Patient Autonomy Dilemma

Patient Autonomy Dilemma

Ethical Dilemma

Describe a situation of ethical dilemma that you have experienced in practice and how it was resolved. (Saunders, 2014)

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Reviewed on TURNITIN, no repeat work.

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APA

Answer

Ethical Dilemma in Practice: Balancing Patient Autonomy and Safety

In healthcare practice, ethical dilemmas frequently arise, requiring professionals to weigh competing principles and make difficult decisions. One notable ethical dilemma I encountered involved a situation with an elderly patient, Mr. Roberts (a pseudonym to protect confidentiality), who was suffering from chronic kidney disease and diabetes. Mr. Roberts was adamant about managing his condition at home, despite his significant health risks and repeated hospital admissions due to non-compliance with medical instructions. The ethical dilemma centered around balancing respect for Mr. Roberts’ autonomy with the healthcare team’s obligation to ensure his safety and well-being. Patient Autonomy Dilemma

The Dilemma

Mr. Roberts had expressed a strong desire to maintain his independence, preferring to manage his medications, diet, and overall treatment plan without constant intervention. He had declined in-home care services multiple times, despite his history of non-adherence to prescribed dietary restrictions and medication regimens. His refusal of additional care placed him at increased risk of health deterioration and hospital readmission, which not only affected his quality of life but also put a strain on healthcare resources.

The ethical dilemma arose as the healthcare team debated whether to respect Mr. Roberts’ wishes fully or to intervene by recommending a more restrictive care plan, which could limit his independence. On one hand, honoring his autonomy aligned with the ethical principle of respect for individuals, but on the other hand, allowing him to manage his care independently could have severe consequences, implicating the principle of beneficence, which mandates acting in the patient’s best interest. Patient Autonomy Dilemma

Resolution Process

To resolve this dilemma, the healthcare team and I approached the situation using an ethical decision-making model, as suggested by Saunders (2014). This process involved several steps:

1. Gathering Information: We conducted a comprehensive review of Mr. Roberts’ medical history, spoke to his family members, and reviewed his prior care plans. His family confirmed that his primary concern was maintaining control over his care decisions, rooted in a desire to remain independent.
2. Identifying Ethical Principles: We identified the key ethical principles involved, specifically autonomy, beneficence, and non-maleficence (avoiding harm). It was clear that there was tension between respecting Mr. Roberts’ autonomy and ensuring his health and safety.
3. Considering Alternatives: To balance his independence with the need for effective care, we explored various alternatives. This included developing a modified care plan that involved regular phone check-ins and educational sessions on disease management, rather than in-home care, as a compromise that respected his preferences while also addressing his safety.
4. Engaging in Open Communication: The team held a meeting with Mr. Roberts to discuss his preferences, goals, and the potential risks of managing his care independently. We emphasized our commitment to supporting his independence while ensuring his safety. During this conversation, Mr. Roberts agreed to the proposed compromise, expressing willingness to participate in regular check-ins with a healthcare provider.
5. Implementing and Monitoring the Plan: The agreed-upon plan was implemented, involving weekly calls from a nurse to check on his adherence to his treatment regimen. This approach allowed us to monitor his health without infringing too heavily on his autonomy.

Outcome and Reflection

This resolution allowed Mr. Roberts to retain control over his care, respecting his autonomy while also ensuring some degree of oversight to promote his safety. The experience underscored the importance of patient-centered care and open communication in resolving ethical dilemmas. By listening to the patient’s values and finding a middle ground, healthcare providers can uphold ethical principles and…