Group Decision Making and Ethical Reasoning-1
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Assignment 4 DECISION MAKING AND ETHICAL REASONING
Worth 100 points
Read the following document closely and follow the directions to find the correct answers. Be
sure you have reviewed all instructions in Canvas as well. Do not change the format of this
document.
Student Name(s):
All Group Members Names are Required Cortaveon Mack, Dana
Herring, Karli-Gail Davis, Jaycee Vick
I.
ETHICS – 15 points
See Chapter 4 in textbook-pp. 76-101.
A.
Read the following statements.
State
in the blank if you agree
or disagree
with the
statement. (5 points - 1 point per answer)
B.
Then
explain
your decision (agree or disagree) based on the ethical concepts
which are defined in the textbook
AND
identify
the ethical concept(s) –
beneficence, nonmaleficence, autonomy, justice, fidelity, veracity, paternalism,
utility, futility) – upon which you base your decision for each statement. (10
points - 2 points per answer)
1. A person has the right to refuse treatment, even if it will hasten his/her death.
I agree that every person has a right to refuse treatment as the rights-based reasoning states that
individuals have rights that should not be interfered with. I based my statement off the ethical
concepts of autonomy as the patient is taking control and determining their future.
Nonmaleficence is also involved because you intend to do no harm as a nurse by allowing the
patient to take control.
2. People have the right to participate in all decisions related to their health.
I agree that people have the right to participate in their healthcare decisions based off the ethical
concepts of autonomy and beneficence. Patients may feel better about being involved with their
own care, especially since they are not always given a voice for these things. Patients should be
allowed to say what they want as far as treatment goes because they are the ones living with the
outcomes.
3. The therapeutic use of marijuana for nausea and pain control should be legalized in all states.
I agree that therapeutic marijuana should be legalized for the benefits that it can bring to patients
who truly need it, such as it being a hunger stimulant for cancer patients. I based my answer off
the ethical concept of beneficence because it would help the patient and their overall well-being.
I would also use the ethical concept of utility because although everyone may not agree with the
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legalization of marijuana, the focus on the benefits should be recognized and available for the
people who need the therapeutic effects.
4. Healthcare is not a right; it is a responsibility.
Healthcare is our responsibility to provide great care to our patients. It is the patient’s right to
receive adequate healthcare that will benefit their overall well-being. The ethical concept of
justice was used to answer this question.
5. Stem cell research should be financed and promoted by federal funding.
I agree that stem cell research should be funded by the government. I used the ethical concept of
beneficence because the stem cell research would promote well-being and easier access to care
from patients who need these types of treatments.
ETHICAL DILEMMAS – 56 points
Read Learning Exercise 4.4 “A Nagging Uneasiness” on pp. 88-89 in Marquis & Huston,
11th edition.
Utilize the format below and type directly into the document. Each question should
be followed by your response as a group; retain this formatting to facilitate instructor grading.
Remember to be thorough, expand your answer, and demonstrate your critical thinking skills
.
1. Identify
ALL
(must have at least 6 parties) involved in this case study to include the parties
that are directly affected or would have an interest in this case. (6 points total - 1 point each)
1. Nurse
2. Patient
3. Physician
4. Mom/Mom’s boyfriend
5. Dad
6. CPS
2. At what point (name two points that could be considered) did this case become an ethical
dilemma? Give rationale
for both your answers. (6 points total - 3 points each)
1. When the nurse was torn on whether to act further upon the case or leave it alone. The nurse
felt uneasy about letting the child go home with the caregivers after the child reacted the way she
did, but she had no concrete proof to support anything.
2. The second point includes when the biological dad calls and wants the child to stay
hospitalized until the weekend. The physician understands where the dad is coming from, but
from a medical and insurance point of view, he cannot keep the child longer than necessary.
3. Identify three questions that are to be considered or three questions you would ask to gather
more information (regarding all the parties involved). Identify questions that would help you
gather data or assist in the decision-making process if you were the nurse. (6 points - 2 points
each)
1. Can you describe the child’s normal behavior?
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2. Has something happened that may have caused changes in the child’s emotions?
3. How is the child’s behavior around other children and other caregivers?
4. Identify
three alternatives for action
in this case. (6 points - 2 points each)
1. Notify Child Protection Services
2. Involve police authorities to file a report
3. Use the child’s father as a resource to gather more information
5. Identify one of the alternatives/actions that could pose a breach of duty. Discuss how this
alternative is a breach of duty. (4 points)
As a nurse, it is our duty to report suspicion of abuse to the state agency. Notice the nursing
supervisor told the nurse taking care of the child that she did not have any supporting evidence.
