Ethical Decision Making

Ethics-PHI 220 03/16/2012 dangerous decision Making possessup Case Study From Santa Clara University thither argon two types of surrogacy. One type involves a refilling generate who uses her take hold got egg and carries the fry for someone else. The other type is a gestational surrogacy in which the get has no inherited tie to the baby she carries. In the instance presented, a gestational surrogate is apply. A woman, after a bout with uterine undersidecer had a hysterectomy (surgical removal of the uterus). Before, its removal, however, she had several(prenominal) eggs distant for possible fertilization in the future.Now married, the woman wishes to absorb a electric s postulater with her preserve. seemingly she rotternot bear the baby herself, so the equalise utilizes a comp any to find a surrogate flummox for them. The husbands sperm is used to fertilize one of the wifes eggs, and is implanted in the surrogate experience. The meet pays tout ensemble of the womans pregnancy-related expenses and an extra $18,000 as fee for her surrogacy, and after all expenses are taken into account the couple pays the woman slightly $31,000 and the agency somewhat $5,000.Though the surrogate passed stringent mental testing to ensure she was competent to carry other couples child, after carrying the pregnancy to term, the surrogate says that she has become too attached to her child to bequeath it up to the couple. A legal passage of arms ensues. whole tone 1 Gather Relevant Information The Surrogate is carrying a baby that has no genetic ties to her. The Surrogate was paying(a) quiet well to do a assist and decides not to follow with with the service.The surrogate now decides to concur the baby and the money because she has grown to close to the baby. ill-use 2 slip of honourable problem According to Markkula center for applied ethics, justice means endowment each item-by-item what he or she deserves or, in more traditional terms, magnanimous each person his or her due. justice and fairness are closely related terms that are often now used interchangeably. There confine, however, in any sequel been more distinct arrests of the two terms.While justice usually has been used with author to a hackneyed of objurgateness, fairness often has been used with regard to an ability to infer without reference to ones olfactory meettyings or interests fairness has to a fault been used to refer to the ability to make judgments that are not overly superior general but that are concrete and specific to a peculiar(prenominal) lesson. In any case, a idea of desert is pivotal to both justice and fairness. (SCU)The most fundamental dogma of justiceone that has been wide accepted since it was commencement exercise defined by Aristotle more than two thousand years agois the principle that equals should be tough equally and unequals unequally. In its contemporary form, this principle is sometimes express as follows Individuals should be treated the same, unless they differ in ways that are relevant to the situation in which they are involved. (SCU) By the surrogate keeping this baby, she is going against everything that was in the agreement.This baby has no attachment to the surrogate it is the egg of the husband and wife who paid her to carry their child. In the United States it is illegal to pay a person for non-replenish qualified organs. The fear is that money leave behind influence the poor to harm their bodies for the benefit of the rich. Is at that place a correspond between this case and this law? Can go awaying surrogate mothers to be paid for their troubles allow poorer women to be crush? On their website, the AMA says that surrogacy shrinks when the surrogate uses her own egg, while permissible, should grant the birth other the right to void the slenderize within a reasonable period of time after the birth of the child. If the declaration is voided, custody of the ch ild should be determined according to the childs best interests. (SCU) However this is not the case with this couple, the couple used their own egg and implanted it into the surrogate so should the same rules apply? Step 3 Apply Ethical Theories and Approaches Ethical theory is divided into two main types or approaches in this case which are impartiality and duty ethics.Virtue ethics begins by considering what makes a person (or his/her character or motives) morally good (Aristotle, Hume). transaction Ethics focuses on rules or acts and what makes them right (Mill, Kant, Rawls). (Ethical Theory) According to the both theories the surrogate should come about over the child to the biological parents. This surrogate has no real ties to the child and was paid for a service and is violating a contract by not providing the child she was paid to deliver. Step 4 Exploring Practical AlternativesWith this particular case thither are not numerous alternatives. Option 1- being that the su rrogate keeps the child and returns all the money she was paid to do the service and the money put out for her medical bills. The surrogate could in like manner reimburse the couple for their time and heart ache. Option 2- The couple and the surrogate could go in movement of a judge and have the judge decide what is best for the child and the people involved, and what the outcome shall be. Step 5 recognise the Action This is the most grievous step in the ethical conclusion qualification exercise.This is where the actions are carried out. afterwards reviewing all the details and options for this case the most ethical thing to be do is for the surrogate mother to give the baby, who has no biological