Health care setting are vulnerable on very many dilemma on how they are supposed to take certain decision. This is encompassed by the ethical practices that they should practice and a right decision should be taken in any case. There are various ethics that a health practitioner is supposed to heed to. Therefore, if a case emerges to contravene the following health ethics is taken as a great dilemma and require correct intervention from the person in charge or even the management depending with the Consequentialism and utilitarianism theories (Crisp, 1997). The various general health ethics follows the following principles;
Autonomy
This is the right to have self-determination. This is a principle that help the nurse to respect the patients rights I making their decision even if they are not concurrent with their idea. The dilemma appears when the patient decide to have a certain medication or refuse to taken it according to nurse direction. Now the nurse has to ensure that he/she uses the assessment theories such as consequentialism or and utilitarianism theories to come up with the appropriate decision.
Beneficence
This principle allows the health practitioner to do their duty well and to ensure that they do not harm others. For every decision that they make in their career, it should be inclined towards accomplishing their duty well as required and making the client contented. There has been a lot of conflict in this as what the patients or their people require feeling contented may not be inline with the medical ethics. Such scenarios make the health care get to dilemma with their ethical behaviors.
Care
This is an attitude or orientation leading to the beneficial attending to the patient through the act of omission of one person in preference to the other. This means that the health fractioned should develop the principle of care that will enable a certain patient to use the scarce hospital resource in preference of any other patient. This require a critical decision to ensure that the final outcome do not harm may people (Clark, 2002).
Justice
This ensures that the practitioner of the health care is able to distribute risk and benefits to all the patients. This means that equal patients are treated equally and an equal patient are treated unequally. This means that those people who are able to access more and complex facilities in the hospital should be given priorities before others who may require them but economically cannot afford.
Moral
The health personnel should use personal beliefs and their cultural values in service dispensation. They should ensue that they the human conduct is followed in their decision of health practices. The dilemma emerges now when a situation that contradict this and should be tackled. Therefore, the personnel have to use ethical theories to ensure that their decision is worthwhile.
Nonmaleficence
This a principle that the healthy personnel follows that help then ensure that they should cause any harm to the patients intentionally. Nonetheless, this has been faced by many challenges as the patients might require a certain medication that may cause harm to them and the health care personnel is faced with a dilemma on how to handle such cases.
Values
This is another principle that they should follow but really conflict the way they work. This is because apart from their personal belief and altitude that they hold in high esteem, their clients has issues that conflicts such principle making them to get the best decision to offer a fair playground.
Advance directive
These are written directions that are recognized by the act of law that postulates certain health care provisions to be followed especially when the patient is incapacitated. This principle follows under two categories. The first category is healthy care proxy, which give priority to a person to make decisions on behalf another person if the person in question is not able to do so. While the second one is the living will, which is a written directive, where the person is able to specify medical treatment choice.
The above principles have been severally bought a lot of headache in the choice to make as at time the health personnel ahs to break them in attempt to create a more sensible ground of service delivery. With the conflicting issues that bring a lot of dilemma in health care making the practitioners wonder what they will do, there lies theories that can assessed to see how best they could solve their dilemmas. In this case, we will consider two theories to assess how they can be of help to them.
According to Clark 2002, the first theory is utilitarianism. It is a moral idea that an action taken should bring maximum utility, pleasure, satisfaction and total knowledge. It is very closely related to the second theory that is called consequentialism, which suggests that the worthy of a certain action is determined by its action. Otherwise, it suggests that the end justifies the mean. With the above theories, the health care personnel can be able to evaluate the action he/she will take to help come up with the most appropriate decision.
Utilitarianism and consequentialism theories
The application of these theories that are closely related to each other requires the healthcare personnel to understand how they work. The Utilitarianism and consequentialism theories are built in four major beliefs that ensures one understand them how they work. The first one is utility maximization. The belief entails the behavioral preposition that an individual is required to choose rationally towards any action without addressing the morality of this choice (Clark, 2002). The second one is the consumer sovereignty belief that says that an individual is the best judge of his/ her own destiny. Another one is the welfarism belief that ensures that resources should be well allocated solely according to the prevailing conditions. Looking at the tenets postulated they require a policy to be decided according to the assessment done by individuals depending with the utilities they have. The person receiving the utilities and their sources are literary ignored.
