PHI FPX 3200 Capella Universi

Examine end-of-life issues in relation to hospitals, professional ethics, and accrediting bodies.

How Institutional Conceptual Frameworks Influence Ethical Decision Making

We wrap things up by exploring institutions and groups designed to help ensure that hospital staff at all levels think and act ethically in caring for patients. Accrediting bodies are oversight agencies charged with performing accreditation of hospitals and helping to establish standards for health care delivery. Their aim is to keep the quality of care as high as possible and to make sure the care is delivered ethically. Ethics committees are groups of individuals within hospitals that meet regularly to advise staff on ethically difficult cases and to promote an ethical institutional culture.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 2: Apply sound ethical thinking related to a health care issue.
    • Demonstrate sound ethical thinking in applying ethical principles and moral theories to a specific case.
  • Competency 3: Analyze ethical issues associated with patient care from the perspectives of various health care professionals.
    • Explain professional codes of ethics and apply them in to a specific case.
  • Competency 4: Explain the conceptual framework that health care leaders use to make ethical decisions.
    • Explain organizational documents like mission and value statements and use them to analyze a case study.
    • Explain the role of accrediting bodies and applies this understanding in analyzing a case study.
  • Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
    • Provides validation and support within written communications by including relevant examples and supporting evidence using APA citations.
    • Produce writing with minimal errors in grammar, usage, spelling, and mechanics.

Preparation

Complete the Case Study: Tonya Archer media activity, which is linked later in this assessment.

Before you begin creating your submission for this assessment, make sure you have worked through the Tonya Archer case study. This will provide the foundational context for the assessment, for which you will be carrying out independent research by using the Internet to complete the following:

  • Identify the professional code of ethics for your professional specialty or a specialty that you are interested in.
  • With a local hospital in mind (perhaps one you work for), locate the mission, vision, and values statement of that hospital.

After you identify the professional ethics code and the hospital mission, vision, and values statements relevant to your work and interests, it may be useful to complete the following:

  • Identify which item in the ethical code you believe is the most important and explain why.
  • Name something in the code you would like to see addressed in more depth. Why?
  • Which item in the code do you think would be the most challenging to follow and why?
  • Does your code make an explicit distinction between what is legal and what is ethical? That is, is the code clear that, while an action may be legal, it may not be ethical?
  • Finally, how well does your professional code of ethics align with the mission and values statement of your hospital? Can you imagine a situation in which following one would make it challenging to follow the other?

Instructions

For this assessment you will apply some concepts we have learned in the course, particularly those relating to the basic principles of health care ethics, professional codes of ethics, and values of health care institutions.

Write a paper that answers the following questions as it relates to the Tonya Archer Case Study:

  • What are the most relevant end-of-life issues in health care ethics as they relate to this case?
  • What should the hospital do? Should doctors simply keep Tonya on life support, as the parents want? Or, since all medical evidence indicates that Tonya’s brain damage is permanent, should life support be removed?

Support your answer with the following considerations in mind:

  • Explain which principles of health care ethics and which moral theory are the best philosophical foundations for your view.
  • Is your view supported by your professional code of ethics? If so, explain how. If not, explain what your code gets wrong about a case like this.
  • Is your view consistent with the mission statement and values of the hospital you identified in your independent research you conducted to prepare to complete this assessment?
  • Would an accrediting body, like the Joint Commission, support your choice? Why or why not?

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PHI FPX 3200 Capella Universi

Examine the moral and ethical considerations of organ conscription policies and theories.

Scarcity of Medical Resources

For this assessment, you will continue your survey of ethical principles in health care. Especially in our contemporary world, where needs for health care outstrip available resources, we regularly face decisions about who should get which resources.

There is a serious shortage of donor organs. Need vastly outstrips supply, due not only to medical advances related to organ transplantation, but also because not enough people consent to be cadaveric donors (an organ donor who has already died). Munson (2014) points out that in the United States, approximately 10,000 patients die each year because an organ donor was not available, which is three times the number of people killed in the terrorist attacks on 9/11.

