Ethical, Moral and Legal Implications of a Situation
In the contemporary medical world, the challenge of wrong site surgery persists to torment healthcare facilities despite the emphasis on promoting patient safety, an indicator of quality care. A case in point, the Joint Commission recent report estimated that 1196 instances of the wrong site, wrong patient and wrong procedure surgery occurred in the year 2015 across different USA hospitals.
Ethical, Moral and Legal Implications of a Situation
Additionally, approximately 57% of these reported serious medical events led to patient mortality, unplanned additional care and irreversible loss of function (8.9%) (ECRI Institute, 2015). Such a statistic is worrying and shocking given the measures at the disposal of nurse leaders for the reduction of this serious medical adverse event. A befitting example of such preventive strategies is the reporting of this type of adverse event to authorities. An action of this kind is necessary for the initiation of other measures like paying fines that will discourage the occurrence of this event in the future. In the absence of carrying out such obligations, ethical, moral and legal implications are inevitable.
Ethical, Moral and Legal Implications of a Situation
In essence, this paper aims at analyzing a real life situation in which ethical, moral and legal implications arose following the failure of healthcare personnel to comply with the directive of reporting a serious reportable event. Central to the achievement of this purpose is the introduction of various conceptual frameworks of the ethical constructs of ethics, moral, or legal standards. Finally, the discussion will also bring to light the effectiveness of the personal leadership attributes, obtained from Keirsey Temperament Sorter, in acting as a moral agent or an advocate for change.
Conceptual Framework
Precisely, several conceptual frameworks of ethical constructs of ethics, moral, or legal standards are existent. Befitting examples of such models in ethics include but not limited to utilitarianism, intuitionism, right-based and duty-based approaches. All these approaches have unique features that distinguish them from the other. For instance, while the utilitarianism considers common good as ethical, the right-based approach emphasizes on the preservation of individual’s right (Marquis, & Huston, 2015).
Similarly, conceptual models envisaging morality are also existent. According to Rusthoven and Bartholomew, (2014), they include theories based on human relationships, cognitive properties, moral agency and human biological properties. All these frameworks are essential in nursing and are applicable in different scenarios.
Lastly, each profession has its legal framework that regulates and guides the actions of its targeted professionals. For example, in the nursing profession, the Nurse’s Practice Act is the law that directs the work of nurses in the USA (Marquis, & Huston, 2015).
Dilemma at Work
Of the interest to this analysis and worth mention is the dilemma that occurred in the operating room where I work on a daily basis. The dilemma centers on anesthesiologist who performed a nerve block on the wrong side of the patient’s body. The patient had come in for a surgical removal of a left eye cataract, but the anesthesiologist mistakenly administered the local anesthesia on the right eye for nerve blockage. Postoperatively, this action would subject the patient to double vision and pain. Consequently, the anesthesiologist decides not to report the event to the relevant authorities as per the hospital policy and other healthcare professionals in the operating room pledge their unwavering support to cover up this incidence.
Following this turn of events, at the personal level, the dilemma sets in because my persona could not fathom the idea of protecting of anesthesiologist’s reputation at the expense of compromising the patient safety and right to justice. As such, this prompted my refusal to be part of the conspiracy and consequently encouraging the anesthesiologist to act according to the book since the organization and patient’s interest should supersede healthcare personnel desire. Despite presenting this concrete plea, my outcry fell on deaf ears since its reception by the other surgical team members was harsh and even worse the anesthesiologist was more resolute not to disclose this unexpected event. Given the anesthesiologist’s adamant nature and other surgical team members to support his action, I chose not to be part of this scheme and instead decided to report the situation to the authority.
Analyzing the Dilemma
The refusal to disclose the medical error committed resulted in various ethical, moral and legal implications arose that are worth noting. Primarily, in ethical terms, the action of choosing not to comply with the hospital policy of reporting medical errors is wrong given that it fails to take into account many ethical considerations. A typical example of such failure is evident when one considers the duty-based ethical framework for decision-making. Going by this model, healthcare professionals have an ethical responsibility of acting in a universally acceptable manner without failure since acting contrary to this is unethical (Martin, 2014). However, this is not the case given that the anesthesiologist and other healthcare personnel are resolute in not doing their moral duty of reporting medical errors, which is ethically wrong. Strengthening this argument further is the right-based ethical framework approach of decision-making. According to Pence, (2014) the right-based approach posits that protection of an individual’s rights should be of prime focus when making decisions affecting him or her. In this case, the patient’s right to justice is on trial because of the attempt of the anesthesiologist not to disclose the truth. As such, in ethical terms, this attempt is evil since it impedes the patient his right to fair and equal treatment. Clearly, based on these arguments, it is beyond doubt that this dilemma has enormous ethical implications.
