Paper Sample on Minor's Meningitis: Parental Consent vs Professional Duty Dilemma

Introduction

In relation to the details given case study the patient involved is a minor hence for any medical attention to be offered the parents must give their consent first. The dilemma here is the conflict between adherence to the professional rules of duties and the family principles that result in legal engagement. Notably, while the medical practitioner wants to give the patient the required medical attention, the child’s parents disregard the move to diagnose the child with meningitis. The resistance from both the mother and father stems from the fact that they are staunch Christian scientists, with strong beliefs. Medical practitioners have an ethical obligation to provide superior care that manages pain to the patients, (Sturdirant et al. 2020). The physician fearing for the child’s life still goes ahead and offer medical treatment against the approval from the child’s parents.

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In a hospital physician gives importance to supporting, caring, comforting and offering medical support immediately. When faced with an ethical dilemma, it is vital to use an ethical decision making model such as Uustal's "Ethical Decision-Making Model, that ensures the decisions focus on the objective to be achieved. Uustal designed a model that helps physicians navigates around situations that pose an ethical dilemma. According to Uustal (1993) the models involve: identifying the problem or the dilemma in the health sector where saving lives is the top priority of medical practitioners. Imperatively, physician’s values and ethical position should be in line with this model alongside other alternatives that should be considered so as to examine and categorize them while predicting possible outcomes. In saving lives the medical officers must prioritize alternatives, develop action plans, implement the plan and finally carry out evaluation of the outcomes. After treating the patient, medical officers question themselves whether they did the right thing and if their actions were ethical.

Question 1: Perspectives, Need and Expectations of Stakeholders

The Child and Parent

The child who is the patient requires immediate medical support and to the child’s point of view parents will not allow them to feel pain. The most important thing needed by the child at this point is medical attention to reduce pain and at least have hope for survival. It is expected for parents to care about their children and most parents will go against any belief or customs to save their children. As parents, what they care about most is their children and it is expected that in this case, the parents become supportive of the physician attending to their child. According to Uustal (1993), ethics of care has its basis on interrelatedness of humans and being responsible. For a person to practice this value he or she must understand what is the most supportive of the person requiring care by being attentive and responsible. The child requires immediate medical attention and as Christians and parents they are expected to be attentive and offer what’s best for their child.

Physician and Health Care Staff

There is nothing that a medical practitioner does more than making decisions especially in intensive care units and these decisions have consequences. It is expected of practitioners situated at the intensive care to be effectively prepared to solve complex ethical problems. Practitioners are expected to give excellent medical care to their patients, advocate for the patient, give relevant information to the patient and relatives, be honest and give the patient or relatives’ freedom to make decisions, Sturdivant (2020). From the above case the physician prefers to save life above everything. Health care workers and institutions need support from relatives of the patients to make their work a bit easier and for them to care for the patients adequately. The healthcare staff advocates for their staff and often have to fight for what they believe to be right, ethical pain management by physicians requires a balanced approach and it is much better when there is full support by the patient’s relatives.

Hospital and Administrator

From the hospital’s perspective it is better to save lives if possible than leave it to fate. The hospital needs parent’s support in order to offer best medical attention to the patients hence expecting the parents to comply. A research conducted by Gehlert (2018) shows that some individuals and groups are prone to exploitation in the medical field therefore considering cases that require special protection, children are the top priority. Denying the child medication is socially unfair and in such circumstances the hospital management must protect the vulnerable by offering medical attention to a much needed child irrespective of the beliefs of the Christian Scientist parents.

The Attorney

It is expected of the attorney also to act as the child’s protector. The parent’s beliefs should not be the reason for the children losing their lives. A child has a right to good health, and the attorney as the state’s representative, should advocate for this. The government supports consent when it comes to medical care since this is a crucial step. Frezza (2019) states, “There is no greater area of ethical concern for government and the general public than clinical research demonstrating patient safety and autonomy” (p. 203). The physician was more mindful of the patient’s safety which led to the immediate medical attention. It is expected of the attorney to help promote awareness of the importance of medical care to people who are Christian scientists because God helps those who take actions to solve problem alongside faith.

