HCS 335 Week 2 Ethical Health Care Scenarios Example

A Donor's Mother, a Family Who Wants Everything Done and a Surgeon's Instagram Post: Three Ethical Scenarios Worked Through From the Manager's Chair

[Student Name]

University of Phoenix

HCS/335: Health Care Ethics and Social Responsibility

Week 2 Assignment

[Instructor Name]

[Date]

The hospital, its patients and staff are composites written for a model paper; principles and policy guidance come from the sources listed.

Managers in a composite 300-bed community hospital face ethical problems that rarely come labeled as ethics. They arrive as a phone call from a donor, a tense family meeting or a screenshot from social media. This paper works through three such scenarios using the four principles of health care ethics (Beauchamp & Childress, 2019) and a consistent method: facts, issue, principles, stakeholders, options and decision.

Scenario One: The Donor's Mother

A retired executive who gave $2 million toward the hospital's new cancer center calls the vice president of operations. His 84-year-old mother has been admitted with pneumonia and is in a semiprivate room. He asks that she be moved to one of the four private rooms, all occupied, and that the hospital "find a way."

Issue and Principles

The issue is whether influence should change access to a scarce clinical resource. Private rooms are assigned by clinical need, such as infection control and end-of-life care. Justice requires that scarce resources be distributed by fair criteria. Beneficence toward the donor's mother is real, but the patients now in private rooms have needs too. Moving a dying patient or an isolated patient to satisfy a donor would use a clinical resource to repay a gift, which is exactly what fair allocation forbids.

Stakeholders and Options

Stakeholders include the mother, her son, patients in private rooms, nursing staff and the hospital's reputation. Options: move another patient out; refuse flatly; or explain the policy and offer what can fairly be offered.

Decision

The vice president should explain that private rooms go by medical need and that her mother will be placed on the list if her condition calls for it. She can offer amenities available to any family, a visit from the patient relations team and daily updates. Respect and communication can be generous; clinical priority cannot be sold.

Scenario Two: A Family Who Wants Everything Done

A 79-year-old man with advanced dementia, kidney failure and multiorgan failure after sepsis has been in intensive care for 19 days. The team believes further life support will not return him to any interaction and asks to shift to comfort care. His daughters insist on continued treatment, including dialysis and resuscitation.

Naming the Treatment Carefully

Kon et al. (2016), writing for the Society of Critical Care Medicine, recommended that futile be used only for treatment that cannot accomplish its intended physiologic goal, and that potentially inappropriate describe treatment with some chance of effect that clinicians believe is not justified. Continued dialysis here falls in the second category. The policy recommends that disputes over such treatment be resolved through a fair process, including expert consultation, a second medical opinion, an ethics committee review, the option of transfer and notice to the family, rather than by unilateral decisions.

Principles, Stakeholders and Decision

Autonomy, exercised by the daughters as surrogates, should reflect what their father would have wanted. Nonmaleficence weighs against prolonging burdensome treatment. Beneficence asks what serves him now. Stakeholders include the patient, his daughters, the team and other patients who need the ICU bed. The manager's role is to make sure the process happens: arrange a family meeting with palliative care, request an ethics consultation and support the team through a fair process rather than a deadline.

Scenario Three: The Surgeon's Post

A surgeon posts a before-and-after photo of a patient's reconstructed hand on his own public profile, naming the patient by first name and commenting on how difficult the case was. The patient's face does not appear, but the patient's tattoo does. A nurse reports it to her manager.

Issue, Principles and Decision

The issue is disclosure without consent. Respect for autonomy includes control over one's own health information, and the tattoo makes the photo identifiable. Varkey (2021) noted that confidentiality is central to the trust patients place in clinicians. Stakeholders include the patient, the surgeon, the nurse who reported and the hospital. The manager should ask the surgeon to remove the post immediately, notify the privacy officer to assess whether a breach occurred and thank the nurse for speaking up. The surgeon's department chair should address the behavior, and the hospital should remind staff of its policy on clinical photos.

Supporting Staff Through Hard Cases

Managers also owe something to the staff inside each scenario. The charge nurse who must tell the donor no, the ICU nurses caring for a patient they believe is suffering and the nurse who reported the surgeon all carry moral distress. The hospital offers debriefings after difficult family meetings, access to the ethics committee for any staff member and a clear statement that reporting a privacy concern is valued. Supporting staff is not a side issue; people who feel abandoned in hard cases stop raising them.

Documentation

In each case the manager should document the facts, the reasoning and the actions taken. A clear record protects patients and staff and helps the ethics committee spot patterns, such as repeated requests for special treatment.

What the Scenarios Share

In each case, someone with power, a donor, a determined family or a senior physician, wants something that would be unfair or harmful to someone with less voice: other patients, the dying man himself, a patient who never consented. The manager's recurring duty is to protect fair process and the people who cannot protect themselves.

Legal and Ethical Questions

Each scenario also has a legal side: room assignment rules, surrogate decision laws and privacy regulations. The law sets the minimum, and a manager who stops there has answered only half the question. Ethics asked more in each case, such as explaining kindly to the donor and supporting the family through grief.

Conclusion

Working through facts, issue, principles, stakeholders, options and decision turned three stressful situations into reasoned choices. In each, the four principles identified the conflict and the manager's role was to act fairly, communicate clearly and use the organization's processes.

References

Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

Kon, A. A., Shepard, E. K., Sederstrom, N. O., Swoboda, S. M., Marshall, M. F., Birriel, B., & Rincon, F. (2016). Defining futile and potentially inappropriate interventions: A policy statement from the Society of Critical Care Medicine Ethics Committee. Critical Care Medicine, 44(9), 1769-1774. https://doi.org/10.1097/CCM.0000000000001965

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. https://doi.org/10.1159/000509119