Ethical Issues in Health Care: A Case Study Analysis Report

This report provides a detailed analysis of a healthcare ethics case study involving a physiotherapist and a surgeon. The report identifies two primary ethical issues: a surgeon's impaired state due to alcohol and a physiotherapist discontinuing a patient's treatment. The analysis explores these issues through ethical perspectives, including deontology and utilitarianism, and discusses the importance of human dignity, human rights, and professional codes of ethics. The report further examines the principles of healthcare ethics, such as beneficence, non-maleficence, and respect for patient autonomy. Recommendations for professional practice are offered, emphasizing the need for healthcare professionals to adhere to ethical standards, address ethical dilemmas, and prioritize patient well-being. The report highlights the importance of empathy, humanness, and benevolence in medical practice and underscores the significance of making ethically sound decisions in healthcare settings. The analysis emphasizes the importance of balancing patient care with professional responsibilities and adhering to ethical guidelines to ensure quality healthcare.

Running head: HEALTH CARE ETHICS 1
Health Care Ethics
Student’s Name
University Affiliation

HEALTH CARE ETHICS 2
Table of Contents
Introduction......................................................................................................................................2
The ethical issues at stake in the chosen case study........................................................................2
An ethical perspective on the issues................................................................................................2
Discussion of the ethical issues from the perspectives of:..............................................................3
The requirement to respect human dignity and human rights;.....................................................3
My future profession’s codes of ethics/professional conduct and professional standards;.........3
One ethical theory I have studied in the unit...............................................................................4
The principles of health care ethics..............................................................................................4
Recommendations for professional practice....................................................................................5
Conclusion.......................................................................................................................................5
References........................................................................................................................................6

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Health Care Ethics
Introduction
The selected scenario for this paper is case study 1, which describes the incidence of
Henry and Jim. Henry is a physiotherapist while Jim is a patient who has undergone bilateral
keen replacement. Henry discontinues Jim’s treatment at one point and reports a case of a
surgeon who arrives at work smelling alcohol. Firstly, the assignment will identify ethical issues
in the case study. Secondly, it will analyse the issues and conflicts. Thirdly, the assignment will
present a discussion of professional codes. Fourthly, it will discuss human dignity and human
rights. Fifthly, the assignment will present an evaluation of ethical principles. Lastly, it will offer
recommendations for professional practice.
The ethical issues at stake in the chosen case study
There are two main ethical issues in the selected case study. First, one of the surgeons
regularly arrives to work smelling alcohol, including in those days on which he performs
surgery. When a health care provider loses, through illness or other impairment, the capacity to
maintain the baseline manual and intellectual skills needed to accomplish their ethical
obligations, they should cease clinical practice to promote and enhance the health-related
interests of their patients. All the medical practitioners have a professional duty to be alert to any
impairment and to limit their practice correspondingly. Specifically, surgeons should understand
and promote the delicacy of touch, quickness of eyesight and steadiness of hand, which are
important to the successful performance of an operation (Jones & McCullough, 2012).

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Second, Henry decided to discontinue Jim’s treatment because he had a waiting list of
patients who required his assistance. In this case, Henry did not have a genuine reason to
discontinue the treatment even if Jim had shown little improvement. Based on professional
ethics, a health care provider should strive to do good to promote the well-being of their patients
regardless of the ensuing situation. Besides, the society expects care providers to uphold a
certain level of ethics when dealing with patients. Conclusively, the act of discontinuing
treatment and being drunk at work are critical ethical conditions. The medical profession as a
public trust should retain and enhance standards of practice for the benefit of existing and future
clients.
An ethical perspective on the issues
Deontology is the primary ethical perspective on the ethical issues identified in the case
study. Based on the deontology perspective, Henry should not discontinue the treatment while
the drunkard surgeon should cease operation. Deontology is ethics of duty where an action is of
more importance than the outcome. Harm is completely unacceptable regardless of its
implications. The deontology concept was first delineated by Immanuel Kant and thus popularly
known as Kantian deontology (Misselbrook, 2013). In some instances, the action of a
deontologist might be appropriate for a person but may not produce good outcomes for the
society. The medical practice cultivates the principle of deontology, and thus the relationship
and interaction between a physician and a patient are deontological. A context of medical
negligence occurs when deontology is breached (Mandal, Ponnambath, & Parija, 2016). The
concept of deontology guides medical practitioners to do good to patients at all times. Henry
should thus continue assisting Jim irrespective of the outcome.

