DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
DNP-815A Topic 4 DQ 2
Based on your response to Topic 4 DQ 1, provide a decision tree of how you came to the decision of ethical theory application. Table 1: “Checkpoints for Ethical Decision Making,” in the article “Resolving Ethical Dilemmas: Applying the Institute for Global Ethics’ Ethical Fitness’ Model to Occupational and Environmental Health Practice Issues,” provides a model for guidance. DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
Nurses have a responsibility as advocates for patients’ rights; as a consequence, nurses confront ethical quandaries daily (Johnstone ,2021). As the healthcare system becomes more complex and demands for high-quality nursing care increase, nurses struggle to solve multi-faceted ethical challenges. DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
Early nurse theorists positioned the principles and practice of nursing as having their origins in ‘universal human needs. Ethical issue addressed was on justice and the principle of non-maleficence among mental health patients in seclusion. Justice was one of the fundamental rights of mankind, patients with the mental disability still had their inherent rights to be treated equally, their integrity and dignity should also be respected.
Ethical decision-making is a vital aspect to working within the mental health professions. There are benefits in the DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application use of an EDM model to work through ethical dilemmas in mental health professions (Johnson, et al 2022). Ethical decision-making (EDM) models are designed to guide professionals in a systematic and standardized manner to provide a framework for helping someone determine an acceptable and defensible outcome when confronted with an ethical dilemma. DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
According to Johnson 2021, the decisions in ethical dilemmas can be resolved by (a) evaluate whether training on the use of EDM models improves decision quality, (b) compare the acceptability of EDM models as rated by participants, and (c) demonstrate that EDM model use, training practices, or similar decision-making strategies, are associated with feelings of preparedness or improved decision-making.
The use of ethical decision-making models has its setbacks s, such as social influences, culture, ethical mindset, and biases in decision-making, but understanding these limitations also allows practitioners to consider supplementing existing models with steps that take into account checks for biases.
The principle of deriving nursing care from human needs was thought to provide a guide not only for promoting health, but for preventing disease and illness. The nursing profession has had a longstanding commitment to social justice as a core professional value and ideal, obligating nurses to address the social conditions that undermine people’s health (Lee, et al 2020).
References DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
Johnstone M. J. (2011). Nursing and justice as a basic human need. Nursing philosophy : an international journal for healthcare professionals, 12(1), 34–44. https://doi.org/10.1111/j.1466-769X.2010.00459.x
Johsons, M.K., Weeks, S.N., Peacock, G.g., Rodriquez, M.M. (2022). Ethical decision-making models: a taxonomy of models and review of issues, Ethics & Behavior, 32:3, 195-209, DOI: DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application10.1080/10508422.2021.1913593
Lee, W., Choi, S., Kim, S., & Min, A. (2020). A Case-Centered Approach to Nursing Ethics Education: A Qualitative Study. International journal of environmental research and public health, 17(21), 7748. https://doi.org/10.3
The decision tree derived from the article of Bruchem-Vissera, R. (2020) is based on the methodology described in AACN nursing theory elements like asking, assessing, affirming, and acting. The first step involved designing a decision tree fit to all situations and then moving to secure the probabilities and utility of the outcome against the selected situation.
The third step involved the affirmation of the particular decision following the calculation of cumulative probabilities ( Bruchem-Visser et al., 2020). The final step according to AACN’s theory is to DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
take action that can be analysis of the information as per the situation stated in DQ1. Following is a decision tree representing the decision taken by the nurse in response to the application of ethical theory in practice:
According to the selected article for analysis against the ethical theory, the checkpoints DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
that need to be considered in ethical decision making can be enlisted as follows:
Checkpoint Description
Identification of problem or dilemma: DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
The first step of the decision tree involves the identification of issues and need special attention. the nurse moves to examine the moral dilemma related to that issue and tries to identify the manners and social agreements while taking things into monarchy or conflicting standards which are not moral and economical and technologically aesthetic ( Bruchem-Visser et al., 2020).
Application of Global Ethics:
The nurse manager will evaluate the decision based on institutional global ethics standards like credibility, transparency, and accountability. However, taking an assessment of the decisions the nurse needs to keep a high level of patience, coordination, and determination.
Ethical Fitness :
The next checkpoint in the decision tree is to observe the ethical fitness of the decision. This feature is comprised of social circumstances like the patient has certain perceptions regarding the release of information about his disease ( Bruchem-Visser et al., 2020). These perceptions reveal the quality of the information provided to nurses and the medical care provided to them.
