Ethical dilemmas play an enormous role in the decision-making process at hospitals and directly influence the outcome of any treatment. Nurses have to comply with numerous requirements from the guidelines established by a variety of policies concerning ethical rules in medical care. Therefore, it is crucial for nurses to fully understand the universal framework shaped by the UK legislation on biomedical ethics. Thus, learning to prioritize specific guidelines over others by referring to a virtual hierarchy of values can ensure that patients are treated in the most efficient ways.
The case study featuring Mr. Stone’s condition leads to a primary ethical dilemma that centers around the patient refusing treatment after being assessed to lack capacity. The patient was diagnosed with an acute subdural hematoma, which requires him to undergo surgical treatment. However, the patient refused to be treated because he feared surgical intervention (Ooi et al., 2020). The patient’s refusal to accept the desperately needed measures results from mental confusion and slurred speech that prevents him from making informed decisions regarding the preferred treatment process.
Ethical dilemmas within the health sector have caused frequent debates between patients, caregivers, and nurses while creating a misunderstanding when it comes to medical treatment. The case study portrays a major ethical dilemma regarding the treatment of a patient who lacks capacity. Therefore, laws and ethics are to be introduced in the nursing sector to ensure effectiveness and quality healthcare. Surgery is the only reasonable option that can duly improve the patient’s condition. It will allow Mr. Stone to return to normal life, while the absence of urgent treatment will lead to death.
The case study indicates how caregivers and medical practitioners experience ethical dilemmas when dealing with patients. Mr. Stone’s refusal to get surgical treatment is a major ethical dilemma in this context (Russell, 2018). Thus, the caregivers have to balance the needs of Mr. Stone when considering his confidentiality, benefits, risk of medications, and the potential for abuse (Smebye et al., 2016). Another moral predicament that has been observed in the scenario is the decision-making capacity and competency among medical practitioners (Vaitheswaran et al., 2021). Despite all this, the patient’s human rights are to be respected after his refusal to undertake a surgical operation. Nevertheless, it is essential that nurses check the patient’s ability to repeat the information provided to him and weigh the risks.
The four major moral principles that should be considered while making the final decision include respect for autonomy, beneficence, non-maleficence, and Justice. Despite the fact that the patient, for some reason, does not want to undergo surgery, it is vivid that Mr. Stone desperately needs it. Therefore, medical workers should not respect autonomy at the expense of other principles. Moreover, if it is a matter of life and death, medical workers should not hesitate to act decisively. The patient’s right to live undoubtedly overweighs his desires under the circumstances described in the case study, which include the notion of the patient’s lack of capacity. The highly preferred order of analysis that should be performed is as follows: medical indications, patient preferences, quality of life, and contextual features.
Respect for Autonomy
Mr. Stone’s refusal to get surgical treatment could be respected if he didn’t show a lack of capacity. Autonomy refers to patients’ right to make appropriate decisions about their health care in any circumstance (Smebye et al., 2016). In relation to the patient’s ethical challenge of refusing to undertake the surgical treatment, the nurses and caregivers are expected to explain all the details of the problem to the patient. It will help minimize the ethical dilemma by assisting the patient in making his own informed decision concerning the necessity of the surgical operation (Childress & Beauchamp, 2021).
Beneficence and Non-Maleficence
Beneficence refers to the action of practicing kindness to a patient. In the UK, a decision is usually beneficent when a specific verdict can be made regardless of who was making the decision (Bhui, 2018). This implies that the concept of beneficence focuses on providing wellness to the patient and not harm. The principle of non-maleficence has four significant roles: do not kill, do not cause suffering or patient’s pain, do not cause offense, and do not incapacitate (Coope & Richards, 2020). Medical workers should practice the principle of non-maleficence by providing effective treatment procedures to Mr. Stone while maintaining the healthcare ethical concepts.
