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Purtilo & Doherty (2011) Chapter 5 A Six-Step Process for Ethical Decision Making

Purtilo & Doherty (2011) Chapter 5 A Six-Step Process for Ethical Decision Making Slides by W. Rose, C. Polek, P. Butler, H. Brock College of Health Sciences and College of Arts and Sciences University of Delaware. Chapter 5 Introduction The Six Step Process. Introduction Cast :

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Purtilo & Doherty (2011) Chapter 5 A Six-Step Process for Ethical Decision Making

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  1. Purtilo & Doherty (2011) Chapter 5 A Six-Step Process for Ethical Decision Making Slides by W. Rose, C. Polek, P. Butler, H. Brock College of Health Sciences and College of Arts and Sciences University of Delaware

  2. Chapter 5 Introduction The Six Step Process College of Health Sciences

  3. Introduction • Cast: • Physical therapist Alexia Eliopoulos • Patient Anthony Carnavello, 76 y.o. • AE in week 2 of new job at nursing home. Her observation of AC and his care disturb her. She talks to the nursing supervisor about her concerns. She decides to call a social worker at another nursing home. College of Health Sciences

  4. The Six Step Process • Gather Relevant Info • Identify the Type pf Ethical Problem • Use Ethical Theories or Approaches to Analyze the Problem(s) • Explore Practical Alternatives • Act • Evaluate the Process & Outcome College of Health Sciences

  5. The Six Step Process • Gather Relevant Info • Clinical Indications • Dx or Prognosis • Reversible illness? • Life saving treatment medically futile? • Present treatment regimen • Usual & customary tx. • What is needed to provide comfort • Caregivers? • Medical & social hx. • Patient Preferences • What does pt want • Who has communicated realistic options • What was pt told • Was patient heard? • Patient Preferences • Pt competent? • Living will, etc? • Health care proxy? • QOL • Patient’s beliefs & values • Caregivers’ QOL considerations & biases • Hope for improvement? • Clinician biases re. QOL? • Contextual Factors • Institutional policies • Legal • Resource scarcity? • Payment? • Family issues? College of Health Sciences

  6. The Six Step Process • Gather Relevant Info • Identify the Type pf Ethical Problem • Moral distress • Ethical dilemma • Locus of authority College of Health Sciences

  7. The Six Step Process • Gather Relevant Info • Identify the Type pf Ethical Problem • Use Ethical Theories or Approaches to Analyze the Problem(s) • Narrative approach • Caring response • Relevant virtues • Utilitarianism • Duties College of Health Sciences

  8. The Six Step Process • Gather Relevant Info • Identify the Type pf Ethical Problem • Use Ethical Theories or Approaches to Analyze the Problem(s) • Explore Practical Alternatives • Imagine • Out of the box • Don’t breach confidentiality College of Health Sciences

  9. The Six Step Process • Gather Relevant Info • Identify the Type pf Ethical Problem • Use Ethical Theories or Approaches to Analyze the Problem(s) • Explore Practical Alternatives • Act College of Health Sciences

  10. The Six Step Process • Gather Relevant Info • Identify the Type pf Ethical Problem • Use Ethical Theories or Approaches to Analyze the Problem(s) • Explore Practical Alternatives • Act • Evaluate the Process & Outcome • What went well, and why do you think so? • Most challenging aspects? Compare to other situations? Wht future applications? • Who helped most? Feedback from pt, family, others? • What did you learn? WWUD differently? College of Health Sciences

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