The nurse supervisor also informed the nurse taking care of the child that she should leave it
alone because she would be causing conflict for the job and traumatic experiences for the mother
without supporting evidence. If the nurse taking care of the child fails to report the information
to child protective services, it will cause a breach of duty. It would cause a breach of duty
because if the child were to experience harm after leaving the hospital, the nurse did not contact
child protection services to report the findings on her second admission.
6. As the nurse, which party should receive your fidelity? Explain your answer. (5 points)
It is the nurse and physician’s responsibility to provide fidelity to the 15-month-old child and the
child’s father because he knows something is not right in the home. The nurse and physician
need to follow up with the child protection service to ensure that the child is safe and well taken
care of. Child protection services fail a lot of children because they do not take the necessary
actions to protect the child from harm or complete follow-up visits to ensure that children are
safe in their homes.
7. Make one
concise
statement
describing the ethical problem in this situation. (4 points)
Advocate for safe nursing practices in all healthcare settings and ensure safety and protection in
the home environment of each consumer seeking care.
8. Name two specific factors that influence your decision-making in this ethical dilemma.
(4 points - 2 points each)
1. The child’s hesitant reactions towards the mom and her boyfriend.
2. CPS previous interactions with the family.
9. Name two “assumptions” that influence your decision making in this ethical dilemma;
assumptions are not facts; what do you “assume” about this situation or your attempts to
intervene? (4 points - 2 points each)
1. I would first assume that the child is being abused in some way at home. This makes me want
to intervene for the child’s sake to keep her safe.
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2. I assume that the biological dad knows that something is going on with his child and the mom
and boyfriend are making it harder for him to intervene.
10. Describe ONE approach (utilitarianism/teleological/consequentialist, deontological, duty-
based reasoning, rights-based reasoning, or intuitionist) for dealing with this ethical dilemma
utilizing concepts discussed in the text. Explain your answer. (6 points)
- The duty-based approach is one way that this ethical dilemma could be handled. Duty-based
approach is making decisions because one has a duty and is responsible from performing certain
actions. In this scenario, if evidence was found, the nurse would have reported the family to CPS.
In turn, the child would not have been able to return home with the family until she was seen by
a case worker.
11. Assume this was a real case. Twenty-four hours after the child’s discharge, she is readmitted
with critical head trauma. Police reports indicate that the child suffered multiple skull fractures
after being thrown against a wall by her mother’s boyfriend. The child is not expected to live.
Explain how your group’s problem solving and approach to this ethical dilemma would have
been altered, now that you know the outcome. (5 points)
- We would have taken a more active approach on the situation. Although there was not concrete
evidence supporting child abuse, the child shows signs of withdrawal from the caregivers and
CPS has already been involved before for the same reasons. The gut feeling would have been
followed and the case would have been reported.
III.
CRITICAL THINKING – 10 points
A.
Refer to Display 1.1 “Characteristics of a Critical Thinker”
on p. 4 in Marquis & Huston,
11th edition. After collaborating with your group, identify the single one
characteristic
that your group believes is the most important factor to critical thinking. Give rationale
for the characteristic that you selected. (3 points)
-
The single one characteristic that our group agreed is the most important factor to
critical thinking is having an open mind. It is the most important because to find a
solution to certain problems, there does not have to be a single way. There are
different ways to solve different problems. Having an open mind allows every person
that has an idea to be heard and offers a different solution that may or may not be
better than our own.
B.
Discuss your group’s preferential or most commonly used model for Decision Making
and explain your answer: Traditional Problem-Solving, the Managerial Decision-Making
Model, the Nursing Process, the Integrated Ethical Problem-Solving Model, or the
Intuitive Decision-Making Model found in Chapter 1, pp. 5-10. (4 points)
5
-
We collaborated and agreed that the most used model for decision making is the
Nursing Process (ADPIE). We use this in our everyday work, and even possibly our
everyday lives. This allows us to assess the problem, diagnose the problem, plan for a
solution, implement the plan, then evaluate the outcome. It is a constant input
throughout the process. In doing this, we are consistently receiving feedback from
this process. It works excellent with patient care and accountability.
C.