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Another perspective is the Egalitarianism, which proposes the theory of distributive
justice. The basic objective of equality is to compensate for people having challenging family
circumstances, born with poor endowments or suffering from diseases and accidents (Ekmekçi &
Arda, 2015). Clinicians thus have a duty to promote equality based on these perspectives.
Discrimination against patients due to their personal lives should be avoided when offering care.
This concept supports the argument that Henry should reconsider his position.
Discussion of the ethical issues from the perspectives of:
The requirement to respect human dignity and human rights;
Healthcare presents a challenge to respect human dignity and human rights because those
seeking health care are mainly restricted in expressing their dignity. Patients might be restricted
in expressing their dignity due to their ill health and the conditions needed by healthcare (Jones
D. , 2015). In the case study, Henry and the drunkard surgeon should express the respect for
human dignity as well as human rights. Human rights perspectives that apply to patient care are
the right to attain high standards of health and civil rights. A patient has the right to highest
attainable health standards. Besides, a patient should be free from inhumane treatment and
torture. Inhumane treatment limits a patient’s right to receive better care. Discontinuance of
treatment in the case study can be viewed as inhumane because the physician is limiting the
patient’s right to quality health care. Human rights further focus attention on the right of socially
precluded groups to be free from discrimination in the delivery of health care. On the other hand,
the rights of the health providers should also be observed and promoted in a health care setting.
The fundamental rights for physicians are freedom of association as well as the enjoyment of a

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decent work environment (Cohen & Ezer, 2013). This argument does not insinuate that the
actions of Henry are justified; however, he has the right to better working conditions.
My future profession’s codes of ethics/professional conduct and professional standards;
The case study has prompted me to consider three professional standards that would be
applicable in the future. These professional standards are empathy, humanness and benevolence.
Empirical evidence suggests that medical practitioners, mainly nurses, always experience
dilemmas in their practice (Shahriari & Baloochestani, 2014). Hence, professional standards are
fundamental to address such dilemmas. For instance, in the case study, Henry experienced a
dilemma on whether to uphold his previous decision of discontinuing care or reconsider his
position. The principle of benevolence entails being kind to patients, accommodating their views
and expressing tolerance. In addition, benevolence cultivates the culture of deriving enjoyment
from serving others and viewing the medical practice as charitable work rather than a profit
making practice. In my future practice, I will practice the benevolence virtue and avoid focusing
on profit-making. Empathy is also a fundamental aspect of medical practice specifically in
delivering quality health care. Healthcare professionals, who observe empathy, enter the patient’s
world of illness and suffering, experience the condition and then help the patient to recover from
the illness. It entails not only emotions response to the patient’s suffering but also a passion for
the patient (Marcum, 2013). Humanness will guide me to be more caring when offering care.
The virtue of humanness emphasizes on treating the patient as a human and upholding their
dignity. The combination of empathy, humanness and benevolence will be vital in handling
dilemmas in practice and making appropriate decisions to avoid ethical issues.

