Ethics Of Care Case Study

Introduction

The case which came up related to Jaymee Bowen, also known as Child B had captured the attention of all the media and healthcare department. The incident is about the father who was looking for the finest care for his daughter but the doctors and health service managers beg to differ due to the use of resources available. The point on which health services took the stand was to efficiently use the sources, which were limited, but the lawyers took the matter to court. The media highlighted the matter, which shows the dilemmas of health services and the challenges in making the right decision. The case in the court took a turn which gave the lesson to health services of how to make decisions and the choices in the health services which are difficult (Milligan and Jones, 2016).

Description

The ethical theory with the name of ethics of care in healthcare services is a normative theory that gives the lesson that providing care is the moral duty regarding interpersonal relationships and care. This theory was developed in the mid of the twentieth century by feminists, along with other ethical theories. These theories provide a sense of moral duty, which is a universal standard, and response, which emphasizes the ethics of care. There are four main parts which are included in the theory of ethics care. The first one is attentiveness, which refers to meeting the requirements and needs of others by responding. Ignorance and inattentiveness are not always against ethics, but questions are when it is required. The second factor is responsibility, which refers to obligation. A person is obliged to take responsibility when it comes to providing care ethically because of their moral duty. The third actor is competence, which is the most important one because it refers to taking responsibility for all the actions and trying to amend the mistakes. The third factor involves responsiveness, which comes under providing care to the one who is in need of taking responsibility (Perry et al., 2017).

The case that was referred to earlier should be explained in detail in order to understand the complexities and gain an understanding of the situation during that time. Jaymee was a 6-year-old healthy girl who was diagnosed with non-Hodgkin’s lymphoma.  Her treatment started at Addenbrooke’s Hospital in Cambridge, and later, the doctor figured out that she also had cancer. Jaymee went through chemotherapy and also a bone marrow transplant for her leukemia in London (Spiers and Beresford, 2017). After all the treatment, she spent nine months in stable health, but her health collapsed, and the doctor informed her that she was left with only eight weeks to live. After looking at her condition, the doctor suggested to admit her in palliative care. The doctors in London’s suggestion regarding her treatment was rejected by her father because he had done his personal research from books and articles related to the medical field, and also, his brother from the United States helped him figure out the most suitable treatment for his daughter. Later, he found out that there were two doctors in California who were willing to do a second bone marrow transport of his daughter, which would hopefully give her a stable health condition (Raghuram, 2016).

The contradiction started among the doctors, and the one who was in charge of Jaymee’s health and was aware of her medical history suggested to her father that a second bone marrow transplant would not be good for her health because it’s an intensive treatment, whereas, the suggested treatment of palliative care will only give the stable health to her. David Brown, who was the father, took the suggestion of a specialist, and he gave the green signal that her second transplant would be good for her, but the grant he requested to treat her daughter was rejected because only the positive remarks of the doctor, who was aware of Jaymee’s health will help him get the grant approved. David Bowen, after facing the rejection, sought the help of the courts for the approval of his appeal and let authorities decide what was best for his daughter. The court reviewed the application, and it was granted them because they argued that the right to live is everyone’s right and the hospital should consider giving the grant to Jaymee’s treatment (Parton, 2003).

After the court, the matter came to notice in the media and through media, the information went public, and as a result, a donor offered help to pay the expenses for her treatment. The offer of the donor was accepted by David, and treatment started. The doctors, instead of using the method of the second bone marrow suggested by the doctors from California, used another method which eventually gave the good health to Jaymee for a few months. The father was proud and claimed that his action provided her with good health even though it was short because she eventually died after a few months (Sevenhuijsen, 2003). After the case of Jaymee, a series of ethical issues were raised by many concerned parties. The resources and the use of those resources were brought into question that how healthcare managers spent those resources in view of ethics. The limited resources should be considered before spending, but the precious lives of patients are also important for the healthcare department as it’s their duty. The decision was taken after the David Brown application for the review of the decision. Despite the fact that Jaymee lived only a few months after the treatment, the father was concerned for his daughter. The rules for consuming the resources should be looked after because the whole community intervenes when it comes to the life of the innocent daughter. The question here is what ethical consideration should be taken when making the decision and what is the perspective of rescuing the health of patients facing similar conditions. The ethical dilemmas related to health care are crucial, and priorities should be set in the decision (Preshaw et al., 2016).

Many researchers have conducted research and provided several ethical factors that should be implemented in order to meet the ethical standards when it comes to making the decision. The following important factors are highlighted:

• The new technologies and adaptation of new practices should be made public which can help in understanding why the technologies are being adopted and how much resources are being spent on them.
• All the decisions should be taken with their reasons, evidence and principles, which come from fair-minded people. The agreement of all the stakeholders involved in healthcare should be included when setting the priorities and making the decision. The limited resources are the public property and it should be spent on fair approaches.
• The decision when it’s being taken should have room in which it can be challenged, and a review could be done on all the decisions so that it can be argued and taken into further consideration.
• The public should be involved with the set regulation so all the conditions and factors could be full filled. The process should be followed when making the decision (Bromley, 2015).

