Case Study On Ethical Dilemma Nursing Essay

1836 words (7 pages) Nursing Case Study

13th Feb 2020 Nursing Case Study Reference this

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Health care has evolved tremendously over the years to become a complex entity. This growth has brought with it considerable challenges. Health care professionals face complex scenarios because of their patients. This, therefore, calls for the development of a suitable approach to handling the ethical and legal difficulties they face. This paper seeks to analyze and present a satisfactory solution pertaining to ethical and legal implications of a patient’s case.

Introduction.

The ever changing health care system has brought tremendous challenges to the health care actors, consequently, questioning their expertise and morals. A new trend has emerged where the health experts have to make complex legal and ethical decisions pertaining to their patients. The billion dollar question then, is whether the health care practitioners have the mental capacity to handle these matters. In addition, some unscrupulous medical experts have tried to make quick money by setting up illegal hospitals and dispensaries. These have further led to the decline in the quality of treatment offered since they do not follow the recommended standards of treatment. Others, due to greed put money first instead of the patient’s health. They demand to be paid before attending to the patient, no matter the urgency of the situation, consequently leading to death. There is, therefore, need to identify such issues and educate the public and the health practitioners on their ethical duties in order to improve the health care industry (Rhodes,1986).

This case study seeks to help achieve this by analyzing a step by step process in coming up with legal and ethical decisions based on a patient (Davis, Goodman & Nogueras, 2007).

Case Background.

Daniel is a forty two year old dental surgeon. He over the years built a reputation for his medical expertise and also as a drunkard. His love for the bottle, consequently, led to the revocation of his license to practice after his negligence made a patient permanently lose sensitivity of the tongue. Rendered jobless, he desperately tried to make ends meet and eventually met Rajan, who had recently opened up his own private hospital, and was hiring doctors. Rajan gave Daniel the job because of his extensive work experience.

Christine is a thirty five year old single mother with a tooth ailment. She decided to go see a dentist and have her teeth extracted, and ended up in Rajan’s hospital. At first, they denied her treatment claiming that she had to first pay for the services. Desperate, she borrowed money from her son’s education fund and paid the hospital. Daniel was then asked to perform the extraction. He showed up drank but then, he was the only dental surgeon in the hospital, and was, therefore, allowed to proceed.

After the surgery and the tooth extracted, Christine bleeding could not stop because her blood pressure had shot up. To make matters worse, Daniel extracted the wrong tooth. She collapsed. She, therefore, had to be admitted in the critical ward and observed till she became stable and then have the right tooth extracted. Three days later, the Daniel checked her out and found that she had a tooth infection but decided not to tell her for it might make her blood pressure shoot up. He instead extracted her tooth and discharged her.

A fortnight later, the pain persisted, and Christine decided to consult a separate dentist. The dentist informed her that she suffered from oral cancer and that the previous hospital had misdiagnosed her. Angry, Christine decided to sue Rajan’s hospital for negligence, and for withholding vital information from her, and demanded compensation.

PART 1: FACTS.

The fist part of this analysis is to determine the existing problems. Here, the moral issue is whether Rajan’s hospital had the right to withhold information about Christine’s infection from her. In addition, the hospital’s love for money thereby putting the patient’s life at a significant risk is to be questioned. Hiring Daniel without checking the validity of his license puts the hospital management in the spotlight since they need to have consulted with Daniel’s former employer. Further, allowing Daniel to work yet he was drunk was wrong.

Daniel’s competency as a dentist needs to be scrutinized. As a doctor, he should have taken into account Christine’s past medical history and ordered for relevant checkups before proceeding with the extraction. In addition, extracting the wrong tooth, according to medical laws, was fertile ground for a dental malpractice lawsuit (Pozgar, 2010).

PART 2: OPTIONS.

In this part, methods of amicably solving the ethical problems need to be identified. The management of the hospital first needs to dismiss Daniel on the grounds of incompetence and for his drunkenness. Moreover, they need to change their priorities. They should put the patient’s needs first relative to money. They also need to take responsibility for their action of not providing adequate medical facilities and care as required of them by the law. In addition, they need to compensate Christine fro the damage they caused her, and even refund her the fees she had paid them.

