Emergency Physicians: Ethical Dilemmas & Decision-Making - Essay Sample

Introduction

The daily routine of the emergency physicians presents them with numerous ethical problems particularly in meeting the patient's needs. The physicians in emergency medicine have to make constant tough medical decisions, but at the same time, they must consider moral values and principles involved. In essence, the ethical decisions the physician makes, often affect not only the patient but also the family, the community and the medical institution. On this note, this essay compares and contrasts the ethical dilemma that an emergency medical physician may face to the ethical dilemma of the primary care physician. The paper infers that the emergency setting is more challenging to physician compared to the controlled environment of medical such as primary care. Nonetheless, it is important for the physician to have an adequate ethical knowledge, to make appropriate ethical decisions even in the most difficult case.

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According to Morrison and Furlong, (2014) ethic can be defined as a way of studying moral behaviors; it is more than obeying the laws. In other words, a person can abide by the law, but fail to act ethically. In medical care, ethical issues are some of the most prevalent problems that arises when treating a patient. Markedly there are huge differences between the ethical issues in the primary care and emergency care treatment. Essentially, the decision in emergence case often involves selection of beneficiaries in a situation where the physician has to prioritize certain benefits (De Carvalho Fortes & Pereira, 2012). For instance, the physician may be faced on an ethical dilemma on which and who to access certain resources such as hospital bed or treatment equipment when these resources are scarce or in a situation where for instance an organ for transportation is needed by two patient and only one organ exist. Such cases are not necessarily present in the primary care since the physician can prioritize depending on circumstance and alternative available.

Other ethical dilemma involved in emergency cares includes treatment options and the family values and goals (Morrison & Furlong, 2014). For instance, at the end of life, CPR is commonly performed. In most cases, CPR is a helpful means of saving the patient life (Erbay, 2014). Nevertheless, in other cases, resuscitation attempts may not benefit the patient or may not align with the values and goals of the patient or the family. In another situation, a blood transfusion may be needed, but the patient and the family may have different values that explicitly prohibit transfusion. In emergency cases, a decision has to be made quickly, based on the information that is available, and sometimes the information may be incomplete or erroneous. Therefore, emergency physicians are often faced with tough ethical dilemma than the primary care health care professional who may have sufficient time to assess the patient and access complete information.

Unlike the primary care, emergency care is sensitive, primarily because of the urgency involved and the crowding. Urgency of care comes with a combination of psychological and physical distress (Erbay, 2014). Additionally, an emergency is often life-threatening and instant decision are required to save the patient but at the same time uphold their values and needs. When the patient values and commitments contradict with the physician opinion and diagnosis, ethical issues are likely to arises, on the best course of action. Conversely, the primary care can educate the patient, so that they can come to a standard treatment plan; therefore, ethical issues in regard to the values contradictions are unlikely to occur.

In addition to treatment options and medical priorities, other issues that can emerge in emergency care includes unpredictable patient's profiles and administration of care. Primary care physicians have the time to think and assess the patient outcome consider medical and other factors of the case and situations (Erbay, 2014). On the contrary, in emergency care, it is very hard to think through every aspect of the situation or a case in a shortest time available. The issue of beneficence becomes a fundamental principle in this case, but more often than not, there are likely to arise many ethical conflicts on the issue of what is better for the patient.

In primary care, the physician has the ability and time to access the patient's decision-making capacity, but this is different in emergency care. A patient may refuse a certain form of treatment, and in critical zones, the physician is not required to access the decision-making ability of the patient. Other ethical challenges that may arise are associated with the emergency physician with the medical team. However, different opinions and ego on an emergency situation can lead to ethical conflict in the team. In the smallest time available, it is often difficult to determine the best cause of action.

Another ethical issue that often occurs in emergency care and not with primary care physicians is the informed consent, where a patient decides to facilitate the physician decision. The ethical issue that arises is whether the physician will decide to save the patient lives or to use the patient consent to make the decision. In primary care, the patient will have all the time to make an informed consent, but in emergency care, the time and the condition may not be sufficient to make informed consent. Other ethical issues that the emergency physician are likely to encounter include terminal stages where for instance a patient is severely ill and near death. The difference in expectation between the patient and the physician may contradict particularly dues to the situation at hand the time involved. In essence, a tough ethical issue always emerges in such situation.

An emergency medicine physician experiences many ethical challenges some of which requires an instant decision. The emergency setting is more challenging to physician compared to the controlled environment of medical such as primary care. In emergency medicine, all patients are unique and ethical application can be unique; therefore physician may not have a quick formula on the right course of action. Nevertheless, it is important for the physician to have an adequate ethical knowledge, to make appropriate ethical decisions even in the most difficult case.

References

De Carvalho Fortes, P. A., & Pereira, P. C. A. (2012). Patient prioritization in medical emergencies: an ethical analysis. Revista da Associacao Medica Brasileira (English Edition), 58(3), 335-340.

Erbay, H. (2014). Some Ethical Issues in Prehospital Emergency Medicine. Turkish Journal of Emergency Medicine, 14(4), 193-198.

Morrison, E. E., & Furlong, B. (Eds.). (2014). Health care ethics: Critical issues for the 21st century (3rd ed.). Burlington, MA: Jones & Bartlett Learning.