Capella FPX 4000 Assessment 3

Capella FPX 4000 Assessment 3

Name

Capella university

NURS-FPX4000 Developing a Nursing Perspective

Prof. Name

Date

Applying Ethical Principles

Dr. Emily Clark, a cardiologist at Mercy General Hospital, has to face an ethical dilemma when taking informed consent from 58-year-old Mr. Rajan Patel, who is a limited English speaker. Mr. Patel needs major heart surgery, but language barriers hinder his understanding of the risks and benefits. This case highlights the tension between autonomy, respecting the patient’s right to decide, and beneficence, acting in his best interest. This paper examines the ethical actions required to resolve this dilemma.

Case Study and its Overview

In the case study of Mr. Rajan Patel, the stakeholders include Mr. Patel himself, Dr. Emily Clark, and the healthcare team involved in his care. The challenge arises from Mr. Patel’s limited English proficiency, which makes him unable to completely understand the risks and benefits of a necessary surgical procedure. This is an ethical dilemma for Dr. Clark, who has to balance the autonomous desire of Mr. Patel and her duty of beneficence. Taking into account the case study analysis that eventually led to this ethical dilemma, the following facts have been gathered:

Informed Consent and Patient Understanding

Informed consent forms the basis for determining Mr. Patel’s autonomy. His inability to speak fluently in English compromises his capacity to make informed choices. He was confused about what he should say to explain the procedure and its risks. Appropriate communication is one aspect that has been termed necessary for ensuring that patient consent is indeed informed, especially when patients have linguistic and cultural barriers (Zhao, 2021). This challenge calls for clear and culturally responsive communication, thus guaranteeing ethical requirements in patient care based on empirical evidence.

The Tension between Autonomy and Beneficence

Dr. Clark needs to balance her role to respect Mr. Patel’s autonomy and her ethical role to act in his best interest. The language barrier complicates informed consent and risks undermining the principle of beneficence. Studies have shown that healthcare providers often face challenges when patient autonomy conflicts with beneficence, especially in multicultural contexts (Alshehri & Al, 2023). This evidence makes the ethical dilemma Dr. Clark faces navigating these competing principles more complex.

Legal and Ethical Responsibilities of Healthcare Providers

It is Dr. Clark’s legal and ethical obligation to ensure that Mr. Patel is fully aware of the process of obtaining his consent and applying all available tools, like the interpreters, to minimize this barrier. Indeed, medical research notes that language difference is one of the components of ethical and legal practices within a patient’s healthcare setting (Pergert & Tiselius, 2020). This analysis seals the need to balance Dr. Clark’s obligations with Mr. Patel’s rights to provide equal care.

The Effectiveness of Communication Approaches in the Case Study

In the case of Mr. Rajan Patel, Dr. Emily Clark must navigate the ethical challenge of ensuring informed consent despite significant language barriers. Her approach should prioritize culturally sensitive and effective communication to uphold Mr. Patel’s autonomy while ensuring he fully comprehends the surgical procedure and its associated risks. Dr. Clark’s success hinges on establishing trust and clarity without compromising Mr. Patel’s right to informed decision-making.

Principal Strategies for Effective Communication

To address the language barrier, Dr. Clark should utilize a professional medical interpreter proficient in Gujarati to facilitate accurate and empathetic communication. This ensures Mr. Patel receives all necessary information in a language he fully understands (Patel, 2021). Employing visual aids or translated written materials could reinforce his understanding of the procedure and its risks. Asking Mr. Patel to repeat the information in his own words, a technique known as “teach-back,” ensures he comprehends the details and makes an informed decision (Varnadoe, 2022). Another key strategy is active listening. Dr. Clark should validate Mr. Patel’s concerns and encourage him to voice questions or doubts, which fosters trust and mitigates any feelings of vulnerability or alienation (Greene & Ramos, 2020).

Dr. Clark should avoid making assumptions about Mr. Patel’s understanding based on nonverbal cues, such as nodding or smiling, as these may not accurately reflect comprehension. Relying solely on family members to translate rather than a professional interpreter could lead to inaccuracies or bias in the conveyed information, further compromising the informed consent process.

Applying the Ethical Decision-Making Model and Its Effectiveness

Moral Awareness: Dr. Emily Clark shows great moral awareness in recognizing the ethical dilemma presented by Mr. Rajan Patel’s limited understanding of the surgical procedure. She knows the tension between respecting Mr. Patel’s autonomy, a fundamental principle of informed consent, and her duty to act in his best interest by ensuring he has the information necessary to make an informed decision. This awareness enables Dr. Clark to identify critical ethical issues and prepare for thoughtful moral judgment.

