ESSAY Moral Dilemmas and Ethical Decisions

ESSAY Moral Dilemmas and Ethical Decisions

Healthcare policies and protocols

Triage is the process where the patients are classified according to the priority of their needs in an emergency department. The classification is vital because it rations the treatment of patient especially when the resources are insufficient and cannot serve all the patients at once. In dealing with the respiratory difficulties experienced by Frank Jeffers and Brent Damascus, there are various ethical procedures, which the triage nurse must adhere. Emergency Nurses Association (ENA) provides the Code of Ethics which guides the nurses at the emergency department (Zafar, 2014).

Health Care Policies and Protocols That Are in Place That Direct Triage Care in an Emergency Situation

One of the main things to be observed is the principle of Nonmaleficence. This principle is concerned with proper handling of the patients and not doing any harm to them. The principle authorizes the nurses at the emergency department to treat the patients according to their ability and judgment (Zafar, 2014).  The nurse cannot inflict harm directly unless the patient is hopelessly injured and is placed in the dead category. Therefore, Jeffers and Brent should not be discriminated because of their backgrounds.

Another protocol that would be observed in the above case is the principle of Justice. This principle requires that decisions be made fairly and the resources available be allocated without favoring some patients. The principle gives attention to equity, meaning the patients are treated according to the intensity of their conditions. Since the resources are scarce, the patients cannot be served at the same time. So there can be no equality.

Principle of beneficence is also critical in the cases of Jeffers and Brent. This provides moral obligation of the nurses to contribute to the wellbeing of the two patients by taking positive actions. The principle aims at promoting good and preventing evil or harm and also removing the harm at all costs.

The last principle that guides nurses at the emergency department is the respect for autonomy. This principle provides that the competent people have the right to make decisions according to their own healthcare. This principle provides that the nurses should respect the patients right to make decisions and to hold their views, and that they should take action according to their values and beliefs (Becker et al., 2013).

How Health Care Disparities Impact Treatment Decisions

Due to the diversity and urgency at the emergency departments, there is unique ethical considerations which results from time constraints, insufficient information about the medical history of the patients, and high rates of impaired cognitive abilities among the patients. Determinants of health are factors that emanate from economic, personal, social, and environmental conditions that effect the status of health of patients. Health disparities in making treatment decisions arises from imbalanced and inequality in access to health care facilities and tools by care providers. The disparity may stem from unfair access to facilities based on care giver’s race, gender, religion ethnicity, and socioeconomic status.

 Many writers have concluded to the fact that Emergency Department is specialized and complex which leads to invasive interventions that do not depend on informed consent of the patient or from surrogates (Becker et al., 2013). Therefore, triage nurse has no room for obtaining detailed information. However, a quick assessment must be undertaken and action taken based on established protocols. This may ignore patient’s preferences.

The expectation of the nurses at the Emergency department is to treat acute conditions as soon as possible and to minimize loss of functionality, suffering and protect the patient from death. The first priority will therefore not focus on detailed historic information for the above patients. The most basic thing would be to contain their conditions irrespective of their backgrounds.

A healthcare Disparity would also be evident in the case where the above two patients differ in that one has comprehensive healthcare cover while the other while the other one does not. This presents an ethical dilemma as to who to give priorities.

Healthcare Care Policies for Uninsured Individuals

Health insurance is important and it gives one the right to access healthcare. In case one is uninsured, there is usually limited access to quality care since the healthcare policy requires that all people have healthcare insurance and facilitates this by providing better terms. Incase uninsured person faces medical emergency, such a person can get healthcare in any hospital under Emergency Medical Treatment and Active Labor Act (EMTALA). If the hospital does not offer some emergency services, they have the obligation to ensure that the patient is transferred to a facility where they can get the treatment. This is done in accordance to Paul Gaynor the bureau chief of investigations at the Attorney general’s office of Illinois. However, the Hospital has the right of declining the medical obligation if the patients become stabilized (Venkat, Fromm, Isaacs, & Ibarra, 2013).

Moral Ethical Challenges for Nurses

The nurses face many challenges when making a decision on who to give priorities. It is a hard task despite the fact that it may seem easy. Jeffers and Brent poses even a bigger challenge because they differ broadly despite having the same intensity. One challenge is that one person is insured while the other is not. The nurses cannot discriminate the two patients because of their past. Brent happens to come from a poor background and a poor medical history and is also proving incapable of paying the hospital bills. This does not disqualify him from receiving emergency care from the hospital. However, Jeffers who has insurance cover stands better position to be given the first priority. The United States Health care policy provides that lack of adequate health insurance is likely to affect one’s ability to access healthcare.

Despite the fact that safety and emergency care should be given to all people regardless of their ability to pay or whether they are insured or not. But since the nurses have to make a choice, the main factor to consider is the insurance cover. However, the nurses are likely to face ethical constraints such as discriminating the other person because of his poor background which can be considered as a violation of protocols and principles (Venkat et al., 2013).

Recommendation on Strategies for Managing the Uninsured and Indigent Population

One of the things that hospitals should focus on is bettering their services at the emergency departments so that they can be able to attend all the patients more efficiently. Their goal should be oriented in a zero percent turn away policy so that they can keep both their profitability and reputation high. This their policy should give attention even to the uninsured. The emergency departments should also better their triage patients. Such things as checking of blood pressure and temperature should be done immediately. The checking of insurance can also be done as soon as the patient arrives because it enables hospital reimbursement. The hospital must always seek to implement changes that provides wider and efficient services for the Emergency cases. Finally, there should be a competent taskforce for executing quick and accurate decisions and giving priorities for the patients.

Conclusion

One of the key issues that the Emergency Nurses Association (ENA) insists is the maintenance of high competence levels, sound judgment and protection of lives and privacy of the patients. The association provides guidelines that the patients be treated with compassion and with regard for human dignity. These codes therefore create a common ground to guide the care giving process to two patients because Frank and Damascus suffers from the same condition and with similar intensity. This should be the point of reference during offering them assistance and not their backgrounds or their history.

ESSAY Moral Dilemmas and Ethical Decisions