Write a 2-3 page paper that examines end-of-life issues in relationship to hospitals, professional ethics, and accrediting bodies.
How Institutional Conceptual Frameworks Influence Ethical Decision Making
We wrap things up by exploring institutions and groups designed to help ensure that hospital staff at all levels think and act ethically in caring for patients. Accrediting bodies are oversight agencies charged with performing accreditation of hospitals and helping to establish standards for health care delivery. Their aim is to keep the quality of care as high as possible and to make sure the care is delivered ethically. Ethics committees are groups of individuals within hospitals that meet regularly to advise staff on ethically difficult cases and to promote an ethical institutional culture.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 2: Apply sound ethical thinking related to a health care issue.
Demonstrate sound ethical thinking in applying ethical principles and moral theories to a specific case.
Competency 3: Analyze ethical issues associated with patient care from the perspectives of various health care professionals.
Explain professional codes of ethics and apply them in to a specific case.
Competency 4: Explain the conceptual framework that health care leaders use to make ethical decisions.
Explain organizational documents like mission and value statements and use them to analyze a case study.
Explain the role of accrediting bodies and applies this understanding in analyzing a case study.
Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
Provides validation and support within written communications by including relevant examples and supporting evidence using APA citations.
Produce writing with minimal errors in grammar, usage, spelling, and mechanics.
Complete the Case Study: Tonya Archer media activity, which is linked later in this assessment.
Before you begin creating your submission for this assessment, make sure you have worked through the Tonya Archer case study. This will provide the foundational context for the assessment, for which you will be carrying out independent research by using the Internet to complete the following:
Identify the professional code of ethics for your professional specialty or a specialty that you are interested in.
With a local hospital in mind (perhaps one you work for), locate the mission, vision, and values statement of that hospital.
After you identify the professional ethics code and the hospital mission, vision, and values statements relevant to your work and interests, it may be useful to complete the following:
Identify which item in the ethical code you believe is the most important and explain why.
Name something in the code you would like to see addressed in more depth. Why?
Which item in the code do you think would be the most challenging to follow and why?
Does your code make an explicit distinction between what is legal and what is ethical? That is, is the code clear that, while an action may be legal, it may not be ethical?
Finally, how well does your professional code of ethics align with the mission and values statement of your hospital? Can you imagine a situation in which following one would make it challenging to follow the other?
For this assessment you will apply some concepts we have learned in the course, particularly those relating to the basic principles of health care ethics, professional codes of ethics, and values of health care institutions.
Write a paper that answers the following questions as it relates to the Tonya Archer Case Study:
What are the most relevant end-of-life issues in health care ethics as they relate to this case?
What should the hospital do? Should doctors simply keep Tonya on life support, as the parents want? Or, since all medical evidence indicates that Tonya’s brain damage is permanent, should life support be removed?
Support your answer with the following considerations in mind:
Explain which principles of health care ethics and which moral theory are the best philosophical foundations for your view.
Is your view supported by your professional code of ethics? If so, explain how. If not, explain what your code gets wrong about a case like this.
Is your view consistent with the mission statement and values of the hospital you identified in your independent research you conducted to prepare to complete this assessment?
Would an accrediting body, like the Joint Commission, support your choice? Why or why not?
Case Study: Tonya Archer
Introduction : It is one thing to consider medical ethics in an abstract setting, but by their nature, medical ethics involve deeply personal and emotional situations. This activity asks you to consider a case in which the family’s wishes are in conflict with the medical advice they have been given. You will be asked to answer some questions at the end of this activity. Tonya is admitted to the hospital: Tonya Archer is a fifteen year-old who has been admitted to Saint Anthony Medical Center for surgery to repair an ACL injury she suffered while playing softball. Tonya and her family have met with her surgeon and understand that while all surgery carries risks, this is a straightforward procedure that he has performed many times with no complications. Post-surgical complications: The surgery goes as expected, but as Tonya is being transferred from the recovery room to her hospital room, she went into cardiac arrest. While Tonya received immediate medical attention, it took over seven minutes to restore cardiac function and the loss of blood circulation resulted in brain damage. During the attempt to resuscitate Tonya, she was intubated and placed on a ventilator. The medical staff has determined, though, that the loss of circulation caused brain death. Doctors recommend ending life support: Tonya’s doctors explain to her family that the damage Tonya sustained is irreversible and that she suffered whole brain death, which means that there is no neurological function, even at the most basic functions such as respiration or cardiac function. They tell the family that the next step is to take Tonya off the ventilator. Tonya’s parents reaction is of steadfast refusal. They tell the doctor that they understand that Tonya has had a serious accident, but they point out that her body is warm, her heart is beating, and that she therefore is not dead. Hospital administrator and medical ethicist: The doctors, hospital administrator, and the hospital’s medical ethicist tell the family that while the ventilator and other interventions can sustain the body’s functions, the damage done by the cardiac arrest will get worse and there is near certain expectation that Tonya will not recover any brain function. The family is told that there is no reasonable hope of benefit to Tonya by continuing ventilator and other treatment.
Reflection: What are the most relevant end-of-life issues in health care ethics as they relate to this case? This question has not yet been answered. The parents’ right to make end-of-life decisions for their child, the benefit or futility of continuing the treatment, and the appropriate use of hospital resources are all issues that factor into this case. What should the hospital do? Should the hospital keep Tonya on life support as the parents desire, or should life support be removed because all medical evidence indicates whole brain death? This question has not yet been answered.Most bioethicists feel that the designation of brain death is sufficient to justify withdrawing life support and the law generally supports a hospital’s decision to discontinue life support. The courts, when they have been involved, may call for limited reasonable accommodations in order to allow for a second opinion of the diagnosis or when religious objections have been made.
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