Capella 4000 Assessment 3

Capella 4000 Assessment 3 Applying Ethical Principles

Name

Capella University

NHS-FPX 4000 Developing a Health Care Perspective

Prof. Name

Date

Applying Ethical Principles

Ethical principles in healthcare settings help in making clinical decisions and ensuring patient-centered care. These principles include beneficence, which emphasizes benefitting patients; non-maleficence, the obligation not to harm; autonomy, respecting patients’ rights; and justice, ensuring fairness and equity in healthcare access and treatment (Varkey, 2021). These principles help healthcare professionals navigate complex situations, one of which is presented in this assessment. By adhering to these ethical guidelines, healthcare providers in the moral case study will maintain the integrity and quality of care through morally sound solutions. 

Background Case Study

Dr. Laura Simmons, a clinical psychologist, has been treating Mr. Alex Turner, a 35-year-old patient, for six months to help manage his severe depression and anxiety. Over time, the therapy sessions have been marked by a trusting and open therapeutic relationship, where Alex confides his deepest struggles and emotions. During a recent session, Alex discloses disturbing thoughts about harming a colleague. He details a plan motivated by enduring professional opposition and recent personal conflicts. While Alex shared his homicidal thoughts, Dr. Simmons faced a critical ethical dilemma between confidentiality, which is a key to maintaining a physician-patient therapeutic bond, and professional obligation of preserving ethical principles of beneficence and non-maleficence, requiring her to act in Alex’s and others’ best interest and to prevent harm. 

Analyses of Case Study Facts Through Peer-reviewed Sources

The ethical dilemma in Dr. Laura Simmons’ case arises from conflicting responsibilities: maintaining patient confidentiality and ensuring safety for others. Several factors contribute to this dilemma. Firstly, Alex’s disclosure of homicidal thoughts presents a forthcoming threat requiring intervention. His detailed plan and expressed intent indicate a clear risk, activating Dr. Simmons’ duty to protect not only her patient but also the potential victim. According to Kafka et al. (2024), confidentiality is a crucial component in a psychologist-patient relationship during and after therapy sessions. This obligates therapists to prevent information disclosure without patients’ prior consent. In Dr. Simmons’ case, Alex’s trust depends on safeguarding his disclosures. However, the potential for harm complicates this. In this case study, Dr. Simmons must balance confidentiality and adhere to the principles of non-maleficence and beneficence, which emphasize preventing harm and prioritizing patient welfare, respectively (Cheraghi et al., 2023). 

The chosen articles by Kafka et al. (2024) and Cheraghi et al. (2023) provide crucial insights supporting the analysis of Dr. Simmons’ ethical dilemma. Kafka et al. (2024) emphasize the centrality of confidentiality in the psychologist-patient relationship, which is highly relevant in this case. This perspective underlines the tension Dr. Simmons faces, as breaching confidentiality could severely damage the therapeutic alliance and Alex’s treatment progress. On the other hand, Cheraghi et al. (2023) explore the principles of non-maleficence and beneficence, which are key to Dr. Simmons’ decision-making. Beneficence compels her to act in the best interest of both Alex and his colleague, while non-maleficence requires her to prevent harm. Their work highlights the ethical balance needed when the psychologist must weigh patient confidentiality against the risk of damage to others. It provides a strong foundation for understanding the ethical complexities Dr. Simmons encounters in her decision.

Effectiveness of Communication Strategies in the Case Study

In Dr. Laura Simmons’ case, effective communication is critical to addressing the ethical dilemma while maintaining patient trust and ensuring safety. Dr. Simmons can utilize clear, empathetic, and non-judgmental communication when discussing Alex’s troubling thoughts. This communication approach is effective as it fosters trust, encourages openness, and reduces defensiveness, allowing the patient to discuss their emotions honestly (Babaii et al., 2021). This approach enables healthcare providers to assess the homicidal risk accurately and provide effective interventions to ensure safety. Moreover, this approach will encourage Alex to remain open and transparent, reinforcing the therapeutic alliance. Another key communication strategy involves actively listening to Alex’s concerns and validating his feelings while expressing concern for his and others’ safety. Dr. Simmons can use motivational interviewing techniques. This strategy allows patients to change their contradictory and harmful perspectives into positive behaviors (Bischof et al., 2021). This communication approach may prevent Alex from harming his colleague, allowing him to address the situation constructively.

These approaches should be utilized more. However, dismissive or aggressive communication should be avoided as that could alienate Alex and damage the patient-provider therapeutic relationship. Likewise, failing to communicate the seriousness of the situation to relevant authorities would put others at risk and breach Dr. Simmons’ duty of care. Effective communication helps establish trust, ensure patient compliance, and protect both the patient and the public. In contrast, poor communication may escalate Alex’s distress, lead to disengagement from therapy, and jeopardize the safety of the potential victim. Effective communication allows Dr. Simmons to balance ethical responsibilities, while ineffective communication could result in harm to all parties involved.

