C426 Healthcare Values and Ethics
Ethical Dilemmas
Western Governors University
Name and ID
Date
,2
A1. Potential Ethical Dilemmas
Jamilah Smith was taken to the hospital after collapsing beside her bed in an extended
care facility. She is 90 years old and speaks little English but is highly educated. Tests were
performed and it was determined that she had a heart attack. She has no advanced directives and
her youngest son is listed as her next of kin. Time is of the essence, as she only has days to live
without treatment, and there are differing opinions regarding her treatment moving forward. Her
family is requesting only care to keep her comfortable until she passes. A social worker reports
that she was told by the patient that she wishes to live and be helped. The healthcare team
naturally wishes to treat the patient to the best of their abilities. There are three ethical dilemmas
that I would like to discuss further: autonomy, beneficence, and nonmaleficence.
A1a. Ethical Principles and Legal Requirements
Autonomy - The patient has a right to determine her own treatment. However, there are
many factors that make this unclear to the healthcare team. The factors of her age as well as the
fact that she lives in an extended care facility create confusion for her family as to the state of her
mental capacity. Her sons, being from a patriarchal culture, feel that they should determine her
care, regardless of and in addition to that confused state of her mental capacity. They feel that
Jamilah should be allowed to pass without intervention beyond those of comfort. The social
worker that has interacted with Jamilah personally attests that she has full mental clarity and a
strong desire to be helped and to live. The social worker feels that all medical measures
necessary to treat and save Jamilah’s life are what she truly wished. The healthcare team is
legally bound to follow the wishes of Jamilah, however, without advanced directives this is
unclear to the healthcare team and they are duty bound to follow the wishes of her next of kin.
, 3
Beneficence – The healthcare team wants to treat Jamilah with kindness and compassion.
Without her being able to speak for herself and tell them her personal wishes for treatment or
possible lack thereof, they are duty bound to follow the wishes of her next of kin. The healthcare
team is sensitive to the culture of Jamilah and her family as a patriarchal society. However, the
healthcare team’s natural inclination of paternalism creates additional confusion in the desire to
believe that the social worker is correct and has Jamilah’s personal interests at heart and they can
save her life by any means necessary. Without written and filed advanced directives the
healthcare team is legally bound to follow the wishes of her next of kin.
Nonmaleficence – The healthcare team has a duty to avoid causing harm. The next of
kin’s decision to withhold treatment conflicts with this duty. By requesting that treatment be
limited to only comfort care, they are unable to follow this principle. However, if it truly is the
wishes of Jamila herself to be allowed to pass with only comfort care then no principle has been
broken and they are doing the correct course of treatment, or lack thereof. The healthcare team
is currently legally required to follow the wishes of the next of kin in only providing comfort
care.
A2. University of Washington Paradigm
Course of Action 1: Follow Bashir’s wishes
MEDICAL INDICATIONS: The Principles of Beneficence and Nonmaleficence
1. Lab tests and EKG reveal that Jamilah has suffered a heart attack. The heart attack is an
acute problem. The heart attack is not considered to be chronic. Jamilah’s heart attack is
critical and without cardiac catherization or a potential coronary bypass will be fatal. A
heart attack is not reversible but treatable. Jamilah’s condition is classified as emergent,
Ethical Dilemmas
Western Governors University
Name and ID
Date
,2
A1. Potential Ethical Dilemmas
Jamilah Smith was taken to the hospital after collapsing beside her bed in an extended
care facility. She is 90 years old and speaks little English but is highly educated. Tests were
performed and it was determined that she had a heart attack. She has no advanced directives and
her youngest son is listed as her next of kin. Time is of the essence, as she only has days to live
without treatment, and there are differing opinions regarding her treatment moving forward. Her
family is requesting only care to keep her comfortable until she passes. A social worker reports
that she was told by the patient that she wishes to live and be helped. The healthcare team
naturally wishes to treat the patient to the best of their abilities. There are three ethical dilemmas
that I would like to discuss further: autonomy, beneficence, and nonmaleficence.
A1a. Ethical Principles and Legal Requirements
Autonomy - The patient has a right to determine her own treatment. However, there are
many factors that make this unclear to the healthcare team. The factors of her age as well as the
fact that she lives in an extended care facility create confusion for her family as to the state of her
mental capacity. Her sons, being from a patriarchal culture, feel that they should determine her
care, regardless of and in addition to that confused state of her mental capacity. They feel that
Jamilah should be allowed to pass without intervention beyond those of comfort. The social
worker that has interacted with Jamilah personally attests that she has full mental clarity and a
strong desire to be helped and to live. The social worker feels that all medical measures
necessary to treat and save Jamilah’s life are what she truly wished. The healthcare team is
legally bound to follow the wishes of Jamilah, however, without advanced directives this is
unclear to the healthcare team and they are duty bound to follow the wishes of her next of kin.
, 3
Beneficence – The healthcare team wants to treat Jamilah with kindness and compassion.
Without her being able to speak for herself and tell them her personal wishes for treatment or
possible lack thereof, they are duty bound to follow the wishes of her next of kin. The healthcare
team is sensitive to the culture of Jamilah and her family as a patriarchal society. However, the
healthcare team’s natural inclination of paternalism creates additional confusion in the desire to
believe that the social worker is correct and has Jamilah’s personal interests at heart and they can
save her life by any means necessary. Without written and filed advanced directives the
healthcare team is legally bound to follow the wishes of her next of kin.
Nonmaleficence – The healthcare team has a duty to avoid causing harm. The next of
kin’s decision to withhold treatment conflicts with this duty. By requesting that treatment be
limited to only comfort care, they are unable to follow this principle. However, if it truly is the
wishes of Jamila herself to be allowed to pass with only comfort care then no principle has been
broken and they are doing the correct course of treatment, or lack thereof. The healthcare team
is currently legally required to follow the wishes of the next of kin in only providing comfort
care.
A2. University of Washington Paradigm
Course of Action 1: Follow Bashir’s wishes
MEDICAL INDICATIONS: The Principles of Beneficence and Nonmaleficence
1. Lab tests and EKG reveal that Jamilah has suffered a heart attack. The heart attack is an
acute problem. The heart attack is not considered to be chronic. Jamilah’s heart attack is
critical and without cardiac catherization or a potential coronary bypass will be fatal. A
heart attack is not reversible but treatable. Jamilah’s condition is classified as emergent,
