Learning Task #3: Bioethics

BIOETHICS
BIOETHICS
BIOETHICS
LEARNING TASK #3
BIOETHICS
SIA, ERJEN ALEXANDRIA M.

BSN2B
learning task #3
4 Ethical Concerns on Evidenced-based Practice

There are four ethical concerns that are found on evidenced-based practice. First is that Some
types of knowledge are not included in EBP. In health care, EBP fits best with tightly defined
areas of practice, particularly pharmacology, but is ill suited for the more craft-like areas,
such as surgery and nursing.In these areas, experience counts for a great deal, and a patient
would be better served by an experienced practitioner rather than one well-versed in recent
research evidence. However, the point is rather that experience and intuition can point in
directions counter to those suggested by EBP. For example, whilst guidelines based on EBP might
suggest a new treatment for all patients, a practitioner might believe that overall, some
patients who are well established on the old treatment would be best left on it.Second ethical
concern, EBP runs counter to patient-centred care, this it is a continuation type of knowledge
that is discounted by EBP is often specific to case or circumstance. By insisting that all
practice is based on up to-date research evidence where it is available, patient-centred care,
which requires case-specific knowledge and intuition, is undermined.The issue arises particularly
where EBP enters protocols and guidelines which are supposed to be used as the primary decision-
making aid for practitioner. Third ethical concern, "Testable by RCT" is not the same as "most
effective" EBP puts highest value on evidence from randomised controlled trials (RCTs). However,
it can cause unethical results. Last is Decisions based on EBP can be unjust. Those funding a
health system would seem well advised only to fund interventions for which there is evidence. The
preference for RCT-testable interventions described in the previous paragraph easily mutates into
a preference for funding such interventions.
learning task #3
THERE ARE TWO TYPES OF PROBLEMS, PATIENTS LOSE CHOICE

& PRACTITIONERS LOSE CHOICE. THE FIRST TYPE, PATIENTS
LOSE CHOICE WAS DESCRIBED BY RESEARCHERS AS EVIDENCE-
Provide BASED PATERNALISM. IN MY OWN UNDERSTANDING, IT
feedback on the
CREATES PROBLEM BECAUSE PATIENTS DECIDES ONLY ON WHAT
EVIDENCE THEY SEE. THEY SOMETIMES MAKES WRONG
two types of DECISIONS FOR THEIR HEALTH, THAT COULD HARM THEM
problems MORE, EVEN THOUGH THEY’RE ADVISED BY PHYSICIANS OR
involving to OTHER HEALTHCARE PROFESSIONALS, THEY’LL FOLLOW WHAT
THEY THINK IS RIGHT. SECOND IS PRACTITIONERS LOSE
counter the CHOICE, IN MY UNDERSTANDING THIS IS WHEN THE
patient-centred HEALTHCARE PROFESSIONALS LIKE DOCTORS ARE LEFT WITH
care. NO CHOICE BUT TO TRY OTHER TREATMENT IT COULD BE LESS
EFFECTIVE BUT THEY’LL TRY IN ORDER TO SAVE/GIVE THEIR
BEST CARE. IT COULD ALSO BE INFORMING THE PATIENT AND
HIS/HER FAMILY THAT THE TREATMENT IS NOT EFFECTIVE
AND THEY DID EVERYTHING THEY CAN.
learning task #3
Strategies on moral decision-making

process
There are steps being followed on ethical/moral decision making process. First step
is to gather the facts.Never jump into conclusions without facts. Use WH questions or
formulate ‘who, what, where, when, how, and why’ when gathering information. However,
facts may be difficult to find because of the uncertainty often found around ethical
issues. Make sure to clarify the assumptions you are making. The second step is to
define the ethical issue(s). Don’t jump into solutions without first identifying the
ethical issue(s) in the situation.Then define the basis for the issue you want to
focus on. Remember, there may be multiple ethical issues in a situation – focus on
one major issue, one at a time. Third is to identify the affected parties. Make sure
to identify who are the primary/direct stakeholders and secondary/indirect. Then
formulate why they are the affected stakeholders for the issue or simply perspective-
taking, see things through the eyes o the affected individuals. Fourth step is to
identify the consequences, both potential positive and negative consequence for the
affected parties by the decisions. Like what are the magnitude of the consequences
and the probability that the consequences will happen. Always consider what your
decision would be based only on the consequences and move on and see if it is similar
given other considerations.
learning task #3
continuation
The fifth step is identifying the relevant principles, rights, and justice issues.
Obligations should be thought of in terms of principles and rights involved. Make sure
to consider any relevant cognitive barriers/biases.Then formulate the appropriate
decision or action based solely on the above analysis of these obligations. Sixth step
is to consider your character and integrity. Consider what your relevant community
members would consider to be kind of decision that an individual of integrity would
make in this situation. The specific virtues relevant in the situation should be
considered. Seventh is to think creatively about potential actions. Be sure you have
not been unnecessarily forced into a corner. Make sure to consider other choices and
alternatives that might satisfy the interests of the primary parties involved in the
situation. Eight, check your guts. Even though the prior steps have argued for a
highly rational process, it is always good to “check your guts.” Intuition is gaining
credibility as a source of good decision making – knowing something is not “right”.
Last step is to decide on your course of action and prepare responses to those who may
oppose your position. Consider potential actions based on obligations, consequences,
and character approaches.
learning task #3
ETHICAL dELIMMA (Case Analysis)

case answer:
The first ethical principle I noticed involved is autonomy, it is when the patient
should've been the decision maker. It gives the patient the rights to decide and have
control of her own body. For the case of Mrs. Sandra, she told her son to not
resuscitate her if cardiac arrest happens. Because of her NFR request, the autonomy of
the patient shouldnt be violated, respect her decision and grant her request. If there
will be any family member who would object, it is the responsibility of the physician
to explain to family & make them understand the situation, the NFR, and this ethical
principle. Beneficence was also seen in this case, wherein the ICU team should've
still continue the procedures and treatments for the patient but their response in
case cardiac arrest happen shouldn't have conflict with the patient's decision of not
being resuscitated. Healthcare workers must have or maintain a high level of skill and
knowledge, have the mindset of doing whats best for their patient and consider their
individual circumstances in order to ensure beneficence. Fidelity is also important in
this case. The healthcare workers like the physician must keep his words and grant the
request of the patient. He/She should stay truthful and faithful to his works
providing honest information to the patient about his/her condition. The diagnosis and
prognosis should be mentioned to the patient truthfully at the same time explaining
all sides/consequences/any possible result of the patient's decision of having NFR.

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BIOETHICS

SIA, ERJEN ALEXANDRIA M.

4 Ethical Concerns on Evidenced-based Practice

THERE ARE TWO TYPES OF PROBLEMS, PATIENTS LOSE CHOICE

Strategies on moral decision-making

ETHICAL dELIMMA (Case Analysis)

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