But what is an efficient and morally sound solution to this problem? The policy of presumed consent, where enacted, has scarcely increased supply, and other alternatives, such as allowing donors to sell their organs, raise strong moral objections. In light of this, some have advocated for a policy of conscription of cadaveric organs (Spital & Erin, 2002). This involves removing organs from the recently deceased without first obtaining consent of the donor or his or her family. Proponents of this policy argue that conscription would not only vastly increase the number of available organs, and hence save many lives, but that it is also more efficient and less costly than policies requiring prior consent. Finally, because with a conscription policy all people would share the burden of providing organs after death and all would stand to benefit should the need arise, the policy is fair and just.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 1: Articulate ethical issues in health care.
    • Articulate the moral concerns surrounding a policy of organ conscription.
    • Articulate questions about the fairness and justness of organ conscription policy.
    • Explain the relevance and significance of the concept of consent as it pertains to organ donation.
    • Evaluate alternative policies for increasing available donor organs.
  • Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
    • Exhibit proficiency in clear and effective academic writing skills.
References

Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston, MA: Wadsworth.

Spital, A., & Erin, C. (2002). Conscription of cadaveric organs for transplantation: Let’s at least talk about it. American Journal of Kidney Disease, 39(3), 611–615.

Instructions

Do you consider the policy of organ conscription to be morally sound?

Write a paper that answers this question, defending that answer with cogent moral reasoning and supporting your view with ethical theories or moral principles you take to be most relevant to the issue. In addition to reviewing the suggested resources, you are encouraged to locate additional resources in the Capella library, your public library, or authoritative online sites to provide additional support for your viewpoint. Be sure to weave and cite the resources throughout your work.

In your paper, address the following:

  • On what grounds could one argue that consent is not ethically required for conscription of cadaveric organs? And on what grounds could one argue that consent is required?
  • Is the policy truly just and fair, as supporters claim? Explain.
  • Do you consider one of the alternative policies for increasing available donor organs that Munson discusses to be preferable to conscription? Explain why or why not.

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PHI FPX 3200 Capella Universi

Write a 2-3 page paper that explains and defends your view on the issue of whether or not patients with no other treatment options have a moral right to unproven drugs.

Introduction

Many doctors, nurses, medical technicians, and other health care workers are involved in medical research. The field of medicine is not limited to the direct treatment of patients but also involves the continued expansion of medical research. A large part of such research is clinical research, which puts patients into the role of experimental subjects. This raises a number of challenging questions for health care ethics, many of which follow from the fact that physicians, nurses, and others involved in clinical research have a dual role. As researchers, they are committed to generating new knowledge about diseases, developing new treatments and drug therapies, and, in general, helping to improve the welfare of human beings by eliminating or controlling diseases and increasing longevity. However, researchers involved in clinical research must also be committed to the highest quality care for individual patients taking part in research studies. This assessment explores some of the ethical issues that clinical research raises and some of the safeguards in place to protect the interests of patients involved in research.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Articulate ethical issues in health care.
    • Explain how the principle of informed consent is relevant to these issues.
    • Explain the costs and benefits of offering unapproved experimental drugs to patients.
  • Competency 2: Apply sound ethical thinking related to a health care issue.
    • Identify relevant ethical theories and moral principles.
    • Articulate arguments using examples for and against offering pre-approved drugs to wider pools of patients.
  • Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
    • Exhibit proficiency in clear and effective academic writing skills.

Preparation

When a new drug is undergoing clinical trials to be approved for treatment, it must pass through a number of distinct phases of testing. These phases require rigorous study and evidence to demonstrate the safety and efficacy of new treatments. Passing through these phases and achieving approval takes many years for some trials. Before approval, patients not part of a clinical trial have limited or no access to experimental drugs, even though these drugs could be helpful and potentially save their lives. There are various groups pushing for greater patient access to drugs still in the experimental stage. In recent years, the FDA has made it somewhat easier to receive treatment with experimental drugs, but according to advocacy groups there are still too many restrictions (Munson, 2014).

This leads to a potential quandary when early stages of research on a drug sometimes suggest that the drug could be effective in treating a certain disease. On one hand, offering easier access to early stage trial drugs could help individuals suffering with a medical condition. However, on the other hand, making early access to experimental drugs easier could limit the pool of patients available to participate in clinical trials that establish whether or not the drug is truly effective and safe. This is an important consideration, as the vast majority of experimental drugs turn out to be completely ineffective or could have very dangerous side effects that will only show up over time and across a wider test population.