attachments to her back to the biological parents. The surrogate can keep the $18,000 she was paid for hire for her time and expenses, plus the money put out for all her medical expenses. kit and boodle Cited Justice and Fairness. Santa Clara University. Web. 17 Mar. 2012. . Et hical Theory. Web. .Ethical Decision MakingEthical Decision Making End of Life Submitted by Anthony Mcdew Ethical nursing armorial bearing Nurses are faced with ethical decision making on a daily basis. This could be both stressful and challenging. The following case study I chose to walk by dint of is Mr. Clarke is a patient who has advanced AIDS with related pain syndromes and is also participatingly abusing drugs. The apply is bear on about his abusing his pain medications and is not sure if she should give them to him as he leaves the hospital. It will be my presumption that this patient is nearing the end of their animateness.The value, be, do ethical decision-making model will provide the framework I withdraw to treasure this case study (Schaffer and Norlander). I also will be using ethical decision making tools to travel by my decision making process. What should I value? The first step of the value, be, do ethical decision-making model answers the question what s hould I value? It is time that I look deep into the meaning of my feeltime in regards to my professional nursing practice. What do I value in life? The meaning of life for me involves personal and professional respect for my patient and his physician in charge of his care.This involves respecting my patient and his situation. Also, trusting the prescribing Physicians command and training is something I value. Along with valuing respect I value quality end of life care for my patient. Every individual deserves a peaceful death with minimal pain and suffering if possible. To obtain this, I also indigence to value my relationship with my patient. Developing a trusting relationship is important for him and also me when dealing with uncomfortable conversations that whitethorn have to take place. Finally, I think that I value my bringing up and critical thinking skills.These skills are important to value because I will have to make a decision if I think my patient can handle taking hi s own pain medications on his own. My education and critical thinking skills will guide me to problem resolution that has the best outcome for the patient. Who should I be? not only is it important to understand what values impact my actions and decisions it is also important to make sure my actions reflect my values. The values I have make sure that I am an root on for my patients comfort as well as their safety.They also service me be an active and compassionate listener as well as a teacher. If I am a trusted person my patient will hopefully feel comfortable talking to me about his addiction. Finally, to ensure a quality end of life experience for my patient, I will stay educated on medication dosages, side effects, and other treatments for pain. By critically thinking, I should be able to educate my patient and tending communicate to the Physician about the patients concerns regarding pain addiction and pain control. What should I do?By taking into custody what I value and who I am I now should be able to fulfill my actions. First, I feel that I should take time to analyze the patients past medical history and medications that friended his pain. Second, I will review the pain medications with the Physicians to ensure I have a proper understanding of his or her plan. then(prenominal) I will review what is needed to provide quality end of life care with good pain control to a dying AIDS patient. After I feel that I have a great understanding of the situation it is time I listen and talk with my patient.Assure them that I am there as their urge on for safe and complete end of life care. This may ask me to act as a counselor or bring in interdisciplinary team members to supporter my patient. My number one goal is to provide safe end of life care but as painless and comfortable as possible. Analyze response to case study It is always challenging to give patients medications knowing that they may become, or have become habituated. In my current practi ce we see many patients who go to pain clinics and have pain contracts to help with their addiction and pain management.The difference is, my patients are not dying. Thirouxs universal ethical principles allow nurses to take time and review the ethical situation. In my case study, I personally feel the Mr. Clarke has the right to a peaceful death if possible. The problem is that the medications we are giving him may kill him first. Thirouxs principles allows for individual freedom and valuing life. My patient should have the freedom he involve to decide if the pain if worse or the addiction. Depending on how long he has to live, the addiction may be the least of his problems.I feel that I need to value his life and quality of life. Also, I need to understand that death most likely is going to happen. (Blackboard). Thirouxs universal ethical principles allow nurses to assess the client situation as well as the caring and justice model (blackboard). This model enhances how nurses fe el about ethical problems. Mr. Clarkes situations force me as his primary nurse to understand how to be an advocate for him and his situation. It also reminds me to use my compassion and virtue when caring and talking with him about his pain addiction.Finally, I have learned that solving or being part of an ethical dilemma can be easier on a nurse by incorporating spirituality. I think that by assessing