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