MODULE 3case analusis RESUBMITTED
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MODULE 3:3:2 DRAFT ASSIGNMENT: CASE ANALYSIS ETHICAL
FRAMEWORK
Colleen White
Southern New Hampshire University
PHL-260: Ethical Problem Solving
Dr. O’Leary
November 29, 2023
(Resubmitted)
In this case study a middle-aged man suffering from paranoid thoughts was committed to a psychiatric hospital for posing a danger to himself and to others (“Application of Ethical Frameworks to Social Work Case Study”). His violent behavior has been controlled with injectables against his will with the consent of his adult son who was awarded medical power of attorney and guardianship. The goal is for this man to return home to his community and close to his son, but the injections only control the aggression. They do not treat the paranoid thoughts so his chances of returning to his community are unlikely. The hospital informed his son of a new drug introduced to them to treat his father's paranoid thoughts, but it is only available in pill form. His father is paranoid of being poisoned so the suggestion was made to crush up the pill and put it into his food since the man would willfully take the pill. Consent was given by his son on the basis that doing so would achieve the goal of his father returning home to the community. Although consent was given by his son, the nurses did not feel comfortable deceiving the patient by crushing the pill up and putting it in his food.
My moral intuition leaves me feeling like crushing up medication and mixing it into a patient's food is really questionable ethically speaking. Though I can see the reasoning is logical, the risk is pretty high in ruining the trust of a
patient. Is crushing the pill going to change the composition, or how it works? Is deviating from its intended use going beyond the scope of competence? Who is legally liable? Should nurses deceive a patient and mix the medication
in their food?
The IDEA Decision-Making Framework is a four-step process with guided questions that lead to the most ethical decision for the issue at hand. The first step is to identify the facts such as clinical indications, individual preferences, evidence, contextual features, and personal considerations. Step
two common principles are autonomy, beneficence, non-maleficence, and justice. Determine which ethical principle is in conflict. Step three explores the
viable options including the pros and cons of each option and applying the principles identified in step two to each one. Finally, step four is acting on the decision and documenting the steps taken to reach the decision with the process for evaluating the decision (“Ethics Frameworks”).
When applying the IDEA Decision-Making process to the issue of ethical uncertainty, the guided questions in step one led me to identify the facts as
diagnosed with paranoid thoughts,
mental incompetence,
current injections against will
preferences for patient are made by the son, and
personal considerations identified ethical guidance is needed.
Step two led me to the principles of BENEFICENCE: defined as acting beneficently toward others (contributing to the welfare of others, which may include preventing harm, removing harm, promoting well-being, or maximizing
good)(
IDEA: Ethical Decision- Making Framework Guide
) in conflict.
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Step three options to consider are
giving the medication mixed into food,
approaching the patient with the medication and instructing him to take it,
taking the time to gain the trust of the patient for the willful cooperation in taking the medication, or
not giving him the medication at all.
After going through each step of the process step by step it was clear that the answer is NO. Nurses should not mix the medication in the food without knowing if taking that medication is in the best interest of the patient, even if consent is given. Separating the facts from feelings in step one really taught me a lot about poor decisions I have made in the past. Additionally, in an effort to resolve any ethical uncertainty, I reviewed the professional code of
conduct in the National Association Social Work, (NASW), code of ethics guide.
Work Cited
“Ethics Frameworks.” Champlain Centre for Health Care Ethics
, www.champlainethics.ca/ethics-frameworks. Accessed 9 Nov. 2023.
“Highlighted Revisions to the Code of Ethics.” Www.socialworkers.org
, 2021, www.socialworkers.org/About/Ethics/Code-of-Ethics/Highlighted-Revisions-to-the-
Code-of-Ethics. Accessed 5 Nov. 2023.
IDEA: Ethical Decision- Making Framework Guide
. 9 Nov. 2023.
Markkula Center for Applied Ethics. “A Framework for Ethical Decision Making.” Santa Clara University
, 8 Nov. 2021, www.scu.edu/ethics/ethics-resources/a-framework-
for-ethical-decision-making/. Accessed 9 Nov. 2023.
NASW. “Code of Ethics History.” Socialworkers.org
, 2017, www.socialworkers.org/about/ethics/code-of-ethics/history.