Ethics

Ethical Dilemmas Essay Ethical and legal problems arise in healthcare organizations when the decision-making capacity of an elderly patient is uncertain, particularly when the patient’s decisions are at odds with the rest of the family’s preferences. The scenario provided here is about this type of situation. This performance assessment will provide you with experience in sorting through the sometimes-competing issues related to a scenario such as the one described, as well as experience in formulating actions that can help guide a healthcare organization through ethical problems that arise in caring for elderly patients. Note: Students may rely on conversations and notes gleaned from cohort lectures and Boot Camp. SCENARIO You are the healthcare administrator at a local hospital. A social worker has come to you to discuss the case of Jamilah Shah, a patient who has recently been admitted to the hospital. Jamilah is a 90-year-old woman who was brought to the hospital after collapsing at the side of her bed. EKG and lab tests revealed a heart attack. More than 40 years ago, Jamilah emigrated with her wealthy husband (now deceased) and their three sons from Turkey to the United States. Jamilah was a homemaker and learned only basic English, but her children are fluent English speakers. The children are now all in their 50s. The family retains Turkish culture and norms, including the sons acting as patriarchs for the family. Even though Jamilah is highly educated (in Turkey she was trained as a lawyer), the sons make many of the family decisions. Two of the three children are in successful careers. The remaining child, the youngest son, Bashir, owns a small market and struggles financially. Until yesterday, the day of her admission, Jamilah resided in an extended care facility (ECF), where she has lived since her husband’s death. She reportedly has severe chronic obstructive pulmonary disease and adult-onset diabetes mellitus. Jamilah has no advance directives on file. Because of her communication difficulties, the emergency department physician started her on anticoagulants while trying to contact her next of kin. The ECF sent paperwork to the hospital, listing Bashir as the emergency contact. Bashir was contacted and is now at the hospital with his two brothers. He has informed the care team that he is the decision maker, and he wants his mother to have a Do Not Resuscitate (DNR) order with no intervention of any kind other than comfort care. The social worker has come to you with concerns that this decision may not reflect Jamilah’s wishes. When the social worker was visiting with Jamilah alone, Jamilah reached for her hand and said, “Please help me. I want to live.” The social worker shares concerns about the interactions observed between Jamilah and her sons, stating that the relationships seem unsupportive. The hospital’s ethics committee has not yet been involved. The social worker also reports that the emergency physician requested a cardiology consultation, which was just completed. The consultant documented that “Because the family has requested only comfort care, and due to the patient’s multiple comorbidities, the patient will be managed medically, with no intervention, and will not receive cardiac catheterization or be considered for coronary bypass surgery.” If nothing is done, Jamilah will likely die within days. REQUIREMENTS Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide. You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. Note: Complete these prompts by using complete sentences. A.  Write an essay (suggested length of 5–7 pages, not including attachments). Do the following: 1.  Describe three potential ethical dilemmas presented in the scenario: one related to autonomy, one related to beneficence, and one related to non-maleficence. a.  Analyze legal implications associated with each of the potential ethical dilemmas described. 2.  Referencing the scenario, complete the attached “Questions Derived from the University of Washington Paradigm.” Using those answers, describe, in the essay, what happens when following each  of these courses of action: •   Course of action 1: Follow Bashir’s wishes •   Course of action 2: Refuse to follow Bashir’s wishes •   Course of action 3: Briefly delay the decision to gather additional information and other perspectives As a part of the description of what happens when following each of the courses of action, if a question is not applicable for a given course of action, explain within your essay why it is not applicable. Note: The completed “Questions Derived from the University of Washington Paradigm” should be included as an attachment to your task submission rather than in the body of the essay itself. 3.  Putting yourself in the role of healthcare administrator, describe in the essay what should happen next within the scenario by doing the following: a.   Describe two resources that could have made or could still make Jamilah’s wishes more clear. i.   Explain how each resource could have made Jamilah’s wishes more clear. b.   Choose and justify the correct course of action (in response to Bashir’s demands for only comfort care): •   Course of action 1: Follow Bashir’s wishes •   Course of action 2: Refuse to follow Bashir’s wishes •   Course of action 3: Briefly delay the decision to gather additional information and other perspectives i.   Choose one of the courses of action from prompt A3b that you did not justify and explain how possible consequences show that it is not the correct course of action. 4.  Create three policy recommendations that you could make as an administrator to help your employees and the facility’s medical staff handle similar situations in the future. a.  Justify each  policy recommendation.  Note: You may use laws, regulations, and/or ethical principles as recommendations in part A4 and as part of your justification in part A4a. B.   Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized. C.   Demonstrate professional communication in the content and presentation of your submission.