Moral Judgment: In exercising moral judgment, Dr. Clark weighs the situation based on the ethical principles of autonomy and beneficence. She considers Mr. Patel’s right to make an independent decision regarding his healthcare while recognizing that interventions, such as professional interpretation services, must address his linguistic and cultural barriers. Dr. Clark also considers ethical guidelines emphasizing patient-centered communication and informed consent fundamental to ethical medical practice.

Capella FPX 4000 Assessment 3

Ethical Behavior:  As a proactive measure to overcome communication challenges, ethical behavior is reflected in the behavior of Dr. Clark: She involves professional interpreters and uses culturally appropriate tools, for example, translated materials or visual aids, to facilitate Mr. Patel’s thorough understanding of the procedure, risk, and benefits. She will also use active listening and the “teach-back” method to ensure she understands Mr. Patel completely (Varnadoe, 2022). While respecting his autonomy, she tries to act in his best interest by creating an environment that fosters trust and understanding.

The implications of a practical and ineffective ethical approach in this situation could be significant. With effective communication strategies and cultural and linguistic barriers addressed, Dr. Clark can establish trust with Mr. Patel and allow him to make an informed decision consistent with his values. On the other hand, failure to address these barriers may compromise the informed consent process, risking mistrust, miscommunication, and adverse consequences. Therefore, Dr. Clark needs to balance her professional obligations with cultural sensitivity to uphold Mr. Patel’s rights and health outcomes.

Applying Ethical Principles to a Possible Solution

To solve Mr. Rajan Patel’s ethical dilemma, the solution can be set up by incorporating the four key ethical principles: beneficence, non-maleficence, autonomy, and justice. Beneficence is concerned with doing good to Mr. Patel. Dr. Emily Clark ensures that he fully understands the surgical procedure, its risks, and its benefits. By using professional interpreters and culturally appropriate educational materials, she creates a supportive environment in which Mr. Patel can make an informed decision about his health care. It thus prioritizes his well-being by reducing the risk of miscommunication and ensuring that he is adequately prepared for the surgery. Non-maleficence will be maintained by reducing the danger associated with an uninformed consent process.

Dr. Clark tactically addresses Mr. Patel’s limitations in understanding English by using translated documents, visual aids, and a teach-back method to ensure that Mr. Patel understands the procedure and its possibilities and consequences (Varnadoe, 2022. This will certainly avoid unforeseen negative outcomes from misconstruing the information. Dr. Clark respects Mr. Patel’s autonomy by actively including him in the decision-making process. She ensures he is provided with all the necessary information in a format he can understand, empowering him to make an independent, informed choice regarding his treatment. By encouraging a two-way dialogue and giving priority to his values and preferences, she maintains his right to self-determination (Greene & Ramos, 2020).

Dr. Clark’s equity in dealing with Mr. Patel’s language and cultural needs was impressive. Despite the language barrier, she treated him with the same care and understanding as any other patient. This included seeking further support, such as interpreter services, and tailoring communication methods to his needs. Dr. Clark integrates the ethical framework in solving Mr. Patel’s case by incorporating beneficence, non-maleficence, autonomy, and justice. This multi-faceted approach promotes his well-being, respects his rights, minimizes potential harm, and ensures equitable care, creating a balanced and ethically sound solution to the dilemma.

Conclusion

Dr. Clark considers a balanced approach of beneficence, non-maleficence, autonomy, and justice in addressing Mr. Patel’s ethical problem. By providing clear information and taking cultural background into consideration, she gains his consent and respects his rights and needs. This strategy helps establish trust, manage risks, and be ethical in the process. Finally, it emphasizes the value of justice in mediating encounters between patients and professionals across resultative contexts.

References

Alshehri, M. J., & Al, A. (2023). Ethical dilemmas in medical nursing: Navigating complexities. Journal of Namibian Studies: History Politics Culture, 36, 2030–2043. https://doi.org/10.59670/32zsya32 

Greene, J., & Ramos, C. (2020). A mixed methods examination of health care provider behaviors that build patients’ trust. Patient Education and Counseling, 104(5). https://doi.org/10.1016/j.pec.2020.09.003 

Capella FPX 4000 Assessment 3

Patel, A. N. (2021). “I Am Just a Patient for Them”: Narratives of the Gujrati Immigrant Describing the Preventative Healthcare Experience in the United States (Doctoral dissertation, Saybrook University).

Pergert, P., & Tiselius, E. (2020). Intercultural competence and communication over language barriers. Ethical Issues in Pediatric Hematology/Oncology, 203–222. https://doi.org/10.1007/978-3-030-22684-8_10 

Varnadoe, C. (2022). Use of Teach-Back During Informed Consent in Cancer Clinical Trials. Yale University.

Capella FPX 4000 Assessment 3

Zhao, X. (2021). Challenges and barriers in intercultural communication between patients with immigration backgrounds and health professionals: A systematic literature review. Health Communication, 38(4), 1–10. https://doi.org/10.1080/10410236.2021.1980188 

 

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