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M09.03.021 Ethical situations
This document outlines various ethical situations healthcare professionals may encounter, along with appropriate responses to each scenario. Understanding these ethical dilemmas is crucial for ensuring patient-centered care while maintaining professional integrity.
Table of Ethical Situations and Appropriate Responses
| Situation | Appropriate Response |
|---|---|
| The Patient is not adherent. | Attempt to identify the reason for nonadherence and determine the patient’s willingness to change. Avoid coercion and do not refer the patient to another physician. |
| Patient desires an unnecessary procedure. | Understand the patient’s motivation for the procedure and address underlying concerns. Do not refuse to see the patient or refer them to another physician. Avoid performing unnecessary procedures. |
| The Patient has difficulty taking medications. | Provide written instructions, simplify treatment regimens, and use the teach-back method to ensure comprehension by asking the patient to repeat the regimen back to you. |
| Family members ask for information about the patient’s prognosis. | Do not discuss the patient’s prognosis with relatives without the patient’s permission. |
| Family member requests not to disclose test results due to fear of emotional impact on the patient. | Identify the family member’s concerns. Explain that, unless the patient lacks decision-making capacity, information will not be withheld. Invoke therapeutic privilege only if there is a serious risk of self-harm or harm to others. |
| A 17-year-old girl is pregnant and requests an abortion. | Follow state laws regarding parental notification or consent for minors. Do not influence the patient’s decision for or against an elective abortion unless there are specific medical risks associated with the pregnancy. |
| A 15-year-old girl is pregnant and wants to keep the child, contrary to her parents’ wishes. | Respect the teenager’s right to make decisions regarding her child. Provide information on the practicalities of caring for a baby, discuss options if requested, and encourage dialogue between the teenager and her parents to reach a mutually agreeable decision. |
| A terminally ill patient requests assistance in ending their life. | Most states prohibit physician-assisted death. Physicians may prescribe appropriate analgesics even if they shorten life, ensuring the patient’s comfort while adhering to legal standards. |
| Patient is suicidal. | Assess the seriousness of the threat. If it’s serious, suggest voluntary hospitalization. If the patient refuses, involuntary hospitalization may be necessary. |
| A Patient finds the physician attractive. | Ask direct, closed-ended questions and consider using a chaperone. Romantic relationships with patients are inappropriate, and transitioning care to another physician may be necessary. |
| A Patient feels “ugly” after a mastectomy. | Explore the reasons behind the patient’s feelings. Avoid providing false reassurances. |
| A Patient is angry about wait times. | Acknowledge the patient’s anger, apologize for any inconvenience, and avoid defensiveness. Do not take the anger personally. |
| A Patient is upset with treatment from another doctor. | Encourage the patient to address concerns directly with the physician in question. If the complaint involves office staff, assure the patient that you will speak to the concerned individual. |
| An invasive test is performed on the wrong patient. | Regardless of the outcome, it is ethically required to inform the patient that a mistake has occurred. Transparency and accountability are essential in maintaining trust. |
Points to Remember
- Patient Autonomy: Respecting a patient’s right to make decisions about their health is paramount.
- Confidentiality: Always maintain confidentiality, discussing patient information only with authorized individuals.
- Transparency: Honesty about mistakes fosters trust and accountability in the patient-provider relationship.
- Support: Offer emotional and psychological support to patients facing difficult decisions or outcomes.
References
- American Medical Association (AMA). (2021). Code of Medical Ethics. Retrieved from AMA
- Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics (7th ed.). Oxford University Press.
- Gillon, R. (1994). Medical Ethics: Four Principles Plus Attention to Scope. BMJ, 309(6948), 184. Retrieved from BMJ
- National Institutes of Health (NIH). (2022). Informed Consent for Research. Retrieved from NIH