Posted: September 4th, 2023

Ethical Dilemma in Healthcare: Balancing Autonomy and Paternalism

Discussion Post 5 Role. Describe a situation of ethical dilemma that you have experienced in practice and how it was resolved. (Saunders, 2014)
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

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Ethical Dilemma in Healthcare: Balancing Autonomy and Paternalism

Introduction:
Ethical dilemmas are a common occurrence in healthcare practice, often requiring healthcare professionals to navigate complex situations involving conflicting values and principles. In this discussion, I will describe an ethical dilemma I encountered in my nursing practice and how it was resolved, highlighting the importance of balancing patient autonomy and paternalistic concerns.

Situation:
During my clinical rotation in a busy hospital, I encountered a situation where an elderly patient with multiple chronic conditions, including heart failure and diabetes, refused to comply with the prescribed treatment plan. The patient, Mr. Johnson, had been repeatedly advised to adhere to his medication regimen, follow a specific diet, and engage in regular exercise to manage his conditions effectively.

Mr. Johnson expressed his frustration with the side effects of the medications, the restrictions imposed by the diet, and his limited ability to engage in physical activities due to his age and health status. He felt that the treatment plan was causing more harm than good and wanted to explore alternative approaches, such as herbal remedies and dietary supplements.

Ethical Dilemma:
The ethical dilemma arose when considering the balance between respecting Mr. Johnson’s autonomy to make decisions about his own health and ensuring his well-being through the evidence-based treatment plan recommended by healthcare professionals. On one hand, it was essential to respect his autonomy and allow him to make choices about his own body. On the other hand, healthcare professionals had a duty to protect Mr. Johnson from potential harm and provide the best possible care based on their expertise.

Resolution:
To address this ethical dilemma, I engaged in a collaborative and patient-centered approach, focusing on effective communication, shared decision-making, and education. I began by listening attentively to Mr. Johnson’s concerns, validating his experiences, and acknowledging his right to autonomy. I empathized with his frustrations and explained that healthcare professionals had a duty to ensure his well-being based on the available evidence.

Next, I discussed the risks and benefits of the prescribed treatment plan, addressing Mr. Johnson’s concerns about side effects and limitations. I provided additional information about the rationale behind each component of the plan, emphasizing the potential benefits in terms of symptom management, disease progression, and overall quality of life. Moreover, I explored alternative strategies that could be incorporated into the plan to address some of his concerns, such as adjusting the medication dosage or exploring physical activities that were better suited to his abilities.

Throughout the discussion, I maintained an open and non-judgmental attitude, encouraging Mr. Johnson to actively participate in the decision-making process. We discussed the evidence for herbal remedies and dietary supplements, examining their potential benefits and risks. I explained that while some alternative approaches may have potential benefits, they might also interact with his prescribed medications or have uncertain effects.

After extensive deliberation and reflection, Mr. Johnson expressed a willingness to compromise. He agreed to adhere to the core aspects of the prescribed treatment plan while incorporating some alternative approaches that were deemed safe and supported by evidence. We created a revised care plan together, which incorporated a modified medication regimen, an individualized diet plan that accommodated his preferences within recommended limits, and low-impact physical activities that he found enjoyable and feasible.

Conclusion:
Resolving the ethical dilemma in this situation required a balance between patient autonomy and paternalistic concerns. By engaging in effective communication, shared decision-making, and education, I was able to address Mr. Johnson’s concerns, provide him with the necessary information, and collaborate on a revised care plan. The resolution respected his autonomy while also ensuring that his well-being was prioritized based on the best available evidence. This experience reinforced the importance of ethical decision-making and the value of patient-centered care in nursing practice.

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