Should Health Professionals Speak Up to Reduce the Health Risks of Climate Change? Cheryl C. Macpherson, PhD and Matthew Wynia, MD Are Physicians Obliged to Lead Environmental Sustainability Efforts in Health Care Organizations? Cheryl C. Macpherson, PhD and Jonathon Hill

Compare and Contrast on two ethical theories. Moral Realism and Divine Command. Basically defending my stance on my defense of Divine Command Theory and how it is stronger when compared to Moral Realism. I will attach previous discussion board replies as well as expected layout example and instructions supplied by instructor. Please Use some of the references listed in discussion board as well as outside scholarly articles. As the instructions detail, it is expected that I atleast use course resources. Since the writer of this essay will not have access to that just use some of the ones I have in my discussion board as well as outside resources.  Textbook is Moral Reasoning: An Intentional Approach to Distinguishing Right from Wrong by Michael S. Jones.

Imagine that you are the new ruler of a new country. This can be a country on Earth, or in a fictional fantasy location. There are no rules or laws in your country at the current time. As the ruler, you are to create a set of laws and values that your people will follow that will demonstrate and foster gender equality. This will help lay the foundation for your great leadership and rule, as you will be remembered throughout the ages as The First of the Wise! In your initial post, introduce yourself as the ruler of your country. Describe your country, your people, and the set of laws you’re developing to address gender equality. Use ethics of care as one of the driving frameworks of your laws. Bring in at least one additional ethical theory to suit your people and your style of rule. Regardless of which additional theories you choose, keep your goal in mind: how will you ensure there is no gender discrimination?

The following work ethics characteristics are emphasized: 1. Attendance  2. Character  3. Teamwork 4. Appearance  5. Attitude 6. Productivity 7. Organizational Skills 8. Communication 9. Cooperation 10. Respect Create a post that explains why you believe these traits are important or why not?

Introduction Kant’s famous First Formulation of the Categorical Imperative reads, “Act only according to that maxim whereby you can at the same time will that it should become a universal law.” Kant taught morality as a matter of following maxims of living that reflect absolute laws. “Universal” is a term that allows for no exceptions, and what is universal applies always and everywhere. Don’t forget about the second formulation of the categorical imperative which states, “Act in such a way that you treat humanity, whether in your own person or in the person of another, always at the same time as an end and never simply as a means.” It is just as important. Initial Post Instructions For the initial post, address one of the following sets of questions: 1.    What are the personal and/or communal ethical factors that may be involved in determining the moral position of either side given a contemporary debate, such as those concerning animal rights, stem cell research, abortion, the death penalty, and so forth? 2.    Elaborate in detail the ethical positions arrived at by using the Kantian categorical imperative relative to the long standing debate surrounding the death penalty or abortion. Argue the ethics from the point of view of the prisoner or from the fetus 3.    Evaluate the ethical positions in part two. You will want to detail whether they are convincing, logical, correct, consistent, etc.

What are 2 ethical issues related to the prison system? Provide examples. Do you feel it is ethical to privatize prisons versus traditional government-run facilities? Provide an explanation for your argument. What consequences should be faced by correctional officers who violate ethical codes of conduct? Do community corrections programs place too much burden and risk on communities and citizens? Are some programs better for community placement than others? Explain your answer. Is there ever a circumstance in which you feel physical punishment is appropriate? Explain your response.

There is another meeting of the Ethics Committee with the CEO in attendance. During this meeting, concerns about the overall payment system are expressed by the CEO. Each member is asked to return to the next meeting more information to share with the committee. Your informational paper for the committee should be 2–3 pages and should include the following: Describe the ethical concerns related to payment systems reform. Discuss how payment systems impact the physician–patient relationship. Do you believe that most health care institutions are financially responsible organizations? In other words, do they spend their money wisely? Explain your answer.

Give an example of a contract that you or someone you know has signed. We sign these things all the time from buying a car to a washing machine to leasing an apartment to going bungee jumping, etc. Please explain who the parties are (buyer-seller; patient-doctor; leasor-lessee). Let us know whether you read the terms of the contract. Tell us whether there was any consideration (payment of money or deposit of something of value). Let us know something that could be considered a breach of the contract (hypothetically). Discuss what you think the damages could be.

Explain the facts of the case, including how leadership decision-making influenced performance. Determine the ethical issues raised by the case. Provide examples to support your findings, including those related to societal values and norms. Analyze the process that was involved in deciding the case. Include the roles of organizational structure and diversity. Present your own resolution to the case, making sure to defend your processes and methods. List some arguments that one might use against your resolution of the case, and then respond to them with evidence.