When completing this assessment, it is important to keep in mind the ethical arguments that are relevant to both views regarding the right to experimental drugs. It may be useful to review the suggested resources and conduct additional independent research while you are planning your assessment submission.

Instructions

Do patients with no other treatment options have a moral right to unproven drugs? Write a paper that explains and defends your view on this issue. In addition to reviewing the suggested resources, you are encouraged to locate additional resources in the Capella library, your public library, or authoritative online sites to provide additional support for your viewpoint. Be sure to weave and cite the resources throughout your work. In your paper, address the following points:

  • Identify relevant ethical theories and moral principles.
  • Explain how the principle of informed consent is relevant to the issue.
  • Explain the costs and benefits of making unproven, unapproved experimental drugs widely available to patients. Consider the costs and benefits not only to the individual patients who take these drugs but also potential costs and benefits to other patients.
  • Explain arguments using examples for and against offering pre-approved drugs to wider pools of patients.
  • Support your view using ethical theories or moral principles (or both) that you find most relevant to the issue.

Additional Requirements

  • Written communication: Written communication is free of errors that detract from the overall message.
  • APA formatting: Resources and citations are formatted according to current APA style and formatting guidelines.
  • Length: 2–3 typed, double-spaced pages.
  • Font and font size: Times New Roman, 12 point.
Reference

Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston, MA: Wadsworth.

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PHI FPX 3200 Capella Universi

Write a 2-3 page paper that examines the moral and ethical issues involved in making a decision regarding limiting life support.

End-of-Life Issues

With our framework of ethical theories and principles in hand, we begin our look at some of the critical ethical issues in our contemporary world, starting with end-of-life issues. This assessment covers ethical questions related to end-of-life care. Passive euthanasia is the removal or refusal of life-sustaining treatment. Examples of passive euthanasia include removal of a feeding tube or a ventilator, or forgoing a life-prolonging surgery. Passive euthanasia is legal in all 50 states, and the principle of autonomy gives informed patients the right to refuse any and all treatments. Patients who are unable to make such decisions in the moment (because they are unconscious, for example) might have made their intentions clear beforehand with an advance directive or similar document. Things become more complicated, however, when a patient who is unable to make treatment choices has not made his or her wishes clear, either formally in a written document, or informally in conversations with family members or friends. Another problem concerns cases in which there is disagreement about whether the treatment is sustaining the life of a person in the full sense or merely as a body that, because of severe and irreversible brain trauma, is no longer truly a living person.

Active euthanasia, or assisted suicide, introduces further difficult moral questions. A patient who has a terminal illness and who has refused treatments that would merely prolong a potentially very painful and debilitating death might want the process of dying to be hastened and made less painful. The patient might want to take his or her own life before the disease reaches its horrible final stages. Should patients be legally allowed to have help in this endeavor? If suicide itself is not morally wrong, at least in cases like these, is it wrong for another person to directly help bring about the patient’s death? Is it wrong for doctors, a role we naturally associate with healing and the promotion of life, to use their medical expertise to deliberately end a patient’s life if the patient wants this?

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Articulate ethical issues in health care.
    • Articulate the moral issues associated with limiting life support.
  • Competency 2: Apply sound ethical thinking related to a health care issue.
    • Demonstrate sound ethical thinking and relevant ethical principles when considering limiting life support.
    • Explain important considerations that arise when contemplating limiting life support.
  • Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
    • Exhibit proficiency in clear and effective academic writing skills.

Preparation

This media piece provides the context for this assessment; make sure you have reviewed the case study thoroughly.

Additionally, it may be useful to think through the following issues as they relate to Mr. Martinez’s case:

  • Should Mr. Martinez be transferred to intensive care, where his respiratory failure can be treated by a ventilator, and by CPR if necessary, and his oxygen level can be monitored?
    • What are the key ethical issues or models at play in this case study?
    • What are the key end-of-life issues at play in this case study?
    • How can an understanding of models and best-practice help to guide health care practitioners to make ethical and legal decisions?

Instructions

In a 2–3 page analysis of the case study, address the following:

  • The patient’s directives.
  • The patient’s quality of life.
  • The family’s stated preferences.
  • The moral issues associated with limiting life support.
  • The ethical principles most relevant to reaching an ethically sound decision.
  • Important considerations such as implications, justifications, and any conflicts of interest that might arise because of the patient’s respiratory failure.

