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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 is 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 the health services and the challenges in taking 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 the healthcare services is a normative theory which gives the lesson that providing care is the moral duty regarding the interpersonal relationships and care. This theory developed in the mid of twentieth century by feminists along with other ethical theories. These theories provide the sense of moral duty which is universal standard and responding which emphasize on 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 meet the requirements and need of others by responding. The ignorance and inattentiveness not always against the ethics but question are the when it is required. The second factor is the responsibility which refers to obligation. A person is obliged to take the responsibility when it comes to providing care ethically because of its moral duty. The third actor is competence which is the most important one because it refers to taking the responsibility for the all the actions and try to amend the mistakes. The third factor involves the responsiveness which comes under providing the care to the one who is in need of taking responsibility (Perry et al., 2017).

The case which was referred as earlier should be explained with details in order to understand the complexities and gain the understanding of situation during that time. Jaymee was a 6 years 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 the chemotherapy and also a bone marrow transplant for her leukaemia in London (Spiers and Beresford, 2017). After all the treatment, she spent 9 months in stable health but her health collapsed and the doctor informed her that she is left with only 8 weeks to live. After looking at her condition, the doctor suggested to admit her in palliative care. The doctors in London suggestion regarding her treatment was rejected by her father because he had done his personal research from books and article 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 are willing to do second bone marrow transport of his daughter which will hopefully give her stable health condition (Raghuram, 2016).

The contradiction started among the doctors and the one who was in charge of his Jaymee’s health and was aware of her medical history suggested her father that second bone marrow transplant will 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 specialist and he gave the green signal that her second transplant will be good for her but the grant he requested to treat her daughter was rejected because only the positive remarks of the doctor who is aware of Jaymee’s health will help him getting the grant approved. David Bowen after facing the rejection, seek the help of courts for the approval of his appeal and let authority decide what is best for his daughter. The court reviewed the application and it was granted by them because they argued that 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 of media and through media, the information went public which in result a donor offered the help to pay the expenses for her treatment. The offer of the donor was accepted by the 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 few months. The father was proud and claimed that his action provided her with the good health which even though was short because she eventually died after few months (Sevenhuijsen, 2003). After the case of Jaymee, the series of ethical issues 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 which was taken after the David Brown application for the review of the decision. Despite the fact that Jaymee lived only a few months later the treatment but the father was concerned for his daughter. The rules for consuming the resources should be looked after because the whole community intervenes when it’s come to the life of the innocent daughter. The question here is that what ethical consideration should be taken when taking the decision and what is the perspective of rescuing the health of patients facing similar condition. The ethical dilemmas related to health care is crucial and priorities should be set in the decision (Preshaw et al., 2016).

Many researchers had conducted research and provided several ethical factors which should be implemented in order to meet the ethical standards when it comes to taking the decision. The followings are the important factors highlighted are:

  • 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 its reasons, evidence and the principle which comes from fair-minded people. The agreement of all the stakeholders involved in the healthcare should be included when setting the priorities and taking 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 the room in which it can be challenged and the review could be done on all the decision so that it can be argued and take 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 taking the decision (Bromley, 2015).

The child B case has taught many lessons to healthcare department and provided the guidance to follow the ethical practices with clear steps.  The choices which are being taken in the healthcare are mostly tragic because it involves 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 which come under the ethical theory of health care 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 gives the authority and protects the right of the patient (Krizek, 2000). The following are the description 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 which needed 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 risk shouldn’t be kept from the patient.
  • The next principle is justice which involves the interference of justice and 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 which 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 regards to ethical procedures.
  • The third principle is regarding the competence and the updating of relevant skills. The training should be provided so that the best health are procedure could be followed and the health of patient relies on the expertise of doctors and nurses.
  • The fourth principle supports the above three principles by giving the moral support and ethical practices. The patient and the people with the patient are emotionally vulnerable so that to deal them it 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 the healthcare services is a normative theory which gives the lesson that providing care is the moral duty regarding the interpersonal relationships and care. The contradiction started among the doctors and the one who was in charge of his Jaymee’s health and was aware of her medical history suggested her father that second bone marrow transplant will 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 the good health which even though was short because she eventually died after 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 which was taken after the David Brown application for the review of the decision. Despite the fact that Jaymee lived only a few months later the treatment but the father was concerned for his daughter. The choices which are being taken in the healthcare are mostly tragic because it involves 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 which come under the ethical theory of health care 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 which needed 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 which 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 regards to ethical procedures. The training should be provided so that the best health are procedure could be followed and the health of patient relies on the expertise of doctors and nurses. The patient and the people with the patient are emotionally vulnerable so that to deal them it should be under the guiding principle. Many researchers had conducted research and provided several ethical factors which should be implemented in order to meet the ethical standards when it comes to taking the decision. The new technologies, all the decisions should be taken with its reasons, evidence and the principle which comes from fair-minded people, all the decision so that it can be argued and take into further consideration and the public should be involved in the policies development. All the lessons learned under the light of theories and case study 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 health105(5), pp.900-908.

Krizek, T.J., 2000. Surgical error: ethical issues of adverse events. Archives of Surgery135(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 Work33(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 health7(1).

Preshaw, D.H., Brazil, K., McLaughlin, D. and Frolic, A., 2016. Ethical issues experienced by healthcare workers in nursing homes: Literature review. Nursing ethics23(5), pp.490-506.

Raghuram, P., 2016. Locating care ethics beyond the global north. ACME: An International Journal for Critical Geographies15(3), pp.511-533.

Sevenhuijsen, S., 2003. The place of care: The relevance of the feminist ethic of care for social policy. Feminist theory4(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 Expectations20(5), pp.920-928.

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