Ethical Dilemmas in Nursing Informatics: A Case Study Analysis of Paul

This case study examines an ethical dilemma in nursing informatics, focusing on a 12-year-old patient, Paul, with diabetes. The case highlights a situation where the doctor failed to promptly inform Paul's parents about rising glucose levels, despite receiving reports through an informatics system. The analysis explores the ethical principles involved, particularly the Principle of Justice, and discusses theoretical approaches such as Principlism and Ethics of Care. The assignment explores alternative solutions like improved communication, ethical decision-making, and bioethical approaches. It assesses the consequences of these alternatives and identifies ethical decision-making as the best approach. The student provides a detailed plan of action for managing Paul's health, emphasizing information collection, alternative options, parental involvement, and medication management, all while adhering to ethical guidelines. The assignment is a response to a problem brief focusing on the ethical applications of informatics, professional responsibilities, and ethical decision-making models within a nursing context.

INFORMATICS AND QUALITY 0
Nursing
March 29
2020

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Contents
Question 1..................................................................................................................................2
Question 2..................................................................................................................................2
Question 3..................................................................................................................................3
Question 4..................................................................................................................................4
Question 5..................................................................................................................................4
Question 6..................................................................................................................................5
References..................................................................................................................................6

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Question 1
The problem that is stated in this case is that the responsible doctor of Paul, a twelve-
year-old patient who is suffering from diabetes. The doctor and parents are managing the
health of Paul through the informatics system. Recently the reports that are generated through
that device show an increase in glucose level from the last five days. To discuss this issue
with parents of the patient a take corrective steps is the responsibility of the doctor. The
doctor has mail about this report but this mail for not shown on the computer of the patient’s
parent. But the doctor did not try to reach them through phone calls so that they can
immediately come and meet the doctor. So that corrective steps are taken on time. The
problem, in this case, is the irresponsibility of the doctor toward informing Paul’s parents
taking corrective steps to manage the health of the patient.
Question 2
Several ethical principles guide the actions of doctors and nurses. In this case, also
ethical principles are involved. This ethical principle is the “Principle of Justice”. According
to this principle, it is the responsibility of the doctor to treat every patient with equal
attention. Doctors are expected to be impartial to all patients. In this case, the doctor shows
partiality in the treatment of Paul. The responsible doctor gets busy because he ignored
calling the parents of the patient. This can result in harmful effects on the health of the
patient. Since the doctor gets busy with other patients he does not feel the importance of
sharing details of the increase in glucose over a phone call. Since Paul’s parents were unable
to read the mail and therefore they did not visit the doctor then also doctor didn’t bother to
call them and inform them (NCBI, 2000).

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Some theoretical views are been involved in this case. These theoretical approaches
help the healthcare department to evolve the changes that are in the society. The theoretical
approach of “Principlism” is an applied principle of ethics. This principle helps in examining
the ethical problems that are being faced in healthcare departments. In this principle, the
basic ethics that are involved are autonomy, non-maleficence, beneficence and Justice
(Beauchamp & Rauprich, 2016). This principle will help the doctor in guiding their actions.
Quality of care will also be improved and impartiality will also be enhanced. There are many
more theoretical approaches that such as anti-principlism, casuistry and many more.
Question 3
There are many alternative options through which these problems can be solved. If a
doctor follows certain ethics health of the patient can be managed easily. “Ethics of care” is
one of the important aspects that should be followed by the doctors. The followers of this
principle will enable the proper care of the patient. Doctors will consider the health of the
patient as their priority. Since doctor is receiving report of patient daily through an
informatics device it is the responsibility of the doctor to inform parents of the patient.
Developing proper “communication and trust” is also one of the alternative options. In this
case because of lack of communication this problem arises doctors should have a regular
conversation with the parents of Paul’s so that they can also take corrective steps. This will
ensure the proper care of a patient’s health (Hardavella, Gaagnat, & Powell, 2017). Parents of
Paul should also be clear about their duties in maintaining the health of the patient. Since they
are also getting regular report they should also consult a doctor about the health condition of
their son (Ha, Anat , & Longnecker, 2010). The doctor should take daily updates regarding
the health of Paul. By this, his parents will also be aware and the doctor can also evaluate the
treatment that is given to him. Proper medication should be provided to the patient. The

