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PHI FPX 3200 Assessment 5 Tonya’s Case: Ethics and Professional Codes

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Capella University

PHI FPX 3200 Ethics in Health Care

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Date

Tonya’s Case: Ethical Considerations in End-of-Life Care

Ethical Principles and Moral Theories

Tonya Archer, a teenage patient, underwent surgery for an ACL tear but experienced cardiac arrest during transfer, resulting in brain death due to compromised blood flow. Despite medical advice to discontinue life support due to futility, her parents insisted on continuing therapy, citing signs of life such as body warmth and a beating heart. This case presents ethical and moral challenges inherent in end-of-life care situations.

The ethical principles of autonomy, beneficence, non-maleficence, and justice are central to Tonya’s case. Autonomy entails a patient’s right to make treatment decisions, with Tonya’s parents advocating for her in this instance. However, parental autonomy must not override the duty to avoid futile or harmful treatment. Healthcare providers are obligated to act beneficently, prioritizing the patient’s best interests. Given Tonya’s irreversible condition and the exacerbation of her suffering with ongoing treatment, the medical team concluded that prolonging therapy is not in her best interest. Acting without malice, healthcare professionals must refrain from causing further harm, which would occur with continued therapy. Justice requires unbiased decision-making, independent of socioeconomic factors, with medical judgment guiding the medical team’s decision-making process (Nandifa et al., 2020).

Moral Theory for the Case

Utilitarianism, a moral framework aiming to maximize overall pleasure and minimize suffering, is pertinent to Tonya’s situation. Decisions are deemed ethical under utilitarianism if they maximize happiness or pleasure for the greatest number of individuals. Applying utilitarian principles involves weighing the consequences of maintaining or discontinuing Tonya’s life support. With Tonya diagnosed as brain-dead and no prospect of benefiting from further treatment, medical consensus favors discontinuing life support (Marseille & Kahn, 2019).

Utilitarian analysis necessitates evaluating potential outcomes. While removing Tonya from life support would undoubtedly cause distress to her family, it would also relieve her from prolonged suffering. Conversely, sustaining life support would prolong Tonya’s agony without improving her well-being. From a utilitarian perspective, discontinuing life support maximizes overall happiness and minimizes suffering, despite emotional repercussions (Vearrier & Henderson, 2021).

Application of Professional Code of Ethics

Professional codes of ethics provide guidance to healthcare practitioners in fulfilling their obligations to patients. The American Medical Association’s Code of Medical Ethics offers relevant principles for this scenario. Non-maleficence justifies the recommendation to discontinue Tonya’s life support to prevent prolonged suffering. Autonomy grants patients the right to make treatment decisions, upheld through surrogate decision-making by Tonya’s parents, who must act in her best interests. Beneficence obliges healthcare professionals to act in the patient’s best interests, affirmed by the conclusion that further treatment offers no benefit to Tonya (Ebbs et al., 2020).

The medical team’s decision aligns with professional ethics, emphasizing beneficence, autonomy, and non-maleficence. While Tonya’s parents retain the right to advocate for her, the medical team is responsible for providing treatment based on sound medical judgment and ethical standards.

Use of Organizational Documents

Organizational documents, such as mission and value statements, establish a framework for decision-making in healthcare settings. The hospital’s mission prioritizes quality care and patient well-being, supporting the decision to discontinue Tonya’s life support to alleviate her suffering. Values like integrity, respect, and compassion underscore the humane nature of this decision, considering Tonya’s irreversible condition (Minicuci et al., 2020).

Hospital protocols for end-of-life care likely guided the decision-making process, ensuring consultation with ethical committees and involvement of surrogate decision-makers. By adhering to organizational guidelines, the medical team acts in alignment with the hospital’s commitment to patient-centered care and professional integrity (Luna-Meza et al., 2021).