Ethical Decision-Making Model Applied to the Case Scenario

An ethical decision-making model has three important stages where an individual identifies and acknowledges the presence of moral dilemmas (moral awareness). This recognition is followed by applying appropriate ethical principles and choosing the right intervention to address the problem (moral judgment). Finally, the solution is impalement to evaluate the consequences of the ethical approach (ethical behavior/action). This model allows service practitioners to improve their practices grounded in ethical principles and moral responsibilities (Suarez et al., 2022). 

In the case study, Dr. Simmons’ approach can be evaluated using the ethical decision-making model. Moral awareness involved recognizing the ethical dilemma between Alex’s confidentiality versus the need to protect a potential victim. Dr. Simmons identifies this conflict, understanding that Alex’s threat is serious and could lead to harm, making her aware of the need to balance patient trust with public safety. Secondly, moral judgment allowed Dr. Simmons to consider the principles of beneficence and non-maleficence to protect both Alex and his colleague. Finally, based on these principles, Dr. Simmons must take appropriate moral steps to prevent harm while minimizing breach of confidentiality. This would demonstrate her commitment to both protecting Alex’s privacy and ensuring safety.

Capella 4000 Assessment 3 Applying Ethical Principles

The consequences of using ethical decision-making in healthcare settings ensure patient safety, trust, and professional integrity. It fosters a strong therapeutic alliance, as patients feel confident sharing sensitive information and knowing their provider acts in their best interest (Varkey, 2021). Ethical practices also protect healthcare professionals from legal and regulatory consequences by adhering to established guidelines and standards. In contrast, non-ethical approaches can result in significant harm. Additionally, unethical behavior undermines patient trust in the healthcare system, potentially discouraging individuals from seeking care. Thus, ethical practice is essential to balancing complex care responsibilities.

Moral Solution for the Case Study

A possible solution to Dr. Simmons’ ethical dilemma is to implement a duty-to-warn approach, where she notifies the appropriate authorities, such as law enforcement or the ethical committee, about his homicidal thoughts while minimizing the breach of confidentiality. Moreover, she must discuss possible positive solutions with Alex, such as a discussion with the colleague or arbitration to prevent harm. This solution is grounded in the ethical principles of non-maleficence and beneficence. While the former requires healthcare professionals to avoid damage to others, the beneficence compels Dr. Simmons to act in Alex’s best interest (Cheraghi et al., 2023). By alerting authorities, she ensures that the potential victim is protected from harm and avoids criminal behavior. Additionally, Dr. Simmons would adhere to the principle of justice by balancing her responsibilities to both Alex and the threatened individual, ensuring fairness in her decision-making process. Lastly, autonomy is respected by discussing possible solutions and mediating between Alex and his colleague, allowing him to make informed decisions and continue to offer support and care.

Conclusion 

In conclusion, Dr. Simmons’ case presents the ethical dilemma between balancing patient confidentiality with the duty to protect patients and others from harm. Effective communication, grounded in empathy and clarity, is crucial in addressing Alex’s intent and preventing damage. Moreover, applying an ethical decision-making model will help the healthcare professional take necessary actions while minimizing harm to both the patient and the potential victim. The proposed solution to this case study includes the involvement of the legal authorities and playing the role of mediator to ensure Alex makes positive decisions in the situation. Adhering to ethical principles will ensure patient trust, public safety, and professional integrity while preventing significant legal and moral consequences in the healthcare setting. 

References

Babaii, A., Mohammadi, E., & Sadooghiasl, A. (2021). The meaning of the empathetic nurse-patient communication: A qualitative study. Journal of Patient Experience, 8(8). https://doi.org/10.1177/23743735211056432 

Bischof, G., Bischof, A., & Rumpf, H.-J. (2021). Motivational interviewing: An evidence-based approach for use in medical practice. Deutsches Aerzteblatt Online, 118(7), 109–115. https://doi.org/10.3238/arztebl.m2021.0014 

Cheraghi, R., Valizadeh, L., Zamanzadeh, V., Hassankhani, H., & Jafarzadeh, A. (2023). Clarification of ethical principle of the beneficence in nursing care: An integrative review. BMC Nursing, 22(89). https://doi.org/10.1186/s12912-023-01246-4 

Capella 4000 Assessment 3 Applying Ethical Principles

Kafka, J. X., Kothgassner, O. D., & Felnhofer, A. (2024). A matter of trust: Confidentiality in therapeutic relationships during psychological and medical treatment in children and adolescents with mental disorders. Journal of Clinical Medicine, 13(6), 1752–1752. https://doi.org/10.3390/jcm13061752 

Smith, C. S. (2023). Applying a systems oriented ethical decision-making framework to mitigating social and structural determinants of health. Frontiers in Oral Health, 4(4). https://doi.org/10.3389/froh.2023.1031574 

Suarez, V. D., Marya, V., Weiss, M. J., & Cox, D. (2022). Examination of ethical decision-making models across disciplines: Common elements and application to the field of behavior analysis. Behavior Analysis in Practice, 16(3). https://doi.org/10.1007/s40617-022-00753-1 

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119