Question 2: Potential Conflicting Values and Principles

There are a number of ethical principles that have proven to be conflicting in the above mentioned case. Since the patient was a minor, for treatment to be administered the parents had to give their consent. In this case the parents don’t believe in modern medicine for they are Christian scientists, but the patient is experiencing pain and showing severe signs for meningitis. The physician has no choice but to follow the medical profession code of conduct and oath to protect lives hence goes against the parents’ religious beliefs to save the child’s life. The patient was found to have meningitis; the parents also need to carry out a genetic examination to determine whether their genetic make-up might be the cause of the child’s medical problem. Offering research results to participants continues to gain acceptance with the premise that participants deserve to know the outcome of research to which they contributed (Beskow & O’Rourke, 2016).Genetic testing can provide valuable information when handling a serious issue like meningitis but with parents having such strong beliefs it becomes hard to hand out the results of the tests.

The beliefs of the parent’s also create conflict. Christian Scientists believe only in God and not modern science, they are the type of people that leave everything to fate. Their values and principles have been disregarded by the physician when medical attention was given to the patient without their consent. As explained by Frezza (2019), medical consent is an essential part in treatment, in the above mentioned case; it gives the patient’s relatives a chance to get to know the physician, mode of treatment, actions required and side effects if any. The physician in this case cannot practice the ethics relating to consent for the parents are consistently against treatment.

Question 3: Solution to the Conflict

While it is best to address conflict and resolve them at individual level, some may require a third party to come in as a mediator. Since the patient’s parents have already presented the case to the court it will be much better if both parties settle for out of court settlement. Though the parent’s belief would have caused severe damage to their child, the physician still went ahead to administer medication to a minor without consent; which if it left unattended to could have caused a lot of damage to the institution. Additionally, the parents’ literacy should also be examined. “Those with low educational attainment and consequent low literacy and numeracy skills, including low health literacy, may find the language of consent documents difficult to comprehend, though a capacity for such an understanding is fundamental to ensuring ethical participation” (Gehlert, 2018). Also, decision making model such as Uustal’s model can be used to identify the relevant facts and moral issues, determine the factors such as policies and professional guidelines, locate the most relevant line of reasoning and facilitate justifiable decision making process.

Expressing regret for the patient’s situation shows the physician’s sense of compassion and understanding to ensure is restoration of the patient’s health. It may not always be apparent when an apology is appropriate, so recognizing fear, frustration, or anger may be the first sign that an apology should be considered (Frezza, 2019). Although the parents are the on the wrong, the hospital administration should apologize just to calm them down and solve the issue amicably outside the court. Furthermore the physician should take responsibility for going against the wishes of the patient’s parents and make a personal apology and explain to the parents why it was necessary to act in the manner he did. The physicians should remember that health care requires collaboration of different stakeholders; the patient, relatives and all the concerned healthcare staff.

References

Beskow, L. M., Rourke, P. P. (2015). Return of genetic research results to participants and families: IRB perspectives and roles. The Journal of Law, Medicine Ethics, 43(3), 502-513. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4617597/pdf/nihms696555.pdf

Frezza, E. (2019). Medical ethics: A reference guide for guaranteeing principled care and quality. CRC Press

Gehlert, S., Mozersky, J. (2018). Seeing beyond the margins: Challenges to informed,
Inclusion of vulnerable populations in research. The Journal of Law, Medicine; Ethics, 46(1), 30-43. https://journals.sagepub.com/doi/pdf/10.1177/1073110518766006

Sturdivant, T., Seguin, C., Amiri, A. (2020). Ethical Decision-Making for Nurses Treating Acute Pain in Patients with Opioid Abuse History. Medsur Nursing, 29(1).https://www.researchgate.net/profile/Azita_Amiri3/publication/339067544_Ethical_DecisionMaking_for_Nurses_Treating_Acute_Pain_in_Patients_with_Opioid_Abuse_History/links/5e3b956fa6fdccd9658a8fed/Ethical-Decision-Making-for-Nurses-Treating-Acute-Pain-in-Patients-with-Opioid-Abuse-History.pdf

Uustal, D. B. (1993). Clinical ethics and values: Issues and insights in a changing healthcare environment. Educational Resources in.