Review Chapter 1, pp. 18-19 that speaks to “right and left” brain thinking patterns. Which
thinking pattern best describes your group and why? Only one answer per group. (3
points)
-
I think the best thinking pattern that describes our group would be “right brain
thinkers.” We are all creative in our own ways. This corresponds to why we chose
that having an open mind is the most important characteristic. We are open to learning
new things and getting creative when we need to solve a problem. We think about the
big picture of things and are empathetic to situations. With having an open mind, we
ask questions, sometimes hard questions, which relate to being intuitive. This is also
helpful to develop leadership because we want to serve an organization, take other
employees and patients into consideration, and adjust things within the workplace or
patient care as needed.
IV.
DECISION-MAKING TOOLS – 14 points
A. DECISION-MAKING TOOLS – 6 points
Many hospitals use a grid or some type of comparison graph to demonstrate various data
on physician’s productivity, patient outcomes, etc. Remember, in your nursing practice, to
use tools that are available to aid in decision making or demonstrate data. Clinical
settings routinely have “tools,” or other quantitative and qualitative data, to aid in data
gathering and decision-making. Name three commonly used decision-making tools in
your clinical setting
or most clinical settings and explain the importance of each tool. (6
points - 2 points each)
1. Decision Grid – This is important for decisions that need to be made and alternatives
that need to be compared against each other. This allows every alternative to be evaluated by
using the same criteria. This could work for staffing purposes or problems that occur within a
unit.
2. Payoff Tables – This tool is important because it can show a cost-profit-volume
relationship. This is helpful for those that oversee ordering supplies. This allows that person to
compare how many items are needed for each unit, compare the prices of those items, see costs
of items that were used in the past, and decide on products based on how much they ultimately
cost.
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3. Consequence Table – This tool demonstrates how different alternatives create different
consequences. Desired objectives can be listed by the manager with different alternatives listed
beside them. While comparing the alternatives, the manager or leader can go through a checklist
to see if the alternative meets the objective. Whichever alternative meets an adequate percentage
of the desired objectives is the one that is then chosen. This helps eliminate the other alternatives
that are not as effective. It allows compare and contrast in a different view with the objectives
being the goals.
B. DECISION GRIDS – 8 points
Who Should Go?
SCENARIO:
You (your group) are the evening shift charge nurse of the intensive care unit. Your
supervisor is sending two nurses from each shift to an upcoming critical care conference
in a nearby city. The supervisor wants each charge nurse to submit names of the selected
nurses. All 12 of the full-time evening shift nurses would like to go. From a staffing
standpoint, any of them could go. All are active in the local critical care organization.
Due to financial limitations, you must limit your choice to two.
Using the decision grid example (Figure 1.3 on p. 22) in Marquis & Huston 11th edition, Chapter
1, develop headings, which serve as criteria for the selection process.
Assign each criteria a point value. Therefore, each of the 12 nurses will have a score according to
the criteria. Scoring will determine which two nurses are selected to attend the conference.
Utilize the grid below and be prepared to share the completed grid with staff
. (See sample below)
Keep in mind that if this Decision Grid is posted for staff to view, that the criteria cannot relate to
confidential employee evaluation information such as tardies and medication errors.
Your criteria headings will be different from the book example
; strive to make the criteria
measurable and objective
. This completed decision grid will serve as a visual process, which
could be shared with staff. It is not necessary on a grid to name the nurse…in this example, the
information is to be shared, so names are not required. In other decision-making tools, numbers
or codes could represent each staff member, so that only that staff member knows how to identify
himself or herself on the grid. Do not use confidential employee information as criteria, since
this tool will be shared with staff.
Insert four criteria and assign points in the table below
that will help you as the Leader
objectively decide who goes to the conference. One example criterion is already listed. No need
to evaluate all 12 nurses; this is an example of how the table would appear. No answer required
for shaded area below. Do not stress over this! I want you to learn how to evaluate the nurses
objectively that need to attend the conference since you will be their BSN Leader.
Nurses
Criteria/points
(example)
Insert:
Criteria/points
Insert:
Criteria/points
Insert:
Criteria/points
Insert:
Criteria/points
Nurse’s Total
Points
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Active in
Critical Care
Org
4 points
Length of
Employment in
this unit
1 point
CCRN
Certification
3 points
Full Time
Status
4 Points
Participation
in hospital
organizations
2 Points
xxxxxxxxxxxx
1
4
2
0
3
0
4
4
5
0
6
4
7
0
8
4
9
0
10
0
11
4
12
4
V.
PROFESSIONAL WRITING – 5 POINTS
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Before you submit, proofread for proper grammar, correct spelling, punctuation, and sentence
structure.
August 2018, August 2019, July 2020, July 2021, July 2022, April 2023, July 2023