Daniel needs to give up alcoholism and also be responsible for his actions. He should have properly diagnosed Christine and told her of the infection. He should have informed the hospital management about his revoked license too. This would have saved the hospital from the damaging legal action.

Christine also has to prove that the hospital was negligent and that Daniel’s actions breached the standards of care and expertise required of him as a dentist

PART 4: DUTIES AND DECISIONS.

Here, the involved parties need to come up with an appropriate and acceptable decision that would reflect the ethical and logical decision made. Daniel has to come clean to the hospital management and confess that his license is invalid. The hospital, on their part, need to dismiss Daniel. Since Daniel was their employee his actions reflect the standard of care the hospital accorded the patients. They also have to compensate Christine for the damages done. After that, they need to restructure their admission procedures and attend to patients first an ask for money after treating them.

PART 5:ASSESSMENT.

Several conflicts emerge in this case that need to be assessed. First is the inadequate post-operative monitoring and treatment, and the failure to warn the patient of a discovered danger. In addition, Daniel extracted the wrong tooth, thereby performing inappropriate treatment procedure that put his competency to test. Lastly, the scope of the hospital’s standard of care needs to be analyzed.

Issue No 1.Negligence: Inadequate post-operative monitoring and treatment.

Daniel, as the dental surgeon, had the legal obligation of putting Christine under several tests to check her health condition and ensure she would undergo the tooth extraction safely. Instead, he went ahead with operation, consequently, jeopardizing her life. Moreover, when he found out about the tooth infection, he chose to conceal it from his patient. He might argue that he acted in the best interest of the patient and prevented further blood pressure related complications. Medical laws on dental malpractice states that failure to tell a patient about a post-operative condition that calls for monitoring is negligence and fraudulent concealment. He should also have taken the time to examine the patient in order to diagnose her correctly. Christine suffered from oral cancer. Daniel might argue that Christine suffered from this prior to visiting the facility and that she practiced poor dental hygiene, but still, it was his responsibility as a doctor to diagnose her correctly and inform her of her condition (Schafler, 1996).

The hospital too was to blame. Their failure to check out with Daniel’s previous employer, and find out reasons for the termination of his employment, puts their credibility as a model medical institution to test. They also let him work even though he was drunk. This put the patient’s life at risk since making judgements when in such a condition is hard. Apart from that, their insistence on payment first before administering medication puts patients at significant risk especially in emergency situations.

Therefore, both Daniel and the hospital are to blame for Christine’s unfortunate situation.

Issue No 2. Inappropriate treatment procedure: Extraction of the wrong tooth.

This is the classic situation of negligence on Daniel’s part. An example is the case Thornton vs. Morgan, where the dentist pleaded guilty of extracting an adult tooth instead of a baby tooth and subsequently charged. Therefore, Daniel is guilty of administering an inappropriate medical procedure and needs to be fined (Ky. Cir. Ct, 2009).

Issue No. 3. Scope of standard of care.

The hospital breached their responsibility of providing an appropriate medical environment by hiring a dentist barred from practicing. The hospital’s management could argue that Daniel did not provide this information to them, but then, it was their duty to consult his former employer and find out reasons behind his termination. Moreover, the hospital allowed Daniel to work while drunk, a state that possibly led to the extraction of the wrong tooth.

Apart form this, the hospital failed to honor the pact they made with Christine of providing her with the proper standard of care. The plaintiff paid for the service as required of her, yet the defendants failed to meet their end of the bargain. In addition, the hospital had only one dental surgeon, which is dangerously below the American Dental Association requirement. Christine ended up having with the wrong tooth extracted and the infection kept secret from her.

Having identified the problems and discussed them adequately based on the available evidence, both the hospital and Daniel are guilty of negligence. The hospital ought to compensate Christine for the harm they caused her and cover her consequent medical issues resulting from the act of their negligence. Daniel, on the other hand, needs to check into an alcohol rehabilitation program and later take an exam to confirm his ability to continue practicing medicine.

In conclusion, this paper attempted to take the reader through the step by step process of analyzing a case of ethical and legal practice issue in a hospital. It, therefore, calls for the experts in the health profession and the general public to undergo basic training in order to enable them know how to handle similar situations should they arise. Hospitals too need to ensure that the environment they create is as per the requirement by the law.

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