Mr. Clarkes spirituality I may be able to help him with his addiction or suffering he is facing. Isaiah 434-5 says that Since you are uncommon and honored in my sight, and because I love you, I will give men in transform for you and people in exchange for your life. It goes on to say that we should not be afraid because divinity fudge is with us and will unite us together. This bible verses supports my belief that God is there for us as nurses and that he had a purpose for us.God gave us the power to support all situations. The verses also leads me to deal that the purpose of lif e is to help others physically, emotionally, or spiritually with whatever gifts you may have. I truly conceptualise that God gave me the guidance I need to make this ethical decision on how to help Mr. Clarke. I believe that with proper education and assessment of his pain protocol Mr. Clarke deserves to have pain relief. This can be done by having his medications monitored. However, they should not be withheld. God does not want suffering and either do I. Quality guidelinesDomains of end of life quality care. The domains of end of life quality care that apply to my case study include pain and symptom control, achieving a sense of control, and possibly strengthen the relationship with love ones. It is my goal to provide quality end of life care to Mr. Clarke. This includes symptom and pain management. By allowing him to have a sense of control with his pain medications he is able to help determine is end of life experience. Finally, by assessing Mr. Clarkes relationship with his fa mily I will be able to see if they can help him.There help could be support, symptom monitoring, and medication management. They also may be able to help him with alternative measures at times including guided imagery, music therapy, massage etc. Bill of last rights. Not only is it important to understand the domains of end of life quality care it is also important to retrieve the bill of last rights. These rights are consistent reminders of the rights dying patients have or basic human rights. Mr. Clarke has a right to control, to be comfortable, and the right to hear the truth.These rights remind me as his caregiver that he is part of this process as well as his medical care team. Even though I feel we cool it should prescribe his medications I also believe that he is entitled to know that he has become addicted and how to work through it. septet Promises. Another tool to use when assessing Mr. Clarkes case study would be reviewing the Seven Promises. The one promise that stand s out the most to me is never be overwhelmed by symptoms (blackboard). This includes never having to endure evoke pain, shortness of breath, or other symptoms (blackboard).This promise reminds me as his care giver that his care team needs to consistently be assessing his pain protocol and symptom management. The other promise that I feel would be beneficial to remember when caring for Mr. Clarke is make the best of everyday (blackboard). This allows the care team to remember that Mr. Clarke is an individual and each day we need to make sure we are helping him. Not only is it important to offer medications for pain management it is also important to offer alternatives. Each day as his nurse I can document what time of day his pain is worse, what stimulus increases and decreases pain.Every day, I can do my best to help him make the best of his day. Precepts of Palliative care. The last option I have encountered that I can to do assess my patients situation is to analyze the organizat ion. By reviewing the Precepts of care, I will be able to make sure the organization is not lacking in any areas that may help Mr. Clarke. This tools will allow us to make sure the organization is respecting the patients decisions, giving worldwide care, utilize resources of team members, address caregivers concerns, and analyzing the environment (blackboard).This can ensure that not only I am providing good ethical care to my patient, as well as the organization and medical care team. Actions/ reception After analyzing and utilizing all of the tools available to me I have decided that Mr. Clarke deserves to get his pain medication. He is actively dying and has the right to pain and symptom control. It is easier to monitor his addiction then his suffering. The Physician is prescribing only a certain quantity of medications at a time. This can help the care team to monitor his addiction.I believe that the situation would be different if the patient was not dying. I believe that with my strong understanding of my values I will be able to allow my actions to be appropriate. This will help guide me through what should I do? Ethical decision making is never an easy process. By having the proper tools, it can help medical care team members make a decision. It is my job to educate, counsel, support, and advocate for Mr. Clarke. I would need to be concerned with his medication addiction if he started to overdose.The case study said he is only having trouble with addiction. However, his medication management still needs to be closely monitored for this scenario. Ethical situations can change depending on the situation. I hold strong to by choice that Mr. Clarke needs his pain medications. acknowledgement Bethel College of Nursing Department (n. d. ). Bethel University NURS344 Blackboard Course modules 2010, St. Paul MN. Schaffer, M. , Norlander, L. (2009) Being present A Nurses resource for end of life communication. Indianapolis, IN Sigma Theta Tau International. .E thical Decision MakingEthics-PHI 220 03/16/2012 Ethical Decision Making