Title: Ethical and Legal Behaviors in Healthcare: A Comprehensive Analysis
In the field of healthcare, professionals are often confronted with challenging ethical dilemmas that require careful consideration of both legal and ethical principles. This analysis aims to explore various behaviors in healthcare practice and categorize them based on their ethical and legal implications. Additionally, it will differentiate between deontological theories, utilitarianism, and principlism, discuss the disclosure of poor prognoses to patients, and examine the ethicality of disclosing information against family wishes. Moreover, it will address situations such as witnessing a colleague’s unauthorized access to medication and a fellow healthcare professional’s inappropriate use of a patient’s identification number. Finally, it will explore the communication of terminal diagnoses to patients and the disclosure of medication information to patients.
Question 1: Categorizing Behaviors
Behaviors in healthcare can be classified into four categories: (1) ethical but illegal, (2) legal but unethical, (3) illegal and unethical, and (4) legal and ethical. Let us examine each of the following scenarios to categorize the behaviors:
a) Working in a clinic that performs abortions:
This behavior can be considered legal but unethical for individuals who have personal or religious objections to abortion. However, it is important to note that the legality of abortion may vary across jurisdictions. Therefore, this behavior may also be legal and ethical in locations where abortion is legal and accepted.
b) Respecting the wishes of a client suffering from ALS that he be permitted to die with dignity and not placed on “breathing machines”:
While this behavior may align with the client’s autonomy and ethical principles of beneficence and nonmaleficence, it can be illegal in jurisdictions where the use of “breathing machines” is mandatory in certain medical situations.
c) Respecting the health surrogate’s wishes regarding termination of life support of her friend:
This behavior can be considered ethical but illegal depending on the specific circumstances and legal regulations surrounding the termination of life support.
d) Observing a coworker take out two tablets of oxycodone as ordered for pain management for his patient but keeping one for himself, administering only one tablet to the patient:
This behavior is both illegal and unethical. It involves theft of medication, which is illegal, and violates ethical principles of integrity, honesty, and patient-centered care.
Question 2: Differentiating Ethical Theories
Ethical theories provide frameworks for evaluating and justifying ethical behavior. The three major ethical theories in healthcare are deontological theories, utilitarianism, and principlism.
a) Deontological theories:
Deontological theories emphasize the inherent rightness or wrongness of an action, regardless of its consequences. These theories prioritize ethical duties and principles, such as the duty to respect autonomy, maintain confidentiality, and uphold honesty. Examples of deontological theories include Kantian ethics and rights-based approaches.
Utilitarianism focuses on promoting the greatest good for the greatest number of people. It considers the consequences of an action and seeks to maximize overall utility or happiness. In healthcare, utilitarianism may involve making decisions that result in the greatest overall benefit, even if they involve sacrificing individual rights or preferences.
Principlism combines several core ethical principles, including beneficence, nonmaleficence, autonomy, and justice. It provides a practical ethical framework by considering and balancing these principles in complex healthcare situations.
Question 3: Disclosing Poor Prognoses to Clients
Disclosing information about a poor prognosis to clients is a complex ethical issue. While providing honest and accurate information is generally considered ethically responsible, the potential for severe distress and psychological harm must be carefully considered.