Question 1

10 / 10 pts

1. Briefly describe the ethical dilemma. 

Your answer:

As described in this case, the ethical dilemma concerns the subject of Jehovah's Witness, who has an issue with contemporary medical care, especially when it concerns receiving blood and blood products. Following the adverse impacts of the novel coronavirus or COVID-19, some of the patients have been subjected to life-threaten symptoms, especially those with weaker immunity and existing comorbidities (Jacobsen, 2020). Critical to this is that COVID-19 has no specific therapeutic agents. Therefore, finding alternative and new treatments is the ideal intervention. Patients diagnosed with COVID-19 and are critically ill can receive a convalescent plasma transfusion to improve their clinical status (Jacobsen, 2020). However, ethical dilemma surfaces when it concerns Jehovah’s Witness patients who explicitly reject that they should not be injected with convalescent plasma transfusion, a blood product, as it goes against their religious faith.

 

Question 2

10 / 10 pts

2. What is your desired outcome for the ethical dilemma you’ve selected?

Your answer:

The desired outcome here is that Theology should trump over medical therapy. The goal here is to demonstrate professional competency by respect patient autonomy about their objecting treatment (Tepper, 2017). This is an important concern in ensuring that the patient received holistic care to optimize the best therapeutic outcomes by putting the patient's concerns in the center. Jehovah's Witness religion is overtly against receiving blood and blood products (Chandrasekhar, 2018; Conti et al., 2018), presenting a plethora of challenges for healthcare practitioners in the treatment and management of these group of patients. In essence, they believe that it is against God’s will to receive blood through transfusion, even if it is their own blood. Members who end up accepting and receiving blood transfusions are expelled and ostracized by their religious community. Healthcare professionals are hence required to consider various alternatives when engaging Jehovah’s Witness patients, including whether they are competent enough to give their consent or refuse treatment, unable to consent or refuse treatment due to their condition, or consideration of children over and under twelve years (Conti et al., 2018). In either case, the medical practitioner should utilize the provisions of the law and the concerns of the patient's right to bodily integrity and autonomy.

 

Question 3

10 / 10 pts

3. Describe one ethical principle that applies to the ethical dilemma.

Your answer:

The principle of autonomy reverses healthcare providers' ability to acknowledge that a patient who can make decisions should be allowed the right to make decisions regarding their care (Childress & Beauchamp, 2017). This is a critical consideration, even when their choices do not lead to the best therapeutic outcomes or go against the physician’s recommendations. Important in this principle is that healthcare providers should ensure that the patient has liberty by facilitating independence in decision-making without exerting any controlling influences, including manipulation, coercion, and persuasion. Thus, healthcare providers should view Jehovah’s Witness patients as being agents of their own health who have the capacity for intentional action. Patient autonomy is important and ranks as the highest priority in medical ethics and bioethics. Thus, all the healthcare provider's undertakings should be centered on ensuring that the patient can put their interest first, and therefore, they facilitate these motivations. Notably, healthcare professionals should ensure that they accommodate their patient's care team consisting of family, friends, and carers. Thus, respecting patient autonomy should also consider taking into account the patient's care team's views.

 

Question 4

10 / 10 pts

4. Describe a second ethical principle that applies to the ethical dilemma.

Your answer:

The beneficence principle is centered on doing good that will benefit others (Childress & Beauchamp, 2017). The modus operandi of healthcare providers is to ensure that they balance the benefits and risks or harms to provide the best therapeutic attention that will lead to positive health outcomes. The beneficence principle requires medical providers to have a moral duty to promote the best action that they believe is centered on the patient's interests. This principle can be applied to Jehovah’s Witness patients' ethical dilemma as medical providers should ensure that they do good for them by placing their interests at heart. Whereby the patient states that they do not want to receive blood and blood products, the medical practitioner should fulfill this request accordingly. 

 

Question 5

10 / 10 pts

5. Describe how one (1) ethical theory applies to the ethical dilemma

Your answer:

The utilitarian approach is an ethical theory that applies to the ethical dilemma regarding Jehovah’s Witness patients. This is a moral theory centered on consequentialism whereby healthcare interventions will be judged on the consequences of healthcare professionals (Childress & Beauchamp, 2017). In this case, the outcome of a particular outcome will determine the morality of health intervention. Simply put, the end justifies the means; hence healthcare providers should engage in morally acceptable actions that will increase net benefit, happiness, and pleasure for the patient and their care team (Childress & Beauchamp, 2017). According to utilitarianism, actions are only considered reasonable if they meet the patient's demands. Hence, no action should lead to pain or wrong. This is explicitly applicable in the ethical dilemma whereby medical providers should ensure that their activities increase overall net benefit. Therefore, to ensure that Jehovah’s Witness patients will not be ostracized and expelled from their religion, they should respect their autonomy if they do not want to receive blood and blood products. 

 

Question 6

10 / 10 pts

6. Describe how you would make an ethical decision for the ethical dilemma using either the PYTHON principle OR the Doherty & Purtilo 6 step process.

Your answer:

Doherty & Purtilo is a six-step process in ethical decision-making (Tepper, 2017). First, it will entail gathering relevant information, which will entail finding important information regarding the patient, including their medical history, patient preferences, beliefs, values, and contextual factors. Secondly, is to identify the type of ethical problem (Tepper, 2017). In this scenario, the ethical issue is that the patient does not want to receive convalescent injections to improve their health outcomes. Third, the medical provider should use ethical theory to analyze the problem. In this scenario, the utilitarianism theory is a relevant theory that best ensures health utility is achieved (Childress & Beauchamp, 2017). The fourth step is to explore alternatives that will be practical in the patient case. Respect to the adverse impacts of COVID-19, a Jehovah’s Witness patient should be subjected to clinical management by infection prevention, control measures, and supportive care (Centers for Disease Control and Prevention [CDC], 2020).  The fifth step is to act. This can entail providing supportive care such as ventilator support and supplemental oxygen. Finally, it is to evaluate the process and outcome. This will entail taking into account what went well, challenging aspects, and lessons from the intervention.

 

Question 7

10 / 10 pts

7. Choose a policy, either federal, state, or municipal and explain how it applies to this ethical dilemma.

Your answer:

Furthered by Section One of the 14th Amendment, the Constitution provides that the doctrine of bodily autonomy should be respected, from the right to life (Childress & Beauchamp, 2017). The Federal government, through the Supreme Court, upheld that adults who are competent have the right to refuse medical treatment, even when the intervention is life-saving. As such, bodily autonomy comes into consideration where a person has the right to self-governance over their body without external influence or coercion. 

 

Question 8

10 / 10 pts

8. During the process of writing this outline and researching your dilemma, did you change your recommendation for an outcome? Why or why not?

Your answer:

Perspectival, I will still consider the original outcome. Jehovah’s Witness patients are also clients, and where they have the ability and capacity to make informed decisions, my goal as a professional is to respect their choice. I will respect their decision and allow them the benefit to stand with their religious views of not accepting blood and blood products, even when it will lead to positive health outcomes.