The principle refers to the fair distribution of benefits, specifically with misfortunes for which individuals cannot be held personally responsible. In other words, Justice is the degree to which medical practitioners distribute equal services within a society such as the UK. Mr. Stone should be treated equally and should not encounter discrimination based on his age, according to the Mental Capacity Act of 2005 and the Human Rights Act (Smebye et al., 2016). Moreover, the patient’s right to live should be considered instrumental in adhering to the principle of Justice. Moreover, according to the Equality Act of 2010, a person concerned with the provision of a service to the public must not discriminate against a person requiring the service.
Analysis of Medical Team
Through appropriate diagnosis, the medical team decided on the best treatment strategy. They provided the pros and cons of the proposed treatment in relation to the case study analysis. Mr. Stone’s fear of surgical treatment is rooted in his lack of mental capacity, which makes him more confused (Ryan et al., 2020). However, his wife can offer a better explanation of the benefits and drawbacks of the selected treatment approach and should help him develop an informed decision regarding the surgical treatment.
In case the patient refuses, the medical practitioners and the patient’s wife will have to take the responsibility of making personal decisions that will save the old’s man life. Prior to treatment, nurses should use relevant healthcare tools to assess the patient, such as sensor‐based technology for safety and independence (Malmgren et al., 2019). This specific technology can help nurses come up with the correct treatment procedure that will assist the patient in the most efficient way.
Role of Nurses
It is impossible to undermine the role of nurses in the entire process that centers around the ethical dilemma. Nurses are expected to comply with numerous requirements and employ the 6 C’s of nursing (care, communication, compassion, courage, commitment, and competence). Therefore, they are expected to play a crucial role in explaining all the details to the patient and, what is more important, to his family, as Mr. Stone demonstrates a lack of capacity. Nurses should find the means to convince Mr. Stone’s family that only surgery can save his life. Therefore, respect for autonomy should not stop them from assisting their family member. The proper explanation and compassion that nurses can provide are instrumental in making Mr. Stone’s family members convince him to undergo surgery.
Caregivers play a vital role by providing a holistic experience that contributes to the reduction of health disparity through medical treatment and caring for patients. Nurses are expected to utilize the concept of the 6 Cs, which are fundamental in any medical institution (Ali, 2019). The medical professionals proved to be compassionate by showing kindness while diagnosing Mr. Stone and providing effective Healthcare treatment (Rus & Groselj, 2021). The pivotal role of nurses implies their ability to transmit all the repercussions of the patient’s serious health issues not only to him but to his family members.
In relation to the role played by nurses in the context of patient surgical treatment, fundamental nursing practices within the community are vital. They include providing effective communication that ensures that the patient is well-informed and making appropriate decisions regarding the surgical treatment approach to minimize his problems (Parker, 2020). Finally, nurses are expected to stay committed and courageous when engaging in Mr. Stone’s health issues in order to find additional relevant strategies that may assist him in overcoming the problem.
The primary ethical theory that has been portrayed in the case study concerning the issue of Mr. Stone is the deontology theory (Shayestehfard et al., 2020). The approach focuses on moral philosophy that helps individuals distinguish between forbidden and permitted morals within modern society. In other words, actions and their outcomes are independent concepts. This is similar to the case study, as Mr. Stone refuses to undertake surgical treatment (Tseng & Wang, 2021). Following the deontology ethical theory, the doctor can educate the patient by providing all the necessary information regarding the benefits and the outcomes related to surgical treatment to capture his attention entirely. Thus, it will help to proceed with the operation that will assist the patient in overcoming acute subdural hematoma (Prabhumoye et al., 2021). This results from the theory’s emphasis on the relationship between duty and consequences regarding an individual’s morality when coming up with the final decision that may be useful or defective.
In this context, practicing surgical treatment for Mr. Stone is a positive moral concept that should be implemented and embraced by the patient because it will assist in addressing the ethical issue, hence minimizing his physical and mental health deterioration (Stos, 2018). This is different from the theory of utilitarianism, which states that whenever there is a specific method of treatment, the patient’s benefit should be maximized. At the same time, the risks and costs should be minimized by the nurse (Kanofsky, 2019). This typically happens when a medical practitioner decides to use an opportunity and continue with the treatment method.
