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Discussion Week 6. Decision Making
Current Health Care Practices Challenged to Improve Caring Based on Ethical Principles
Healthcare practices that limit access to needed care, such as restrictions to mental health services due to insurance limitations or a lack of staffing, raise ethical concerns. These barriers violate the ethical principle of justice, which promotes fairness and equal access to care for all individuals, particularly vulnerable populations. For example, many mental health conditions are underfunded, leading to a limitation in the availability of care and contributing to health disparities. Equally disturbing are the staffing policies, which include forcing nurses to work overtime compulsorily. This is an invitation to the fatigue of nurses, thus disregarding the ethical principle “do no harm.” A worn-out nurse is more prone to making errors, which may endanger the safety of the patients. A re-think on staffing and increasing the number of nurses as per the patient requirement will probably prevent any risk to safety. Moreover, by increasing access to mental health care by incorporating the services into the basic insurance package, it is possible to ensure better care in practice to fulfill the principle of justice and to ensure patients obtain adequate treatment without financial barriers.
Another issue that needs critical consideration involves patient autonomy in end-of-life care. Most institutions still pursue aggressive treatments for patients despite clear directives in their advance care plans to the contrary (Terman et al., 2022). This practice defeats the principle of autonomy, wherein the patient’s will is disregarded in favor of some institutional protocol. In cases like this, the team often favors paternalistic decision-making, which diminishes the patient’s mastery over their care. Healthcare organizations must invest in advancing the practice by providing education in this form of care planning for both patients and providers. Preservation of autonomy can be ensured, while at the same time, the principle of beneficence will not be compromised by unnecessary interventions through advance directives being respected, integrated into the care decision-making process, and accessible.
Ethical Wrongdoing in Clinical Practice and the Role of Emotional Intelligence
In clinical practice, ethical wrongdoing occurs, for example, when treatments are prescribed for patients who are contrary to the patient’s preferences. A real-life example shows the case in which a nurse was instructed to aggressively treat a terminally ill patient who wished to receive only palliative care in her advance directive. This case represents a blatant disregard for patient autonomy and a lack of concern for having any care aligned with what a patient may want. The better the situation could have been dealt with, the more effective EI involved. It involves realizing one’s emotions and those of others in oneself and the team and better communicating those feelings during a moral stand-off.
For example, certain emotions identified, such as frustration and distress of one’s self and colleagues, may lead to pragmatic discussions about ethical issues. The emotion makes the members recognize hidden fears, such as legal fears dominating their reasoning in decision-making. Thus, the group applied emotional reasoning when paying less attention to the pressures from the institution to the desires of the patient, which was stated directly, an indication that it was moving within the framework of the proper care. Clear emphasis shall, particularly, help the family members discuss any issues amicably that may have been pending over various decisions and how and when to involve the patient regarding some of those decisions, knowing at each step whether the patient might like to maintain his or her control.
Research has highlighted the role of EI in minimizing moral distress among health professionals. According to Mansel & Einion, (2019), nurses with high emotional intelligence are better positioned to manage difficult ethical situations. They feel less moral distress, work effectively with others, and are resilient during ethical challenges. Emotional intelligence allows healthcare providers to interact with the patient, the family, and other professionals in an emotionally supportive manner, minimizes conflict, and leads to ethically correct decisions.
Conclusion
Ethical sensitivity in health care is called for by the principles of the ANA Code of Ethics to meet moral challenges and improve patient care. By incorporating emotional intelligence into ethical decision-making, healthcare providers can heighten their ability to navigate complex situations, respect patient autonomy, minimize harm, and promote justice. With training in EI and commitment to ethical principles themselves, health professionals will provide an environment that focuses on ensuring patient-centered care and the ethical considerations at the top as far as clinical decision-making is concerned. Ultimately, these efforts help improve outcomes and satisfaction, not only among patients but also among healthcare providers.
References
Mansel, B., & Einion, A. (2019). “It’s the relationship you develop with them”: emotional intelligence in nurse leadership. A qualitative study. British Journal of Nursing, 28(21), 1400–1408. https://doi.org/10.12968/bjon.2019.28.21.1400
Terman, S. A., Steinberg, K. E., & Hinerman, N. (2022). Flaws in advance directives that request withdrawing assisted feeding in late-stage dementia may cause premature or prolonged dying. BMC Medical Ethics, 23(1). https://doi.org/10.1186/s12910-022-00831-7
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