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PHI FPX 3200 Assessment 5 Tonya’s Case: Ethics and Professional Codes

Name 

Capella University 

PHI FPX 3200 

Prof. Name 

November, 2024

Tonya’s Case: Ethics and Professional Codes

Instead of offering me soul-cleansing water ASHyoung brought in Teenage girl Tonya Archer for an ACL tear surgery at our hospital. She developed a cardiac arrest in transit and, because of this and the resultant restricted access to blood flow, she died of brain death. The doctors told the staff, which included Tonya, that she could no longer be connected to life support as her body had no chance of recovering, but Tonya’s parents said to them that their daughter was still alive because her body was still warm and her heart was still beating. Leaders at the hospital and ethicists added that Tonya’s therapy was unproductive and had no benefits to the patient. This assessment is designed to reflect the ethical and moral dilemmas that occur in end-of-life circumstances.

Ethical Principles and Moral Theories

The principles at work in the case of Tonya are autonomy, beneficence for the patient non-maleficence, and justice. Implicit in the principles of “autonomy,” for example, is the patient’s right to choose how they are treated. The only choices Tonya has here are the ones her parents make for her because she cannot decide for herself. Unfortunately, it wouldn’t be helpful for Tonya if she were to receive more treatment, as she is not expected to recover and further treatment will only turn her condition for the worse, the physicians have stated that in making their recommendations, Tonya is not best helped by undergoing further treatment at this stage. The only sensible thing to do is to pull the plug on Tonya’s life support. Healthcare professionals are required to do nothing with the intent to injure themselves. Further therapy needs to be ceased in this case as Tonya will be only harmed and will not benefit from it (Alanazi et al., 2024). Injustice characterizes a situation when medical decisions are made discriminately rather than fairly. In this case, the medical decision made is purely informed by good medical practice and thus; does not in any way influence the family’s socioeconomic status.

Moral Theory for the Case

Another tough moral theory that can be used is utilitarianism, which seeks to increase the quantity of utility, that is pleasure or happiness and decrease the sum of disutility, that is pain or suffering. In other words, an activity is ethically right if it leads to maximum happiness for a maximum number of people. I think the councils according to the notion of utilitarianism in Tonya’s case will involve assessing the likely consequences of the action of taking her off the life support system or keeping her on it. Tonya is currently brain-dead and her treating physicians and hospital administrators have determined that Tonya cannot gain any benefit from continuing to be on the ventilator or to receive any additional treatment. 

In this case, therefore, a utilitarian analysis would require one to assess the consequences that can arise from any given option. If Tonya were to be maintained on life support permanently Tonya’s family would experience a lot of stress both mentally and financially and more importantly life support would be taken up by Tonya thus depriving other patients the vital resources. In addition, there are no reports of joy or happiness in this scenario for Tonya (Häyry, 2020). At the same time, if the life-supporting equipment is switched off in Tonya’s case, she will die immediately and that will cause a lot of suffering to her relatives. Finally, oriented by the principles of utilitarianism, intensivists stated that cessation of life-sustaining treatments would provide the highest utility for most individuals because it would make the fewest number of people happy releasing medical resources and sparing Tonya more pain they all agreed. Though not may be easy it will be a rational decision as per the utilitarianism aspects (Vearrier, 2021).

Application of Professional Code of Ethics

Legal professionalism regulating the behavior of hugs in their interactions with patients forms the core of medical professionalism. A simple solution to this problem may be the use of the Code of Medical Ethics of the American Medical Association. One of these is the principle of non-maleficence according to which a physician must first not harm. According to this rule, Tonya’s medical team suggests that she should be disconnected from the life support system as they pointed out that any further treatment will make her suffer needlessly without any possible improvement to the quality of her life. The other important value is autonomy or the right of patients to make choices concerning their medical treatment (Minicuci et al., 2020). When the patient is incapable of making choices for herself, her legal representative, Tonya’s parents, must also make decisions in the best interest of the patient. This is because, based on an analysis of the Izzo Model of Shared Decision Making, the medical staff came to a resolution that Tonya would not benefit from the continuation of her treatment (Sharifikia et al., 2024). This principle also applies; protecting patients regardless of the harm that may come their way is known as the beneficence principle for healthcare providers. The medical staff has deemed that Tonya would gain no more in the way of therapy; it only serves to prolong her suffering. The best action is to pull the plug on her life support (Minicuci et al., 2020). The decision of the medical staff to pull out the life-support system from Tonya is normally ethical in compliance with the rules of standard professional ethics precisely because of beneficence, patient autonomy, and nonmaleficence. The medical staff is mandated to act in the best interest of the patient and provide services that are medically necessary for her recovery even though the parents have every right to speak on behalf of their daughter.

Use of Organizational Documents

In healthcare companies, other documents like purpose and value statements give direction to the company’s decisions. The medical staff’s decision to take off the life support for Tonya may be measured against the hospital’s goals and objectives, and incorporated in organizational values. The hospital’s mission statement firmly underlines the provision of adequate and effective treatment or care to the patients and foremost attachment to their security and safety. This goal statement is substantiated by Tonya’s case withdrawal from life-support to keep her alive would only be prolonging her suffering. It could be integrity, respect, and compassion for the hospital because it has not survived long without grasping such a strong organizational culture. Considering Tonya is in that state, it is noble to pull the plug on her since it is the moral thing to do. Since they operate based on personal and ethical decisions and perceptions, the choice made by the medical team is also in congruence with the idea of integrity.

