Answer

Ethical Dilemma during Clinical Placement

            Many patients suffering from chronic illnesses will apply for a Do Not Resuscitate (DNR) order. It prevents healthcare professionals from restarting the heart or taking any measures to prolong life any further in case the patient is brought in to the institution. During the clinical placement, an ethical dilemma was experienced when a chronically ill 25 year old man was brought in to the facility after a biking accident. He had a DNR hand band which prevented any action from being taken by the professionals at the facility. However, his wife was crying and ordering the clinicians to take charge and resuscitate him. Hence, an ethical dilemma is experienced since it becomes confusing on what the right decision should be for the patient.

Personal and Professional Self-Reflection

            Personally, the situation was hectic since the team decided that it was best to honour the DNR order. Going against the order would place the institution at risk of legal action if the patient was to be in a vegetative state or experience a really painful recovery process (Pettersson, Hedström & Höglund, 2020). Performing CPR has the risk of worsening chronic conditions and leading to painful recovery processes that would still lead to death. This patient took the DNR order to avoid unnecessary hospital expenses that would leave his family financially strained. In addition, he wanted to avoid the unnecessary pain. Hence, while my personal feelings were to sympathize with the wife and honour her request to resuscitate the patient, it became evident that the best course of action would be to honour the DNR request. It would reflect the needs of the patient, as well as protect the facility from any legal lawsuits against it.

Evaluation

            When making any medical decisions, it is important to first consider whether the risks outweigh the benefit. The clinicians should always aim at ensuring beneficence, which is working with the choices that reflect the patient’s best interests (Pettersson, Hedström & Höglund, 2018). In this case, the CPR process holds a risk of having the patient’s weak body in a vegetative state. It would mean more suffering and medical expenses. Hence, it makes more sense to honour the DNR order. Also, as the patient is unconscious, he has no say in the current medical decisions. However, through the DNR, it shows that he was already taking measures to make decisions beforehand, for the time when he may not be able to do so.

Analysis

            Although there exists an ethical dilemma in not resuscitating the patient despite the wife’s request, it is evident that the best course of action was to critically consider the situation and weigh what was best for the patient and his family (Piryani & Piryani, 2018). The patient had already foreseen such a situation, which is why he applied for the DNR order. Therefore, to avoid any legal action against the hospital, it is best to focus on the patient’s wishes which are reflected on the DNR.

Conclusion

            Through this reflection, it is evident that there exists many situations in healthcare where an ethical dilemma may be experienced. However, to make the right choice, the professionals need to consider various theories that will help in focusing on the decisions that are best for the patient. Also, it is important to consider how certain orders, such as the DNR impact the ability of an institution to take action.

Strategies for Practice

            To progress as a critical thinking clinician, the analysis above has shown that it is important to separate personal feelings from professional work. In addition, any decisions should be made based on healthcare theories such as autonomy, maleficence, and beneficence among others. With these factors in place, the best decision for the patient will be made.

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