Case Law and Legislation
Nurses can make the appropriate decision to assist Mr. Stone in accordance with the Mental Capacity Act of 2005. The patient was assessed to lack mental capacity precisely when it came to making a decision on his treatment (Whitehouse, 2019). In other words, the ethical dilemma can be addressed through appropriate communication. Still, if the patients insist, the caregivers should avoid his proposal and utilize the healthcare legislation such as the Mental act and the right to life by proceeding with the surgical treatment.
One of the essential health legislations that should be applied to the case study is the Mental Capacity Act of 2005, which was introduced by the government of the UK. The act can help Mr. Stone, as he refused to make an informed decision by declining his surgical treatment. This implies that the Mental Capacity Act of 2005 is a framework that may be used to protect and empower vulnerable people, such as Mr. Stone, who cannot make their own decisions (Alexiadou, 2018). Instead, doctors and caregivers will be responsible for making relevant decisions to avoid the ethical dilemmas in this case and treat Mr. Stones.
Despite the ethical dilemma featuring Mr. Stone’s refusal to take the surgical operation, the Mental Capacity Act of 2005 urges the caregivers to intervene for the benefit of saving the patient’s life. At the same time, it will help to address the ethical dilemma within modern society. According to the NHS constitution, the NHS pledges to identify and share best practices in quality of care and treatments.
Subsequently, the Human Rights Act is applied to the case study whereby Mr. Stone was not discriminated against by his family when he was making decisions concerning his health care (Weatherby & Agius, 2018). The act protects individuals within the UK, explicitly focusing on their right to life, thus making it difficult for caregivers looking after the patient to listen to his advice. Instead, the law requires them to make proper choices and decisions that will result in Mr. Stone’s appropriate treatment, which implies surgical operation.
Anonymity is the only principle contributing to the ethical conflict between Mr. Stone and the medical practitioner (Peate, 2019). The same issue of concealment also poses a challenge within UK medical institutions when it comes to decision-making. However, the dispute between the patient and the nurses within the UK society can be resolved by educating and creating awareness of the patient’s problem while providing the benefit of treatment procedures and approaches. They will be described in relation to all the numerous disadvantages and will help the patient realize all the minor details and make an informed decision of his own.
In summary, the research study has provided an overview of how ethical dilemmas in health care have contributed to the increase in the number of issues that hinder proper decision-making concerning patients and caregivers. The analysis of several problems was based on Mr. Stone’s case study, which reflects broader issues in UK society. The primary ethical issues from the case study include the failure to undertake surgical treatment, which should not be the case. Besides, nurses have proven to be capable of performing their roles duly by adhering to the 6 Cs of nursing.
Medical workers should always seek to achieve the desired result by providing patients with enough knowledge of the benefits and drawbacks of a particular treatment method, which can allow them to make an informed decision. Nevertheless, the fact that patients may lack capacity implies the necessity to explain all the details of the patient’s harsh condition to his family members. Thus, it is possible to resolve the medical dilemma by referring to the UK legislation and save such patients lacking capacity despite their unwillingness to do anything. Therefore, the urgent steps include cooperation with patients’ family members. The study based on Mr. Stone’s case provides a valuable framework that can help resolve conflicts and ethical dilemmas that arise in the UK society and globally.
Department of Health and Social Care. (2021). The NHS Constitution for England. Web.
Equality Act 2010. Web.
Human Rights Act 1998. Web.
Mental Capacity Act 2005. Web.
The Nursing and Midwifery Council. (2018). The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. Web.
Alexiadou, E. A. (2018). Ethnic diversity and access to healthcare from a human rights perspective: The case of the Roma in Europe. European Journal of Health Law, 25(3), 261–283. Web.
Ali, P. (2019). Can we add another C to the 6Cs: C for Clever? Nursing Open. Web.