Model to Healthcare Practice Issue:
The feasibility of the healthcare practice model is another point in the decision tree. It helps nurses to remove the dilemma of situations and to better entertain the stakeholders. For the resolution of dilemmas, the nurses are supposed to use ethical models for the selection of appropriate practices. The nurse can adopt a model based on the concept of autonomy providing the basic rights of healthcare decisions to every patient ( Bruchem-Visser et al.,2020).
References DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
Bruchem-Visser, Z., Dijk, G., Beaufort,I. and Mattace-Raso,F. (2020). Ethical frameworks for
complex medical decision making in older patients: A narrative review. Archives of
Gerontology and Geriatrics, 104-160, https://doi.org/10.1016/j.archger.2020.104160.
Morrell, J., Konda, S.and Grant-Kels, M. . (2019 ). Response to a letter to the editor regarding
"The ethical issue of cherry-picking patients. J Am Acad Dermatol, e127.
Also Check Out: DNP-815A Describe a recent or current ethical issue you have faced in nursing practice
In the work we do as nurses, we face ethical dilemmas. Ethics in nursing offers a framework to ensure nurses and the patient are safe. The framework also guides nurses in difficult decision-making and provides a moral compass to carry out their nursing care fairly (Yildiz, 2017).
The previous discussion explored ethical issues that nurses faced during the COVID-19 pandemic. The lack of supplies led to nurses having to make difficult decisions regarding the duty to provide patient care while possibly placing them in an unsafe situation. Additionally, changes to hospital visitation caused an ethical burden on the nurse-client relationship.
These ethical dilemmas caused challenges however using a decision tree such as the one suggested by Edgar (2002) can help develop optimal solutions for all involved.
The moral issue: In the examples discussed, the moral issue is the duty to do no harm and provide safe patient care while keeping yourself, as a nurse, safe. The other moral issue is autonomous decision-making to have family actively engaged in patient care by being actively present.
DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
Determining the actor: The owner of these ethical dilemmas is the nurse and the healthcare facility that has the responsibility of providing adequate resources to deliver safe patient care.
Facts: The obvious fact is the lack of resources with the expectation that nurses still deliver quality of care. The other fact is the change in visitation rights due to the COVID-19 pandemic.
Is the moral issue right versus wrong: The nurse must first explore what would happen if they refused to provide care due to lack of resources? Additionally, the healthcare organization should consider if not providing resources, due to the scarcity, violates healthcare policy. As it relates to the visitation policy, the gut test could be applied which implies does the action feel wrong (Edgar, 2002).
Not allowing patients to have their families physically present may intuitively feel wrong.
Assigning a dilemma paradigm: The two ethical paradigms applicable to these examples are justice versus mercy and individual versus community. Is it fair to not provide care to the patient in need? Should the patient/family be able to autonomously decide if they want to be at a COVID patient bedside knowing the health risk this could pose to the general society? DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
Apply resolution principles: The principle that aligns with the lack of resources but the duty to provide care is the care-based principle. If roles were reversed the nurse would want to receive adequate care regardless of an organizational issue of not having supplies. In the second situation, the rules-based principle applies. During COVID the rules set by healthcare organizations aimed to protect the nurse, patient, and community they serve.
Identify if a third option exists: Alternative options in this case could be using personal protective equipment that may not meet the standard regulations. The other alternative could be using technology to meet the patient needs.
Make the decision: Once all options are considered proceeding forward with providing the best care possible should be the choice. In other words, doing everything that can be done to uphold the duties of a nurse all the while respecting the patient wishes. DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
Reflect on the decision: As COVID is now part of our daily lives, nurses and healthcare organizations should reflect if is the best decisions were made. Furthermore, these ethical dilemmas may allow healthcare organizations to better prepare if there was a reoccurrence in the future. In my healthcare organization we are using lessons learned from COVID and applying them to operating procedures in case there are a substantial number of patients with Monkeypox admitted.
References DNP-815A Topic 4 DQ 2 provide a decision tree of how you came to the decision of ethical theory application
Edgar, P. H. (2002). Resolving ethical Dilemas. AAOHN Journal, 50(1), 40–47. https://doi.org/10.1177/216507990205000110
Yıldız, E. (2017). Ethics in nursing: A systematic review of the framework of evidence perspective. Nursing Ethics, 26(4), 1128–1148. https://doi.org/10.1177/0969733017734412
Nurses work in a complex environment with many demands from the healthcare system, patients, and families. Nurses make decisions daily based on their ethical awareness (Norlyk et al., 2020). They must assess and analyze findings and possible consequences while determining the best for a patient’s well-being. In my work environment, there are a variety of influences on ethical decision-making. Nurses value and respect the patient’s opinions and belief systems to support them in making the best decisions for care. Policies and procedures are in place to help the patient and healthcare providers in those decisions. An ethics committee is on call to assist with any ethical situations that need to be evaluated and discussed. Preceptors and nursing leadership guide new nurses in the management of these situations. Unfortunately, like many other hospitals, we are dealing with a shortage of staff, sicker patients, higher than average number of travel nurses who all create environments that may make it more difficult for nurses to have the ethical awareness needed to pick up on all of the patient’s needs. It is a continuous process to ensure that the nursing staff has the support they need in this challenging healthcare environment.