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doctor should aware parents of Paul about the possible changes that can be noticed in the
health of the patient. Parents should also be aware of possible changes that can be shown in
the health of the patient. They should also be aware of the primary healthcare treatment so
that it can be used in the case of emergency (ANA , 2020). Doctors can also take “bioethical
decision making”. This will enable the doctor to get in agreement with the patient or
representative of the patient.
Question 4
The consequences of all the suggested alternatives will be that the health of Paul can
be managed easily and he will not face any health complications in the future. If a doctor has
communicated with the parents of Paul they would have come to the clinic and doctors can
discuss with them the treatment that has to give to the patient. By this option, they would
have easily control the glucose level of the Paul. Since reports of Paul’s health are generated
with the help of informatics devices parents should also be aware of the reports that are
generated. They should also evaluate the report of their child regularly and on a timely basis,
they should consult a doctor so that necessary actions can be taken. If doctors will implement
ethical decision-making process they will create a sense of awareness in both parents of the
Paul and doctor. This decision making also involves many ethical principles. By this
agreement, the doctor will become responsible for the health of the patient. A proper
evaluation of health is possible. If parents are also aware of the primary treatment that can be
given to the patient in the case of an emergency it can reduce the chances of more health
damage. In the future, there are chances that if a doctor is unavailable because of some issues
disease of the patient will not increase.

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Question 5
The best alternative for this case is the option of “ethical decision making”. The
process of ethical decision making involves the mechanism of critical thinking and analysis.
With the use of this model ethical problem that is facing by doctors can be solved. The main
goal of this model is to develop a plan for treatment that provides the best treatment for the
health of the patient. While developing plans for treatment ethical models and values are also
considered. Plans are based on proper research and evidence so that they can decrease the
chances of side effects that can be caused to the patient. This model has six approaches that
are used while developing the plan for treatment. This process also involved dynamic
decision making and additional information regarding treatment can be available (Miller &
Davis, 2020).
Question 6
There is a requirement for a plan of action so that the health of Paul can be managed.
If the following steps are involved in the treatment plan for Paul then it can be more effective.
The first step the doctor should involve is the collection of information. Since the doctor is
receiving daily health updates of Paul he should involve in proper evaluation. Further doctors
should think of alternative options that can be taken for the treatment of Paul. He should
consider options that will be effective in decreasing the level of glucose. These options
should also be analysed properly as Paul is a child. A doctor should also consult about these
options with the parents of Paul. It should also be made sure that parents and doctors both
will evaluate the report of Paul regularly and in case of any doubt proper communication will
be done. So that corrective steps will be taken. Medication should be given according to the
age of Paul otherwise it may have some negative effects.

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References
ANA . (2020). Genetics and Personalized Medicine. 03 29, 2020, ANA:
https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/genetics/
Beauchamp, T. L., & Rauprich, O. (2016, 07 16). Principlism.03 29, 2020, Springer Link:
https://link.springer.com/referenceworkentry/10.1007%2F978-3-319-09483-0_348
Ha, J. F., Anat , D. S., & Longnecker, N. (2010). Doctor-Patient Communication: A Review.
The Ochsner Journal, 10(1), 38-43.
Hardavella, G., Gaagnat, A. A., & Powell, P. (2017). Top tips to deal with challenging
situations: doctor–patient interactions. Breathe, 13(2), 129-135.
Miller, H. F., & Davis, T. E. (2020). Practitioner’s Guide to Ethical Decision Making. 03 29,
2020, American Counslling Association: https://www.counseling.org/docs/default-
source/ethics/practioner-39-s-guide-to-ethical-decision-making.pdf?sfvrsn=10
NCBI. (2000). Ethical Issues. Retrieved 03 29, 2020, from NCBI:
https://www.ncbi.nlm.nih.gov/books/NBK64933/
.