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Ethical Dilemmas Models

What are the ethical theories that support making a treatment decision for a patient even when he or she does not want treatment?

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Bioethics is the term applied to these principles when they refer to concepts within the scope of medicine, nursing, and allied health.

An ethical theory is a moral principle or a set of moral principles that can be used in assessing what is morally right or morally wrong (Ellis & Hartley, 2012). These principles provide guidelines for ethical decision making.
Ethical principles are fundamental guidelines that influence decision making. The ethical principles in health care include autonomy, beneficence, nonmaleficence, veracity, and justice. These assist with ethical decision making.

A Model for Making Ethical Decisions-The following is a set of steps that may be used in making an ethical decision.
1. Assessment: Gather the subjective and objective data about a situation. Consider personal values as well as values of others involved in the ethical dilemma.
2. Problem identification: Identify the conflict between two or more alternative actions.
3. Planning:
a. Explore the benefits and consequences of each alternative.
b. Consider principles of ethical theories.
c. Select an alternative.
4. Implementation: Act on the decision made and communicate the decision to others.
5. Evaluation: Evaluate outcomes.

Patient Self-determination Act-Patient Rights
H.R.4449 - Patient Self Determination Act of 1990
Adapted from the U.S. Code, Title 42, Section 10841, The Public Health and Welfare, 1991.

1. The right to appropriate treatment and related services in a setting and under conditions that are the most supportive of such person's personal liberty and restrict such liberty only to the extent necessary consistent with such person's treatment needs, applicable requirements of law, and applicable judicial orders.
2. The right to an individualized, written treatment or service plan (such plan to be developed promptly after admission of such person), the right to treatment based on such plan, the right to periodic review and reassessment of treatment and related service needs, and the right to appropriate revision of such plan, including any revision necessary to ...

Solution Summary

Using ethical dilemma models, the bio-ethical principals, ethical theories-Utilitarianism versus Kantianism and the patient self determination act can assist health care providers to make decisions both ethically and legally appropriate.

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