Bhui, K. (2018). Political and ethical dilemmas for psychiatrists in the media. The British Journal of Psychiatry, 213(5), 677–678. Web.
Childress, J. F., & Beauchamp, T. L. (2021). Common Morality Principles in Biomedical Ethics: Responses to Critics. Cambridge Quarterly of Healthcare Ethics, 1–13. Web.
Coope, B., & Richards, F. A. (2020). ABC of Dementia. In Google Books. John Wiley & Sons.
Kanofsky, S. (2019). Intrinsic skills for physician assistants an issue of physician assistant clinics, E-Book. Elsevier Gezondheidszorg.
Malmgren Fänge, A., Carlsson, G., Chiatti, C., & Lethin, C. (2019). Using sensor‐based technology for safety and independence – the experiences of people with dementia and their families. Scandinavian Journal of Caring Sciences, 34(3), 648–657. Web.
Ooi, L., Dottori, M., Cook, A. L., Engel, M., Gautam, V., Grubman, A., Hernández, D., King, A. E., Maksour, S., Targa Dias Anastacio, H., Balez, R., Pébay, A., Pouton, C., Valenzuela, M., White, A., & Williamson, R. (2020). If human brain organoids are the answer to understanding dementia, what are the questions? The Neuroscientist, 26(5-6), 438–454. Web.
Parker, J. (2020). Ethical issues in the care of people with dementia. InnovAiT: Education and Inspiration for General Practice, 175573802091495. Web.
Peate, I. (2019). Learning to Care. Elsevier Gezondheidszorg.
Prabhumoye, S., Boldt, B., Salakhutdinov, R., & Black, A. W. (2021). Case Study: Deontological ethics in NLP. ArXiv:2010.04658 [Cs]. Web.
Rus, M., & Groselj, U. (2021). Ethics of vaccination in childhood—A framework based on the four principles of biomedical ethics. Vaccines, 9(2), 113. Web.
Russell, G. (2018). Dementia diagnosis and white lies: A necessary evil for carers of dementia patients? International Journal of Care and Caring, 2(1), 133–137. Web.
Ryan, H., Heywood, R., Jimoh, O., Killett, A., Langdon, P. E., Shiggins, C., & Bunning, K. (2020). Inclusion under the Mental Capacity Act (2005): A review of research policy guidance and governance structures in England and Wales. Health Expectations, 24(1), 152–164. Web.
Shayestehfard, M., Torabizadeh, C., Gholamzadeh, S., & Ebadi, A. (2020). Ethical sensitivity in nursing students: Developing a context-based education. Electronic Journal of General Medicine, 17(2). Web.
Smebye, K. L., Kirkevold, M., & Engedal, K. (2016). Ethical dilemmas concerning autonomy when persons with dementia wish to live at home: A qualitative, hermeneutic study. BMC Health Services Research, 16(1). Web.
Stos, S. (2018). Utilitarianism, deontology and virtue ethics. Journal of Business Ethics Education, 15, 315–322. Web.
Tseng, P.-E., & Wang, Y.-H. (2021). Deontological or Utilitarian? an eternal ethical dilemma in outbreak. International Journal of Environmental Research and Public Health, 18(16), 8565. Web.
Vaitheswaran, S., Balasubramanian, S., Natarajan, N., Venkatesan, S., Srinivasan, N., Nagarajan, G., Ramanujam, V., & Sargunan, S. (2021). Ethical issues in delivering psychological therapies in geriatric psychiatry in India. Indian Journal of Psychological Medicine, 43(5_suppl), S66–S70. Web.
Weatherby, T., & Agius, M. (2018). Ethical and organisational considerations in screening for dementia. Psychiatria Danubina, 30, 463–468. Web.
Whitehouse, P. J. (2019). Ethical issues in early diagnosis and prevention of Alzheimer disease. Dialogues in Clinical Neuroscience, 21(1), 101–108. Web.