Theory approach to health care dilemmas
The health care functions provide a wide scope of third party decision welfare in their work to ensure that they come up with the required decision that will help the situation. In their approach, they exclude their focus in the utility but substitute the health with utility as the most important outcome in their interest. The quality of the adjusted life years is used as the measure of health in approach.
In this approach, the decision made in the health care makes welfare substitute health. The approach ignores the principle of good allocation of resources be judged by associated utilities or the welfare gotten by individual. In the health care setting, the personnel in executing their decision will ensure that they come up with a solution toward any situation that will be advantageous to many. For example, in a case where a handicapped person is involved the health person has a capacity to decide to help him/her live a full life there after or otherwise eliminate him/her depending with what will look better to the people who are in this case a third party.
The approach of the above theories ensures that the concept of the fairness extend to issues other than justice distribution (Clark, 2002). The concept of procedural justice dominate the aspect of the decision made and playing great roles in the policies judgment that result to resource allocation. Procedural justice ensures that it answers some questions in the decision-making. How the decision is arrived at and the people involved in the decision made are great questions to be answered. The other thing is the factors considered and the way they affect the allocation process of the resources that are very few in the health care to ensure that the required person is the one given service depending with priority put in place.
Maximization of value
Utilitarianism assesses the human action in terms of the way maximal non-moral values has been produced. However, the value to be produced has predetermined circumstances that dictate the way they are produced. The decision that is made according to this theory must look at the intrinsic value of it not the extrinsic value (Crisp, 1997).. This is the value that the decision made towards an issue has in it. The idea is that the decision is to ensure that we enjoy life for the sake of it, but not what it will produce eventually due to the decision made. In this theory, the intrinsic value encloses several other values that are considered in making of decision using this theory. Such values as life, happiness, love, friendship and many more are encompassed by this decision. Intrinsic values are very important in the judgment of moral issues.
Consequentialism help the health personnel to look at the final out come of the decision. The theory does not have any provision of if the decision made is right or wrong. Its main aim is to know if the outcomes of the action are intrinsically better than any other decision that could have been made in the same capacity.
For health personnel, he/she is morally responsibility of taking an action that will salvage the prevailing condition. Their action can be either wrong or right depending on how they are subjected to scrutiny. However, with the use of intrinsic value, one is able to give relevant judgment in the decision to be made in a capacity that ensures responsibility is not overlooked. Therefore, the intrinsic value no matter the condition; it will always be relevant responsible judgment. Therefore, no matter the theory used in the decision making, the moral justice is the benchmark and it will be good if the decision taken support this and very bad if this decision denies it.
The intrinsic value that is supported by utilitarianism, terms vices as bad and virtues good while the consequentialism do not regard what happens in the decision-making procedure but the end product of the decision made. For example, in the case of abortion where health personnel are required to help the patient to undergo the process, this decision is considered intrinsically bad. However, some people consider it extrinsically good looking at its final value in other means. In such states where an ill mother is required to be saved from death that might be caused by this pregnancy. By use of utilitarianism theory, this is not what is required. This theory will expect that any health practitioner who has been made to take such a decision take an intrinsic value that regards the value of life (Crisp, 1997). The theory do not want to look at the extrinsic impart of the decision made as consequentialism does.
Conclusion
The dilemmas faced in the health personnel and the method of taking affirmative action will obviously relay on so many things. As much as the above theories can be used to make certain decisions, the law put in place should be considered. We do not deny that nurses face so many challenges in their practices. Some situations are very serious for health personnel to just make a decision regardless of how a certain theory is supported. Therefore, in such cases consultation with the ethics committee is paramount. There can be many help if such cases are presented to the nursing and medical ethics rounds.
In such cases as long-term care where a patient requires an intravenous hydration tube for feeding and cannot make his/her own decision, then the health personnel are required to check what the healthy proxy states before they make decision. For examples, if the proxy states that no artificial feeding is supposed to be made, then the health practitioners should make appropriate decision whether to follow the ethics or not. That is when theories are useful to salvage such situation.
Another situation where these theories can be very useful in the health practice is a situation that has no proxy directive. An example of such situation is whereby a distant relative object patient tube feeding. In some states like United State, they do not recognize surrogate decision making. This means in such countries, the patient decision lay on the hands of their family or else if known is available the personnel with make decision on their behalf (Crisp, 1997). This involve constantly referring to the postulated theories as discussed earlier to ensure that the decision reached has a positive impact to the people at large. This decision may integrate both theories to ensure that the decision is all round.