Notwithstanding, moral implications abound from this scenario that are noteworthy. For instance, upholding of moral principles such as veracity and beneficence is in jeopardy, which in moral terms is unacceptable. Butts and Rich, (2015) is of the opinion that veracity refers to telling the truth regardless of the implication it has on an individual. Unfortunately, the principle of veracity is at risk in this situation because the anesthesiologist and other surgical team members collude with the purpose of covering the undesirable medical event by failing to report it to the relevant persons. Such an action if carried out hinders the truth. On the contrary, beneficence entails doing good always regardless of the circumstances (Butts, & Rich, 2015). In this situation, it comes to the fore when I stop at nothing to ensure that the best interests of the patient are at heart. As such, going by these instances, it is apparent that this dilemma posed an enormous moral burden.
Furthermore, the action by the anesthesiologist and other healthcare personnel to refrain from disclosing the truth also has a legal implication that one cannot take for granted. Legally, nurses allowing the perpetration of wrongdoing committed to a patient in their custody without questioning are at risk of facing legal charges (Marquis, & Huston, 2015). As such, in this case, this personal liability that this situation had on me could not let me sit and watch from the sidelines.
Lastly, looking back at this dilemma, there are several roles as a moral agent or an advocate that I ought to have assumed. One of such roles is the advocacy role in which I sought to negotiate for a better treatment of the patient by trying to persuade the anesthesiologist to reconsider his stance of not reporting the medical error. Also, another role that comes to the fore in this situation is that of being a champion of truth. That is for sure given that I decide not to be part of the conspiracy by reporting the issue to the relevant authorities. According to Disch, (2014), the roles assumed in this situation are characteristic of moral agents when faced with an ethical dilemma.
Self-Assessment
In consideration of the self-assessment findings obtained in the Kiersey Temperament Sorter, I have valid reasons to back why I acted in that manner. According to the assessment, my leadership style is that of a guardian leadership (KTS-II, n.d.). Central to this type of leadership is the concrete cooperator feature, which entails talking about the reality of a situation and acting in the right manner (Keirsey.com, 2017). Given this revelation about my leadership style, it is clear that my guardian leadership strategies informed my interventions in this scenario. That is the case since I insisted on doing what is right despite the impediments that I faced. As such, it is beyond question that my leadership traits played a significant role in my actions in this circumstance.
Conclusion
Concisely, this paper aimed at analyzing a real life situation in which ethical, moral and legal implications arose following the failure of healthcare personnel to comply with the directive of reporting a serious reportable event. Indeed, this discussion has achieved this purpose, and it is clear that nurses must draw on the various resources at their disposal to rectify such situations. In the absence of such, harsh effects of these medical errors are inevitable. As such, going into the future, all efforts should be in this direction.
References
Butts, J. & Rich, K. (2011). Philosophies and theories for advanced nursing practice (1st ed.). Sudbury, Mass.: Jones and Bartlett Publishers.
Disch, J. (2014). Using Evidence-Based Advocacy to Improve the Nation\’s Health. Nurse Leader, 12(4), 28–31. doi:10.1016/j.mnl.2014.05.003
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ECRI Institute. (2015). Joint Commission Updates Sentinel Event Statistics. ECRI Institute. Retrieved 5 May 2017, from https://www.ecri.org/components/HRCAlerts/Pages/HRCAlerts111815_Joint.aspx
Keirsey.com. (2017). Keirsey Temperament Website – Overview of the Four Temperaments. Keirsey.com. Retrieved 5 May 2017, from http://www.keirsey.com/4temps/overview_temperaments.asp
Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Martin, M. B. (2014). Transcultural Advocacy and Policy in the Workplace: Implications for Nurses in Professional Development. Journal for nurses in professional development, 30(1), 29–33. doi: 10.1097/NND.0000000000000027
Retrieved from the Walden Library databases.
Pence, G. E. (2014). Medical ethics: Accounts of ground-breaking cases.New York: McGraw-Hill.
Rusthoven, J. & Bartholomew, C. (2014). Covenantal biomedical ethics for contemporary medicine. Eugene, Oregon: Pickwick Publications.