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One ethical theory I have studied in the unit
The ethical issues in the case study can be analyzed based on Utilitarianism, one of the
theories I studied in the unit. In Utilitarianism, a decision is selected depending on the greatest
amount of benefit gotten for the largest number of persons. The Utilitarianism approach is also
referred as consequentialist because the outcome dictates the morality of an action (Tordjman,
2017). In the case of Henry, he can discontinue Jim’s treatment and focus on assisting the
patients who are on the waiting list. This decision could result in harm to Jim, but the net
outcome is a maximum benefit because the patients who are on the waiting list will be assisted.
A utilitarian approach is always driven by calculated benefits or harms for a decision or act based
on evidence (Petrini, 2010). Studies have provided examples of situations where utilitarian can
be applied. For instance, a hospital may set a target for resuscitation of premature newborns
depending on the available resources and time. Perhaps the most elaborate instance of utilitarian
occurs in instances of disasters. A hospital might decide to focus on assisting the people who are
affected by disaster instead of treating an outpatient client.
There are two versions of utilitarian theory including rule and act utilitarianism
(Playford, Roberts, & Playford, 2015). In act utilitarianism, a decision is made for each incidence
after evaluating the benefits and harms enhancing overall good outcome. Before a decision is
made, the potential benefits and harms to the patient are considered, without evaluating the past
evidence or experience. This method of decision-making result in time and resource wastage
and a decision is prone to bias. On the other hand, in rule utilitarianism, an analysis of the
potential benefits and harms is not conducted. The incidence when Henry decided to discontinue
Jim’s treatment was ruled utilitarianism. This method of decision making is efficient compared
to act utilitarianism.

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The principles of health care ethics
Several professional codes of ethics and professional codes of conduct apply to the issues
identified in the case study. Henry failed to observe the principle of beneficence. Beneficence is
an act of mercy and kindness with an aim to do good to other people. Virtually all professionals
have the basic moral imperative of being merciful to others and doing right. In the context of a
doctor-patient relationship, the doctor must value the well-being as well as the interest of the
patient. In medical practice, beneficence is among one of the primary ethics (Kinsinger, 2009).
Another principle of health care ethics that applies to the case study is non-maleficence.
According to the principle of non-maleficence, a provider should not do any harm. As such,
clinicians should avoid delivering ineffective treatments or exhibiting malice towards patients
(Page, 2012). However, many appropriate and useful interventions have the potential of causing
harm, which makes the principle of nonmaleficence less useful to physicians.
The principle of nonmaleficence can be used in collaboration with the principle of
beneficence to enhance the benefits for the patient and prevent harm. Further, respect for patient
autonomy applies to the case study. Henry was informed that Jim is not following his exercise
program at home and decided to discontinue his treatment. Henry did not exhibit the respect for
patient autonomy in this case. The principle of respect for patient autonomy entails allowing
patients to make their personal decisions concerning which health care interventions or treatment
they will receive (Entwistle, Carter, Cribb, & McCaffery, 2010). Autonomy in medical practice
entails allowing competent adults to make informed decisions concerning their medical care.
Physicians who practice the respect for patient autonomy first seek consent before initiating any
form of intervention.

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Recommendations for professional practice
There are two primary recommendations for health professionals in the case study. Henry
should reconsider his earlier decision of discontinuing Jim’s treatment. He should discuss the
issue with Jim as well as Sally, the practice manager. Then Sally can refer the issue of the
drunkard surgeon to the hospital chief-of-staff. Recusal is not a suggestion that the professionals
will be shirking their duties. On the contrary, it means that they have decided to act with the
expected level of professionalism of physicians in health care institutions. It is evident that
health care providers can experience a wide range of ethical issues in practice settings
(Richardson, 2015). Just like several of ethical issues that have been identified in the case study.
A physiotherapist might need to trade-off what is appropriate for the clients because of
regulations and insufficient benefits. They should, however, do that while achieving best practice
standards. Henry, Sally and the concerned surgeon should attempt to understand the morals of
any decision. They should acknowledge that ethics is an issue without a wrong or right answer
(Berry, 2014). The ethics are influenced by personal ethics, professional code of ethics, legal
requirements and professional code of conduct.
Conclusion
As discussed in this paper, case study 1 presents classical examples of ethical issues in
medical practice. Ethics entails a profession’s moral judgment about what is right or wrong in a
particular scenario. Henry has been guided by the principle of utilitarianism rather than
deontology. The virtues of beneficence, respect for patient autonomy and nonmaleficence have
been compromised in the case study. However, the case study has offered insights on my future
professional practice. Hence, in the future, I will embrace and promote the virtues of

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humaneness, benevolence and empathy. The recommendations for this scenario focus on the
observation of legal requirements, professional conduct and ethics.

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