Using the seven-step decision model, solve the following ethical
dilemma. A woman was diagnosed with motor neuron disease five years ago.
This is a condition that destroys motor nerves, making control of
movement impossible, while the mind is virtually unaffected. People with
motor neuron disease normally die within four years of diagnosis from
suffocation due to the inability of the inspiratory muscles to contract.
The woman’s condition has steadily declined. She is not expected to
live through the month and is worried about the pain that she will face
in her final hours. She asks her doctor to give her diamorphine for pain
if she begins to suffocate or choke. This will lessen her pain, but it
will also hasten her death. About a week later, she falls very ill, and
is having trouble breathing. If you were her physician, what would your
decision be? Be sure to outline your decision-making process using the
seven-step decision model.
Your response should be at least 200
words in length. You may use only your textbook as source material
Expert Solution Preview
Introduction:
This ethical dilemma involves a woman diagnosed with motor neuron disease who is facing her final days and is worried about the pain she will endure. She requests her physician to give her diamorphine to relieve her pain but is aware that this may hasten her death. As a medical professional, it is important to make decisions that are based on ethical values and principles. Therefore, using the seven-step decision model, I will address this dilemma and provide an appropriate solution.
Answer:
The first step in the decision-making process is to identify the problem. The problem in this ethical dilemma is whether to administer diamorphine to the patient to relieve her pain, despite the knowledge that it may hasten her death.
The second step is to gather information. This involves consulting the patient’s medical records, diagnosing her current condition, and discussing her prognosis with other healthcare professionals.
The third step is to identify the ethical principles involved. In this scenario, the ethical principles involved are beneficence, non-maleficence, autonomy, and justice. The physician must consider the patient’s wishes to have her pain relieved while not doing harm and ensuring that her autonomy is respected.
The fourth step is to identify alternatives. In this situation, the alternatives are to either administer diamorphine to relieve the patient’s pain or to find an alternative medication that will provide relief without hastening her death.
The fifth step is to weigh the consequences. The physician must consider the positive and negative consequences of both administering diamorphine and not administering it.
The sixth step is to make a decision. Based on the ethical principles involved, alternative options, and the consequences of both actions, the physician should administer diamorphine to alleviate the patient’s pain and provide comfort in her final hours.
The seventh step is to implement the decision and evaluate the outcome. The physician should administer the medication, ensure the patient is comfortable and monitor her condition. After the patient has passed, the healthcare team should review the outcome and determine if any changes need to be made in the future.
In conclusion, the seven-step decision model is an effective tool for addressing ethical dilemmas in healthcare. By using this model, the physician can make an informed decision that is based on ethical principles and best practices. In this situation, the physician’s decision to administer diamorphine to alleviate the patient’s pain and provide comfort is consistent with ethical principles and ensures that the patient’s wishes are respected.