When writing your assessment submission assume that doctors cannot contact Mrs. Martinez and must make this choice on their own. To help you reach an objective, ethically sound decision, draw upon concepts and arguments from the suggested resources or your independent research. Support your response with clear, concise, and correct examples, weaving and citing the readings and media throughout your answer.

Submission Requirements

  • Written communication: Written communication is free of errors that detract from the overall message.
  • APA formatting: Resources and citations are formatted according to current APA style and formatting guidelines.
  • Length: 2–3 typed, double-spaced pages.
  • Font and font size: Times New Roman, 12 point.

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PHI FPX 3200 Capella Universi

Identify the professional code of ethics for your professional specialty or a specialty that you are interested in, describe the decision criteria, and analyze each theory using examples and the Ethical Theory Matrix Template.

Moral Theories, Principles of Health Care Ethics, and Professional Ethics Codes

Ethics is a branch of philosophy devoted to the study of morality. Ethics has a long history of theories about determining right from wrong and identifying the principles of living a good life. For this assessment, you will be asked to apply foundational principles in ethics, such as autonomy and justice, in a relevant health care setting.

Each profession within health care has its own code of ethical behavior designed to help individuals within that profession to make sound ethical choices in carrying out the tasks and practices particular to their professional role. It may be useful to locate one or more relevant codes of ethics for your current or desired career path. This research will be beneficial to your professional development, and you will have a chance to apply it to the Tonya’s Case: Ethics and Professional Codes assessment in this course.

Autonomy, Truth-Telling, and Confidentiality

These are broad-ranging topics, which, if taken alone, seem almost comically simple. Of course, rational people of legal age should be able to make decisions concerning themselves and their minor children. Of course, medical professionals should be honest with patients, and, of course, patients should be honest with members of their health care teams. Of course, one’s medical issues should be kept private. But rarely are things as simple as they seem. Take some time to scratch beneath the surface, and we encounter myriad ethical dilemmas.

Honesty tends to be a revered trait in many cultures. However, many people admit to lying occasionally, especially if the intent is to spare someone pain, embarrassment, or anguish. Is lying to someone because of love, concern, or reputation ever ethical?

Privacy and confidentiality are also important concepts. But are there limits? Can the greater good ever outweigh the rights of individuals?

And at what point can others, whether an individual or an entity such as a government body, ethically determine someone’s actions, fate, or choices? Fluoridated water, smoking regulations, compulsory K–12 education, and speed limits are only a few examples of how we, as a society, agree to limited personal freedoms because these things are good for us.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 1: Articulate ethical issues in health care.
    • Articulate the time-tested theories of ethics.
    • Describe the strengths and weaknesses of the time-tested theories of ethics.
  • Competency 4: Explain the conceptual framework that health care leaders use to make ethical decisions.
    • Identify the decision criteria of the time-tested theories of ethics.

Preparation

As you begin work on your Ethical Theories Matrix assessment, it may be helpful to review the suggested resources focused on moral and ethical considerations. For your own reference, you may want to briefly jot down your thoughts related to:

  • An inventory of the basic principles of health care ethics. These principles are nonmaleficence, beneficence, utility, distributive justice, and autonomy.
    • An explanation of each principle as well as your own example to illustrate the application of each.

Instructions

Drawing from the material covered in the resources as well as your own research, complete this assessment using the Ethical Theory Matrix Template [DOC].

  • For each theory, first describe the decision criteria. The decision criteria are the instructions the theory gives for how to reach the morally correct choice in a situation that requires action.
  • Then, provide your own example of how someone might act using the decision criteria of the theory.
  • Finally, briefly describe the strengths and weaknesses of each theory using the last two columns of the Ethical Theory Matrix Template.

The suggested resources for this assessment could help you get a start on completing the matrix, but do not hesitate to use any outside resources that you can find online, the Capella library, or elsewhere.

This matrix is a tool you will use throughout the rest of the course. Submit your completed matrix as an attachment to this assessment.

Refer to the Matrix of Ethical Theories Scoring Guide for more information on how this assessment will be graded.

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