmas that relate to moral courage. In addition, health organizations should acknowledge the importance of following ethical principles leading to the development of morally courageous behavior (Murray, 2010). Finally, resources relating to moral courage should also be provided for supporting an ethical environment.

Murray, J. S. (2010). Moral courage in healthcare: Acting ethically even in the presence of risk. Online Journal of Issues in Nursing, 15(3).

Week 3: Application Assignments
Institutional Affiliation
Ethical Dilemma-Case Study
Health care is costly in the United States, with the growth rate in spending accentuating recent years (Burke & Ryan, 2014). Research has proven that the per capita spending on healthcare in the country is approximately 50to 200% higher compared to other economically developed nations. In 2017, the number of individuals with health insurance coverage reached 294.6million as per the United States Census Bureau (Florida Tech, 2020). However, despite the tremendous increase in accessing healthcare insurance, Americans with no insurance coverage face challenges in accessing medical services, a basic need due to the related costs, an increase in healthcare demands has led to an increase in the financial costs that will cover the resources, and the hospitals get overwhelmed with the prices. Also, an increase in healthcare expenses has been attributed to the need for high healthcare quality.
Therefore, the current United States population with no access to healthcare insurance is at risk of not getting medical care due to how expensive the need has become.
Ethical Analysis
Utilitarianism affects the decision-making process in healthcare as it attempts to provide guidelines that will achieve the greatest good for the most significant number. The right policies should help healthcare offices make better-informed decisions even when faced with healthcare insurances and that some cannot access them. Health insurance serves two different but related goals that are the preservation of aspects of opportunity for individuals. First, considering deficits in health will considerably affect the range of opportunities that an individual could access due to reduced functions or death, ensuring that healthy persons will contribute to protecting opportunity in society (Saloner & Daniels, 2011). Second, persons are kept functional properly through the prevention and treatment of illness, injury, and disability. Considering that when these issues happen within a population, considerable needs are imposed on some people, including unevenly distributed needs. The needs can be specifically expensive and not within budgets for ordinary individuals. Insurance schemes will give people access to the required services (Saloner & Daniels, 2011).
Notably, healthcare professionals do require the resources needed to avail medical care to their patients. This can only be achieved through the health insurance covers or patients’ pay directly from pocket (Riley & Moy, 2012). The physicians are required to provide service with compassion and respect for human dignity. Ethical conflict comes up when the financial and logistic factors place barriers between one’s perception of the best possible medical care and the reality of healthcare costs. While the public and private resources are present to support patient care, the types of care obligated by the systems could be impractical and could lead to inferior care. There is an imminent challenge for the underinsured or those not insured due to various social factors that cause challenges to receiving optimal care.
Society does have the social obligation of protecting opportunity through ensuring that health needs are met via insurance and that the latter will protect persons from excessive financial burdens. Generally, this social obligation will need to be shared equally through progressively financed insurance (Saloner & Daniels, 2011). People will need to bear this burden as per their capacity to bear it. This kind of insurance will allow better financial protection, especially for poorer households, since they are prepaid and pool health risks across persons. The general government revenues will need to be widespread to provide enough funding for health services in almost every country. Together with the input from citizens, the health sector should receive substantial funds to cater to the more impoverished communities with no insurance.
Burke, L. A., & Ryan, A. M. (2014). The complex relationship between cost and quality in US health care. AMA Journal of Ethics, 16(2), 124-130.
Florida Tech. (2020, July 24). Current ethical issues in healthcare. Florida Tech Online.
Riley, E. C., & Moy, B. (2012). Ethical Challenges: Caring for the Underinsured, Geographically Disadvantaged Patient. Journal of oncology practice, 8(4), 215.
Saloner, B., & Daniels, N. (2011). The ethics of the affordability of health insurance. Journal of Health Politics, Policy, and Law, 36(5), 815-827.

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