The Child B case has taught many lessons to the healthcare department and provided guidance to follow ethical practices with clear steps.  The choices that are being taken in healthcare are mostly tragic because they involve the lives of patients. The court and media showed the negative side but they should be integrated because it involves the public interest. There are four basic and most important principles that come under the ethical theory of health care that should be followed and implemented. The field of healthcare is highly sensitive, and ethics is crucial because it involves the lives of patients who are unaware of the consequences of any action taken by doctors and nurses. Not just the patient but the concerned family with the patients are also the key stakeholders who also need to know the progress and process. The principles which are mentioned earlier give the authority and protect the rights of the patient (Krizek, 2000). The following are the descriptions of those principles:

• The first principle is the autonomy of the patient and deals with the intention of patients along with the thought and action because that will give the right to the patient regarding his/her health. The patient should be aware of all the procedures that need to be followed, and it’s the right of the patient to choose the procedure of providing the health care. Every procedure involves the risk, and those risks shouldn’t be kept from the patient.
• The next principle is justice, which involves the interference of justice and the legislative system. There are rules which are being established regarding the ethics in health care which should be followed regardless of any condition.  The law gives the right to every party involved in the decision that is being taken regarding the health of the patient. The justice principle mainly guides the utilization of resources and how those resources should be spent with regard to ethical procedures.
• The third principle is regarding competence and the updating of relevant skills. The training should be provided so that the best healthcare procedures can be followed, and the health of patients relies on the expertise of doctors and nurses.
• The fourth principle supports the above three principles by giving moral support and ethical practices. The patient and the people with the patient are emotionally vulnerable, so dealing with them should be under the guiding principle.

Conclusion

The conclusive remarks should consider all aspects, even the single incident that it’s about the father who was looking for the finest care for his daughter, but the doctors and health service managers beg to differ due to the use of resources available. The ethical theory with the name of ethics of care in healthcare services is a normative theory that gives the lesson that providing care is the moral duty regarding interpersonal relationships and care. The contradiction started among the doctors, and the one who was in charge of Jaymee’s health and was aware of her medical history suggested to her father that a second bone marrow transplant would not be good for her health because it’s an intensive treatment, whereas, the suggested treatment of palliative care will only give the stable health to her. The father was proud and claimed that his action provided her with good health even though it was short because she eventually died after a few months. The resources and the use of those resources were brought into question that how healthcare managers spent those resources in view of ethics. The limited resources should be considered before spending, but the precious lives of patients are also important for the healthcare department as it’s their duty. The decision was taken after the David Brown application for the review of the decision. Despite the fact that Jaymee lived only a few months after the treatment, the father was concerned for his daughter. The choices that are being taken in healthcare are mostly tragic because they involve the lives of patients. The court and media showed the negative side but they should be integrated because it involves the public interest. There are four basic and most important principles that come under the ethical theory of health care that should be followed and implemented. The field of healthcare is highly sensitive, and ethics is crucial because it involves the lives of patients who are unaware of the consequences of any action taken by doctors and nurses. Not just the patient but the concerned family with the patients are also the key stakeholders who also need to know the progress and process. The patient should be aware of all the procedures that need to be followed, and it’s the right of the patient to choose the procedure of providing the health care. The law gives the right to every party involved in the decision that is being taken regarding the health of the patient. The justice principle mainly guides the utilization of resources and how those resources should be spent with regard to ethical procedures. The training should be provided so that the best healthcare procedures can be followed, and the health of patients relies on the expertise of doctors and nurses. The patient and the people with the patient are emotionally vulnerable, so dealing with them should be under the guiding principle. Many researchers have conducted research and provided several ethical factors that should be implemented in order to meet the ethical standards when it comes to making the decision. With the new technologies, all the decisions should be taken with their reasons, evidence and principles, which come from fair-minded people, all the decisions so that they can be argued and taken into further consideration, and the public should be involved in the policy development. All the lessons learned in the light of theories and case studies should be implemented.

References

Bromley, E., Mikesell, L., Jones, F. and Khodyakov, D., 2015. From subject to participant: Ethics and the evolving role of community in health research. American Journal of Public Health, 105(5), pp.900-908.

Krizek, T.J., 2000. Surgical error: ethical issues of adverse events. Archives of Surgery, 135(11), pp.1359-1366.

Milligan, E. and Jones, J., 2016. Rethinking Autonomy and Consent in Healthcare Ethics. In Bioethics-Medical, Ethical and Legal Perspectives. InTech.

Parton, N., 2003. Rethinking professional practice: The contributions of social constructionism and the feminist ‘ethics of care.’ British Journal of Social Work, 33(1), pp.1-16.

Perry, H.B., Sacks, E., Schleiff, M., Kumapley, R., Gupta, S., Rassekh, B.M. and Freeman, P.A., 2017. Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 6. strategies used by effective projects. Journal of Global Health, 7(1).

Preshaw, D.H., Brazil, K., McLaughlin, D. and Frolic, A., 2016. Ethical issues experienced by healthcare workers in nursing homes: Literature review. Nursing ethics, 23(5), pp.490-506.

Raghuram, P., 2016. Locating care ethics beyond the global north. ACME: An International Journal for Critical Geographies, 15(3), pp.511-533.

Sevenhuijsen, S., 2003. The place of care: The relevance of the feminist ethic of care for social policy. Feminist theory, 4(2), pp.179-197.

Spiers, G. and Beresford, B., 2017. “It goes against the grain”: A qualitative study of the experiences of parents’ administering distressing health‐care procedures for their child at home. Health Expectations, 20(5), pp.920-928.