References
Haahr, A., Norlyk, A., Martinsen, B., Dreyer, P., 2020. Nurses’ experiences of ethical dilemmas: A review. Nursing Ethics 27, 258–272. doi:10.1177/0969733019832941
Dilemma is the name used to describe some of the most challenging cases and ethical issues. Research shows that ethical dilemmas arise from fundamental conflicts among ethical beliefs, duties, principles, and theories. When making tough ethical decisions, individuals tend to rely simply on intuition. Individuals quickly make a value judgment or conclude without thoroughly analyzing the situation or the potential outcomes of one’s decision. However, by adopting a particular ethical lens, individuals can better plan based on sound reasoning. In the article “Resolving Ethical Dilemmas: Applying the Institute for Global Ethics’ Ethical Fitness’ Model to Occupational and Environmental Health Practice Issues,” Edgar P. H. (2002) lists the following four issues that are critical to an ethical dilemma: 1. Technological advancements have rapidly increased the need for careful ethical choices to preserve life and the environment of the global community. 2. No formula exists to resolve ethical dilemmas, but an ethical decision-making model can help maintain a state of ethical fitness. 3. The Ethical Fitness model assumes that specific core values are universal. Maintaining ethical fitness is essential to resolving ethical dilemmas. 4. The process of resolving ethical dilemmas involves analyzing the dilemma using nine checkpoints, four dilemma paradigms, and three resolution principles.
The ethicist Rushworth Kidder developed nine ethical checkpoints that can be used to make a moral decision in each circumstance. Kidder defines ethical Dilemmas as “right vs. right” and “at the heart of our toughest choices (Kidder, R. M. 1996). They are genuine dilemmas because each side is firmly rooted in our core values. When people encounter these tough choices, it is rarely because they face a moral temptation, that is, a choice between right and wrong. The nine chronological and logical checkpoints guide decision makers towards an ethical decision with simplicity to help the decision maker achieve a grounded solution (Gregory, 2010). Kidder lays out the following nine checkpoints for Ethical Decision Making: 1. Recognize there is a moral issue; 2. Determine the actor (who does the problem belong?); 3. Gather the relevant facts; 4. Test for right vs. wrong issues; 5. Test for right vs. suitable paradigms; 6. Apply the resolution principles; 7. Investigate the “trilemma” option; 8. Make the decision; 9. Revisit and reflect on the decision( Kidder, R. M. (1996. The paradigms describe ethical problems as an “either/or” either Truth or Loyalty, either Justice or Mercy. As stated in step 7, there is frequently a third option. Kidder calls this the “trilemma” option. In this third option, he supports both sides in a “right vs. right” argument. He asks, can I create a “Win-Win” in this situation? “Win-Win” is the best obvious choice, and step 7 is especially important to the process. Step 8 is also crucial and is the most frequently overlooked step in the process. People tend to process the problem but never decide or act. It is essential to conclude, settle, work, revisit, and reflect.
Clinical practice can give rise to situations where conflicting interests pose nurses with complex ethical dilemmas). Ethically sensitive problems and issues are not new in today’s health care practice, increasing in frequency and complexity. For practitioners to face these challenges, they must not only understand their values and beliefs but understand the tools available to resolve these ethical dilemmas when they arise. Ethical theories, principles, and decision-making models can assist the practitioner in obtaining a resolution.
Edgar P. H. (2002). Resolving ethical dilemmas. Applying the institute for Global Ethics’ Ethical Fitness model to occupational and environmental health practice issues. AAOHN journal: official journal of the American Association of Occupational Health Nurses, 50(1), 40–47., Retrieve July 31st, 2022.
Gregory, R. (2010). Moral and ethical leadership in administrator preparation. International Journal of Educational Leadership Preparation, 5(3), 1-6, Retrieved July 31st, 2022.
Kidder, R. M. (1996). How good people make tough choices: Resolving the dilemmas of ethical living (1st Fireside ed.). New York: Simon & Schuster., Retrieve July 31st, 2022.