The Best Approach for Ethics Consultation
The four topics, medical indications, patient preference, quality of life and contextual features are a representation of particular questions to be addressed when working on a case. 1 Clinical ethics case analysis when applying the four topics method starts with a clear description of the medical facts of a case2. These facts entail, medical prognosis, how the patient can benefit from the treatment, diagnosis, and treatment options. Patient Preference mainly focuses on presumed or expressed values and wishes of the patient. 3 In addressing a medical situation or case, it is important to consider the how it would affect a patients’ quality of life. On arrival at the hospital, she had lost a severe amount of oxygen to the brain; hence, she was admitted to the intensive care unit.
In the ICU, she was provided with a mechanical ventilation and intubation. An EKG revealed that she had been suffering from QT syndrome for a long time, which she had never been diagnosed with. Patient Preference This is just an informed wish given by a patient, after he or she has been provided with sufficient information regarding her or his medical conditions. If the patient is not able to make a preference because of their medical conditions, a caregiver can act on their behalf. In this case, the daughter evokes her conviction that regardless of the doctors’ recommendations, remain positive that her mother would be well. She states that she would rather visit her mom in the hospital rather than visit her in her graveyard.
Recommendations Based on the analysis of the case, it is important to note that the patient arrived to the hospital in a very severe condition. 9 She negatively responded to her medication over time, hence prompting the doctors to initiate, end to life process. 10The daughter is right to demand for continued medication of her mother; however, the decision is not factual, it is a decision based on fear of death. We begin with the first step that involves clarifying the consultation request. 14In this case, there does not exist any formal request. However, the case requires an ethical help. CASES can be used effectively to eliminate the misunderstanding between the physicians and the surrogate. There is a need for an ethical interjectory because the circumstances that are surrounding the clinical case need an external expertise advice.
17 Step 3; In the analysis of the case, it is vital to synthesize the information to understand the underlying circumstance of the case. 18The most important information in this case is the ethical code that the doctors are required to abide by in their profession. The surrogate also has an ethical significance in her capacity as the only person who can give a verdict on behalf of her mother (VA Web Solutions Office). 19 Although, the patient does not respond to medication, the doctors are in no position to tell whether she will finally start responding to the medicine, she is given. Thus, the issues raised by the surrogate are of great significance. Process and Format Clinical ethics consultations are becoming common in medical practice especially in North America for the past 30years.
There are several reasons that allude to this development. Three main models can be used for consultations, consultation by subcommittee, by individual consultants, and by committee. However, the training of these professionals has constantly been subjected to discussions. 20 Although, several discussions have been done on how patient’s medications should be conducted, very few discussions have been done on literature or even its possible format. 23 Conversations with the Healthcare Professionals The consultant should collect further information concerning the patient from the health professionals who had diagnosed her or him. These professionals should be having all the information about the patient. Interaction with the patient Apart from visiting all these professionals and gathering other useful information about the same, it is imperative that the consultant seeks audience with the patient.
Some patients are quite sensitive when it comes to ethical issues. 24 Hence, before consulting the patient he or she should first request if it ok to as such pertinent questions. However, the very many processes followed restrict it to only a specific line of professionals. It may not be applied in other fields other than medical fields. It also engages a lot of data gathering and collection, which may take time. The last approach known as process and format is not detailed enough. It does not have detailed information necessary for providing sufficient advice. 1808, doi:10. 1001/jama. Borry, P. , et al. "Evidence-based medicine and its role in ethical decision-making. Orr, Robert D. , and Wayne Shelton. "A process and format for clinical ethics consultation.
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