Role of Accrediting Bodies

Accreditation agencies, such as The Joint Commission, uphold care standards in healthcare institutions. Compliance with these standards ensures the delivery of safe and quality care. The hospital’s accreditation status validates decisions regarding Tonya’s care. Accreditation criteria include protocols for end-of-life care, validating the medical team’s decision to discontinue life support as consistent with industry best practices (Gulati et al., 2021).

Even with accreditation, adherence to established guidelines remains crucial in decision-making, particularly in end-of-life scenarios. The medical team’s decision aligns with ethical imperatives and patient-centered care, ensuring the delivery of safe and compassionate treatment (Foglia et al., 2019).

Conclusion

Navigating ethical complexities in end-of-life care necessitates balancing patient autonomy, beneficence, and professional integrity. Despite presenting challenging moral dilemmas, adherence to ethical principles and professional standards guides healthcare practitioners and organizations in making decisions aligned with patients’ best interests.

References

Ebbs, P., Carver, H., & Moritz, D. (2020). Principlism in paramedicine: An examination of applied healthcare ethics. Journal of Paramedic Practice, 12(8), 1–6. https://doi.org/10.12968/jpar.2020.12.8.cpd1

Foglia, M. B., Lowery, J., Sharpe, V. A., Tompkins, P., & Fox, E. (2019). A comprehensive approach to eliciting, documenting, and honoring patient wishes for care near the end of life: The veteran’s health administration’s life-sustaining treatment decisions initiative. The Joint Commission Journal on Quality and Patient Safety, 45(1), 47–56. https://doi.org/10.1016/j.jcjq.2018.04.007

Gulati, M., Levy, P. D., Mukherjee, D., Amsterdam, E., Bhatt, D. L., Birtcher, K. K., Blankstein, R., Boyd, J., Bullock-Palmer, R. P., Conejo, T., Diercks, D. B., Gentile, F., Greenwood, J. P., Hess, E. P., Hollenberg, S. M., Jaber, W. A., Jneid, H., Joglar, J. A., Morrow, D. A., & O’Connor, R. E. (2021). 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain. Journal of the American College of Cardiology, 78(22). https://doi.org/10.1016/j.jacc.2021.07.053

Häyry, M. (2020). Just better utilitarianism. Cambridge Quarterly of Healthcare Ethics, 30(2), 1–25. https://doi.org/10.1017/S0963180120000882

PHI FPX 3200 Assessment 5 Tonya’s Case: Ethics and Professional Codes

Luna-Meza, A., Godoy-Casasbuenas, N., Calvache, J. A., Díaz-Amado, E., Gempeler Rueda, F. E., Morales, O., Leal, F., Gómez-Restrepo, C., & de Vries, E. (2021). Decision making in the end-of-life care of patients who are terminally ill with cancer: A qualitative descriptive study with a phenomenological approach from the experience of healthcare workers. BMC Palliative Care, 20(1). https://doi.org/10.1186/s12904-021-00768-5

Marseille, E., & Kahn, J. G. (2019). Utilitarianism and the ethical foundations of cost-effectiveness analysis in resource allocation for global health. Philosophy, Ethics, and Humanities in Medicine, 14(1), 1–7. https://doi.org/10.1186/s13010-019-0074-7

Minicuci, N., Giorato, C., Rocco, I., Lloyd-Sherlock, P., Avruscio, G., & Cardin, F. (2020). Survey of doctors’ perception of professional values. PLoS ONE, 15(12). https://doi.org/10.1371/journal.pone.0244303

Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International Journal of Environmental Research and Public Health, 17(3), 835. https://doi.org/10.3390/ijerph17030835

Nandifa, V. N. P., Jena, Y., & Joewana, S. (2020). Beneficence is the highest moral imperative of a doctor dealing with the poor quality of patient autonomy. Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education, 9(1), 44. https://doi.org/10.22146/jpki.44511

PHI FPX 3200 Assessment 5 Tonya’s Case: Ethics and Professional Codes

Vearrier, L., & Henderson, C. M. (2021). Utilitarian principlism as a framework for crisis healthcare ethics. HEC Forum, 33(1), 45–60. https://doi.org/10.1007/s10730-020-09431-7

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