Death and Dying Unit 5

Subject: Business
Type: Expository Essay
Pages: 6
Word count: 1481
Topics: Work Ethic, Management, Medical Ethics, Medicine, Nursing

Define the challenge, and present two sides of the issue. Support each stance with the most recent research on this particular topic

Currently, the health care managers are challenged with the ethical issues related to death and dying in their organizations, and therefore, they need to be prepared to see various sides of the debate. With regards to “Prolonging life after physicians have declared a patient brain-dead,” health care managers are challenged with the ethical issue of nurses telling the truth to patients or withholding information. At the point when physicians speak or communicate with patients, being straightforward is an imperative approach to cultivate trust and show regard for the patient (Rising, 2017). Patients put a lot of trust in their doctor and may feel that trust is lost on the off chance that they find or see the absence of genuineness and sincerity by the doctor. However, there are circumstances in which reality or truth can be unveiled in excessively severe a design, or may terribly affect the intermittent patient. The objective of this rundown is to have the capacity to perceive the distinction (Shamasundar, 2008).

In collectivist societies, the benefit of the individual is regularly so enmeshed with the benefit of the family or in-gathering that relatives may have a more noteworthy say in health care choices than the patient does in a few conditions (Singer & Viens, 2014). In numerous nations, relatives may turn out to be exceptionally vexed if a doctor uncovers terrible news straightforwardly to the patient. Patients and families may put a massive value on the privilege not to know although this is totally inconsistent with the gauges put forward in the Patient Self Determination Act (Shahidi, 2010). The Patient Self Determination Act is useful in securing certain rights lawfully for all patients in the U.S. Therefore, the health care framework should be sufficiently adaptable to suit correspondence designs that look unique in relation to those inside the tradition of informed-consent which demands nurses and doctors tell patients everything. It is, therefore, an ethical dilemma to determine who to talk to about the diagnosis or the test results in cross-cultural health care situations (Swaminath, 2008).

In opposition to what numerous doctors have thought before, various reviews have shown that patients do need their doctors to disclose to them truth regarding the prognosis, diagnosis, and therapy (Swaminath, 2008). For example, 90 percent of the patients studied said they would need to be recounted a finding of tumor or Alzheimer’s ailment. Additionally, various investigations of doctor dispositions uncover support for honest disclosure. For instance, by 196os just 10 percent of the doctors reviewed trusted it was right to tell a patient of a deadly tumor diagnosis, however, currently, over 97 percent feel that such a revelation is right (Rising, 2017).

Patients are justified to be told the truth about their diagnosis all the time. Notwithstanding encouraging trust and showing respect, giving patient’s honest and truthful information about their diagnoses assist them in becoming more informed participants in essential health care decisions (Shamasundar, 2008). Along these lines, patients ought to be told every single pertinent part of their ailment, including the nature of the ailment itself, expected results with a sensible scope of treatment options, treatment’s benefits and risks, and other information that is deemed significant to personal values and needs of that patient. However, treatment choices that are not medically shown or appropriate should not be revealed to the patent (Shahidi, 2010). Other information that should not be revealed to the patient includes unimportant facts to the ability of the patient to be an informed participant in decision making, for example, results of particular laboratory tests. Likewise, truthful and complete disclosures require not be fierce or brutal because appropriate sensitivity to the ability of the patient to process muddled or terrible news is imperative.

On the other hand, it is justified to withhold information from the patient. There are two main circumstances in which it is legitimized to withhold the truth from patients. The first situation is if the doctors have convincing proof that disclosing the truth will cause genuine and unsurprising damage, therefore, honest revelation might be withheld (Shamasundar, 2008). Illustrations may incorporate revelation that would make a discouraged or depressed patient effectively self-destructive or suicidal. This kind of judgment is frequently alluded to as the “therapeutic privilege.” It is always essential; however, it is subject to abuse, and subsequently, it is critical to invoke the privilege in the instances when the harm is not merely speculative or hypothetical by seems very likely (Rising, 2017). The second situation is if the patients themselves express an informed preference not to be told the truth about their diagnoses. A few patients may ask that the doctor rather counsels or consult the relatives, for example. It is therefore important, in most cases, that the patient offer idea to the ramifications of abdicating their role in the process of making a decision (Swaminath, 2008). On the off chance that they settled on an informed choice not to be told the truth, notwithstanding, this preference ought to be regarded.

Discuss the impact that this particular issue has on health care organizations as a whole, including legal costs and other challenges

The lawful contentions for the restorative benefit are not viable in light of the fact that they absolutely negate the precept of informed assent. Patients cannot give informed consent when they are not fully informed. The way that patients might be so sick or candidly troubled on accepting certain data is no motivation to withhold data or deceive competent patients (Shahidi, 2010). Therefore, the irrational choice and ‘best interest’ fact are not a sufficient legitimization to invoke the therapeutic privilege. People usually get upset from time to time particularly amid extreme ailment or troublesome decisions, yet that does not imply that their capacity to settle on a sound choice is disabled (Singer & Viens, 2014).

As far as morality, misleading patients cannot be defended under any situation. Deceiving patients and neglecting to educate patients of specific dangers or result abuse the standard of self-rule or autonomy and undermine the regulation of informed consent. Instead of benefiting the patients, it may end up hurting or harming them and disintegrate trust when they find out that they have been lied to. Fundamentally, withholding information about diagnoses from patients violates beneficence, the principle of autonomy and non-maleficence (Rising, 2017). Therefore, it may lead to legal consequences to the organization. In case the physician withholds information and the patient actually gets harmed, he or she may sue the organization which in turn results in litigation expenses as well as damages or remedies in case the patient wins the case (Youngberg, 2011).  There are legal consequences for non-disclosure of patients’ information to the doctors. It is not ethically justifiable because patients are in a better position to determine what is in their best interest on the basis of the information that doctors make available to them (Shahidi, 2010). 

Truth telling about the ailment and its diagnoses and prognosis to patients who are terminally ill is a major moral predicament that nurses need to manage on customary premise. They are dependably at the forefront in healing facilities for patient care, in this way they should be resolved to give honest information to patients and give them support and their families when the truth has been conveyed (Singer & Viens, 2014). They should tell the truth in a convenient and sensitive way to avoid jeopardizing the relationship between the nurse, patient, and family. In case truthfulness is not part of the regular correspondence, the organization may suffer the loss of patients because they will lose trust in the physicians. Dying patients needs to be told the truth so as to have the opportunity of saying goodbye to their friends and families (Shamasundar, 2008). Not telling the truth ensures that further options are out of the knowledge of the patient that could lengthen the time the patient could have on earth. To respect the patient’s dignity and choice, correct information ought to be conveyed to the patient with an end goal of justifying their rights, while valuing their desires at the same time (Rising, 2017).

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  1. Rising, M. L. (2017). Truth Telling as an Element of Culturally Competent Care at End of Life. Journal of Transcultural Nursing, 28(1), 48–55. 
  2. Shahidi, J. (2010). Not telling the truth: Circumstances leading to concealment of diagnosis and prognosis from cancer patients. European Journal of Cancer Care
  3. Shamasundar, C. (2008). Telling the truth to patients and relatives. Indian journal of psychiatry50(3), 219.
  4. Singer, P. A., & Viens, A. M. (2014). The Cambridge textbook of bioethics. Cambridge: Cambridge University Press.
  5. Swaminath, G. (2008). The doctor’s dilemma: Truth telling. Indian journal of psychiatry50(2), 83.
  6. Youngberg, B. J. (2011). Principles of risk management and patient safety. Sudbury, Mass: Jones & Bartlett.
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