Running head: ETHICAL DILEMMA 1 EthicalDilemmaNameInstitution
The ethical dilemma in this case is whether 6-years old childdiagnosed with meningitis should be treated against the wish of thechild’s primary custody mother. The child’s primary custodymother is a Christian Scientist and insist no medical treatmentshould be given to the child on religious grounds. Although thebiological father of the child has given his permission to initiatetreatment on the child, the physician faces ethical dilemma ofwhether he should operate the child without primary custody mother’spermission.
Using a decision-making model helps in making an objective decisionrather than a subjective one. This analysis uses the Uustal (1993)ethical decision-making model. The model has the following steps:
Step one: Identifying the problem by asking who, how, and what is involved. After answering these questions, conflicting values and ethical dilemma should be stated.
Step two: Stating personal ethical position and values regarding the problem. One should ask: how does the issue in question fit within my values?
Step three: Establishing alternatives to solving the dilemma
Step four: Various alternatives should be categorized and those inconsistent with personal values identified.
Step five: Making a prediction regarding all possible outcomes taking into consideration spiritual, physical, social, and psychological consequences of the decision to be taken.
Step six: Prioritizing the acceptable behavior from most the acceptable to the least acceptable.
Step seven: Developing an action plan that takes into consideration all the acceptable alternatives in the case
Step eight: After identifying the possible alternatives the best alternative should be implemented.
Solving dilemmausing the Uustal Decision Making Model
The ethical dilemmain this case is whether the physician should initiate treatment onthe child diagnosed with meningitis against the wish of her primarycustody mother or he should not initiate treatment against the willof the child’s biological father.
Stating PersonalEthical Position
Medical ethicsrequire a physician to give priority to the health of the patient(Percival, 2014). In line with this, my personal values and ethicalposition are that the treatment for the child should be initiatedimmediately. This is incongruent with the religious belief of thechild’s primary custody mother but is congruent with the positionof the child’s biological father.
There are only twoways to solving this problem. One is by initiating the treatment ofthe child, and the other one is handing over the child to her primarycustody mother without having received any treatment.
The option ofinitiating treatment to the child is congruent with my personalvalues. This is the most appropriate alternative. Failing to treatthe child will be a neglect of duty and can lead to deterioration ofthe condition from mild to chronic.
If I inform theparents that the child’s treatment has been initiated, the fatherwill be very pleased, and the mother will be very upset. On the otherhand, if the treatment is not initiated, the mother will be happythat her position is respected but the father will be very upset withthe decision.
Prioritizing theAcceptable Behavior
The most suitablecourse of action, in this case, is to initiate meningitis treatmentto the child. Failing to initiate the treatment would be the leastacceptable behavior.
Developing anAction Plan
Physician shouldinform the biological father of the child about the most appropriatedecision that will help the child to recover. The father should betold that the child will be treated despite mother’s resistance.Then the mother should be called and informed about the decisionarrived at between the father of the child and the physician.
The physician shouldinitiate child’s treatment immediately.
Dialog to thefamily
Father: What didyou decide about our child?
Me: I decidedto initiate treatment immediately
Mother: Why did youdo this against my wish?
Me: I understand your position as the primary custody mother of thischild. I know according to your Christian-scientist belief, notreatment should be offered to your child. Medical professionrequires physicians to get permission from parents before initiatingtreatment of their child. However after evaluating all thealternatives I have decided to initiate treatment on your child. Idecided that this is the best approach to take in this situationbecause:
First, we are required as physician to give priority to the life andhealth of the patient, especially when the case involveslife-threatening condition (Weisz, 2012). By deciding to initiatetreatment I do not undermine the values of either one of you, as theparents of the child, but I took the decision that will protect thehealth of your child.
Second, meningitis has the potential to be life-threatening if notaddressed earlier. Meningitis has caused a high mortality rate,particularly among the children. In many cases, delayed treatment hasbeen linked to the poorer outcome (Day et al., 2013). This means itis important to ensure treatment of your child is not. Attending toyour child as soon as possible lowers the risk posed by meningitis.As such, despite the mother’s position, I will go on and initiatetreatment on the child.
Day, J. N., Chau, T. T., Wolbers,M., Mai, P. P., Dung, N. T., Mai, N. H., & Thai, L. H. (2013).Combination antifungal therapy for cryptococcal meningitis. NewEngland Journal of Medicine, 368(14),1291-1302.
Percival, T. (2014). Medicalethics. CambridgeUniversity Press.
Uustal, D. B. (1993). ClinicalEthics and Values: Issues & Insights in a Changing HealthcareEnvironment.
Weisz, G. (Ed.). (2012). Socialscience perspectives on medical ethics (Vol.16). Springer Science & Business Media.