Ethical Health Promotion
Find a scholarly, peer-reviewed article no more than four years old that discusses an ethical health promotion-related issue.
In your paper:
Briefly summarize the presented issue.
Describe your thoughts on the role health care professionals should play in resolving the ethical issue.
Provide specific theories and refer to specific ethical codes to support your position.
Your paper should be 2-3 pages long. Use APA to cite and reference the article and any other optional sources you use. Adhere to APA formatting throughout your paper.
Ethical Health Promotion
Do-Not-Resuscitate Orders in Operating Rooms
Shapiro & Singer (2019) explored advance Do-Not-Resuscitate (DNR) orders in perioperative settings. Healthcare practitioners often face DNR instructions from patients about to undergo an operation. These directives present various ethical issues. For instance, a healthcare worker cannot compel patients into accepting resuscitation interventions. Doing so would violate patients’ self-determination rights (Shapiro & Singer, 2019). Additionally, some healthcare professionals object to operating on patients who have an advance DNR directive. Thus, they are reluctant to provide care per a patient’s preferences.
The article further states that there are scenarios where DNR directives are appropriate. For instance, if a patient makes an informed decision to decline resuscitation efforts, caregivers must honor it. Such choices arise after deliberations with relatives and caregivers on the best possible outcomes. Sometimes, patients make informed decisions based on their cultural and religious inclinations. A DNR order is also appropriate where CPR is ineffective (Shapiro & Singer, 2019). Finally, when physicians and patients jointly acknowledge that resuscitation attempts would have done more harm than good, a DNR order is suitable.
Healthcare Professionals’ Role in Resolving the Issue
Despite the seemingly clear elaboration of the ethical concern, DNR orders raise significant challenges that require healthcare professionals’ decision-making skills. First, clinicians must determine whether a DNR is authentic, and thus, honorable. For instance, in 2017, a seventy-year-old Miami resident arrived unconscious at a healthcare facility with a tattoo on his chest that stated, “Do Not Resuscitate” (Washington Post, 2017). The medical team struggled with discerning whether they should seriously consider the message or ignore it and do what is best for the patient. Therefore, healthcare professionals must weigh the principle of beneficence against patient autonomy. Beneficence involves doing what is best for a patient. A caregiver must independently decide what would provide the best possible outcomes and implement measures to attain them. Sometimes, resuscitation could be the right action, but if the patient has in some form expressed their rejection for that procedure, then caregivers must honor it.
Additionally, caregivers must aid patients in making the right decision. Cardiopulmonary resuscitation (CPR) is not as effective as many people think. For instance, only 40% of patients who undergo it will have a return of spontaneous circulation (ROSC) outcome. A tenth of those with ROSC will recover enough to earn a discharge, and only a quarter of this population will live for over five years (Shapiro & Singer, 2017). The low efficacy of CPR stems from various medical properties, such as the patients’ age, comorbidity, and pre-existing heart conditions. Thus, caregivers must inform patients and their relatives of the practical chances of ideal outcomes, allowing them to make an informed and independent decision on the appropriateness of a DNR order.
Finally, caregivers must be culturally competent to resolve DNR-related ethical conflicts. Sometimes, patients disregard caregivers’ opinions on CPR and follow their cultural or religious teachings on the matter. Some beliefs unequivocally advocate rejection of CPR despite the potential medical benefits. If a culturally-competent healthcare professional encounters a patient with such opinions, they will understand their position and guide them through their desired care process. Therefore, caregivers must still attend to patients despite differences in care preferences, per the concept of non-maleficence. The principle provides that caregivers must not perform or omit an action that could cause harm to patients. In so doing, they maintain patient autonomy, dignity and protect themselves and their institutions from legal liability.