The ways for deciding the terminal stages may also be described in the manuals and policies of the hospital, use of the ethical committees, and involvement of the patient’s surrogate. Perhaps, it had these rules and procedures when the medical team probably removed Tonya’s life support (Molina & Gallo, 2020). Finally, the medical team can come to a common opinion about removing Tonya from life support on the hospital’s purpose, beliefs, rules, and regulations. The medical staff also should respect the hospital’s commitment to providing quality care and patient safety by being a patient advocate and acting under their professional and personal discretion.

Role of Accrediting Bodies

Accreditation agencies are important if the health care provision is to ensure that it delivers efficient and effective services to the patients. These groups set standards, and they also conduct surveys to determine whether the healthcare institutions practice these standards. The accreditation status of the hospital in Tonya’s situation is a factor that serves in making her decision to take her off life support. The Joint Commission for example is an accrediting agency that evaluates healthcare organizations in the USA. The Joint Commission sets the relative patient care, safety, quality, and on-site survey to assess its compliance. An organization attains accreditation if it meets the standards (Minicuci et al., 2020).

The offenders in the hospital hence the accreditation status can be vital when deciding whether Tonya should be taken off life support. Government hospitals want to achieve accreditation of their medical facilities by the Joint Commission, they need to prove that they adhere to the organization’s norms for end-of-life care, including the policy stating whether the treatment shall be withdrawn or not. Since the medical staff is acting according to the professional code of ethics and their ethics, it would be hard to disagree with their decision to take Tonya’s life support (Marseille & Kahn, 2019). However, even if it is a certified hospital, it still has to ponder options for end-of-life care based on the requirements set by the accrediting body. These requirements which are meant to ensure patients receive efficient, competent as well as wholesome treatment, draw from existing industry standards. Such action of the medical staff, in such circumstances to withdraw the life support from Tonya is compatible with the ethic of nonmaleficence and the principles of patient orientation in treatment (Gulati et al., 2021).

PHI FPX 3200 Assessment 5 Conclusion

Since there are conflicting ideologies when it comes to what constitutes life and death in the case of Tonya it becomes challenging and heart-wrenching to pull her off the life-support equipment. In such selections though, healthcare practitioners and organizations can find help from ethical principles and professional codes of conduct and behavior (Gulati et al., 2020). The following principles are strictly adhered to in the practice of health care provision; The patient must be treated in his/her best interest while bearing in mind his/her attitudes and beliefs of decision-making based on these principles highly and put into practice the principles of; autonomy, beneficence, nonmaleficence, and justice.

PHI FPX 3200 Assessment 5 References

Alanazi, M. A., Shaban, M. M., Ramadan, O. M. E., Zaky, M. E., Mohammed, H. H., Amer, F. G. M., & Shaban, M. (2024). Navigating end-of-life decision-making in nursing: a systematic review of ethical challenges and palliative care practices. BMC Nursing, 23(1), 467. https://doi.org/10.1186/s12912-024-02087-5

Gulati, M., Levy, P. D., Mukherjee, D., Amsterdam, E., Bhatt, D. L., Birtcher, K. K., Blankstein, R., Boyd, J., Bullock-Palmer, R. P., Conejo, T., Diercks, D. B., Gentile, F., Greenwood, J. P., Hess, E. P., Hollenberg, S. M., Jaber, W. A., Jneid, H., Joglar, J. A., Morrow, D. A., & O’Connor, R. E. (2021). 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain. Journal of the American College of Cardiology, 78(22). https://doi.org/10.1016/j.jacc.2021.07.053 

Häyry, M. (2020). Just better utilitarianism. Cambridge Quarterly of Healthcare Ethics, 30(2), 1–25.
https://doi.org/10.1017/S0963180120000882 

Marseille, E., & Kahn, J. G. (2019). Utilitarianism and the ethical foundations of cost-effectiveness analysis in resource allocation for global health. Philosophy, Ethics, and Humanities in Medicine, 14(1), 1–7.
https://doi.org/10.1186/s13010-019-0074-7 

Minicuci, N., Giorato, C., Rocco, I., Lloyd-Sherlock, P., Avruscio, G., & Cardin, F. (2020). Survey of doctors’ perception of professional values. PLoS ONE, 15(12). https://doi.org/10.1371/journal.pone.0244303 

Molina, J., & Gallo, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International Journal of Environmental Research and Public Health, 17(3), 835. https://doi.org/10.3390/ijerph17030835 

Sharifikia, I., Khoshnood, Z., Hosseinnejad, A., Farokhzadian, J., & Rohani, C. (2024). Exploring a guide for codes of ethics for the development of ethical competence in Iranian nursing students: a systematic review and meta-synthesis. BMC Nursing, 23(1), 519. https://doi.org/10.1186/s12912-024-02208-0

Vearrier, L., & Henderson, C. M. (2021). Utilitarian principlism as a framework for crisis healthcare ethics. HEC Forum, 33(1), 45–60. https://doi.org/10.1007/s10730-020-09431-7 

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