Paper Case Study From Santa Clara University There are two types of surrogacy. One type involves a surrogate mother who uses her own egg and carries the baby for someone else. The other type is a gestational surrogacy in which the mother has no genetic tie to the child she carries. In the case presented, a gestational surrogate is used. A woman, after a bout with uterine cancer had a hysterectomy (surgical removal of the uterus). Before, its removal, however, she had several eggs removed for possible fertilization in the future.Now married, the woman wishes to have a child with her husband. Obviously she cannot bear the child herself, so the couple utilizes a company to find a surrogate mother for them. The husbands sperm is used to fertilize one of the wifes eggs, and is implanted in the surrogate mother. The couple pays all of the womans pregnancy-related expenses and an extra $18,000 as compensation for her s urrogacy, and after all expenses are taken into account the couple pays the woman approximately $31,000 and the agency approximately $5,000.Though the surrogate passed stringent mental testing to ensure she was competent to carry another couples child, after carrying the pregnancy to term, the surrogate says that she has become too attached to her child to give it up to the couple. A legal battle ensues. Step 1 Gather Relevant Information The Surrogate is carrying a baby that has no genetic ties to her. The Surrogate was paid quiet well to do a service and decides not to follow through with the service.The surrogate now decides to keep the baby and the money because she has grown to close to the baby. Step 2 Type of ethical problem According to Markkula center for applied ethics, justice means giving each person what he or she deserves or, in more traditional terms, giving each person his or her due. Justice and fairness are closely related terms that are often today used interchang eably. There have, however, also been more distinct understandings of the two terms.While justice usually has been used with reference to a standard of rightness, fairness often has been used with regard to an ability to judge without reference to ones feelings or interests fairness has also been used to refer to the ability to make judgments that are not overly general but that are concrete and specific to a particular case. In any case, a notion of desert is crucial to both justice and fairness. (SCU)The most fundamental principle of justiceone that has been widely accepted since it was first defined by Aristotle more than two thousand years agois the principle that equals should be treated equally and unequals unequally. In its contemporary form, this principle is sometimes expressed as follows Individuals should be treated the same, unless they differ in ways that are relevant to the situation in which they are involved. (SCU) By the surrogate keeping this baby, she is going ag ainst everything that was in the agreement.This baby has no attachment to the surrogate it is the egg of the husband and wife who paid her to carry their child. In the United States it is illegal to pay a person for non-replenish able organs. The fear is that money will influence the poor to harm their bodies for the benefit of the rich. Is there a parallel between this case and this law? Can allowing surrogate mothers to be paid for their troubles allow poorer women to be oppressed? On their website, the AMA says that surrogacy contracts when the surrogate uses her own egg, while permissible, should grant the birth other the right to void the contract within a reasonable period of time after the birth of the child. If the contract is voided, custody of the child should be determined according to the childs best interests. (SCU) However this is not the case with this couple, the couple used their own egg and implanted it into the surrogate so should the same rules apply? Step 3 App ly Ethical Theories and Approaches Ethical theory is divided into two main types or approaches in this case which are virtue and duty ethics.Virtue ethics begins by considering what makes a person (or his/her character or motives) morally good (Aristotle, Hume). Duty Ethics focuses on rules or acts and what makes them right (Mill, Kant, Rawls). (Ethical Theory) According to the both theories the surrogate should hand over the child to the biological parents. This surrogate has no real ties to the child and was paid for a service and is violating a contract by not providing the child she was paid to deliver. Step 4 Exploring Practical AlternativesWith this particular case there are not many alternatives. Option 1- being that the surrogate keeps the child and returns all the money she was paid to do the service and the money put out for her medical bills. The surrogate could also reimburse the couple for their time and heart ache. Option 2- The couple and the surrogate could go in fro nt of a judge and have the judge decide what is best for the child and the people involved, and what the outcome shall be. Step 5 Complete the Action This is the most important step in the ethical decision making process.This is where the actions are carried out. After reviewing all the details and options for this case the most ethical thing to be done is for the surrogate mother to give the baby, who has no biological attachments to her back to the biological parents. The surrogate can keep the $18,000 she was paid for compensation for her time and expenses, plus the money put out for all her medical expenses. Works Cited Justice and Fairness. Santa Clara University. Web. 17 Mar. 2012. . Ethical Theory. Web. .