Communication in the workplace is a vital part of having an effective team. And when that chain of communication is broken, problems will arise. If this is the case, what happens when there is a person’s life on the line? In medicine, these situations happen all the time, and having the ability to communicate effectively is very important. In the ethical dilemma presented, a complication happens during a surgical repair of a ruptured bowel. With a preceptor that may have been intoxicated, the surgery was going on until the ureter was nicked by the doctor but he repaired it and closed it up. However, when the report came out, the accident was not noted and now I nurse wants to know what to do with the patient’s raised creatinine level. This situations presents the PA with an ethical dilemma that is a difficult when discussed alone; however, when analyzed through Jonsen’s Four Topics may be easier to decide how to handle this situation (Jonsen, Diegler, & Winslade, 2010).
Medical Indication- The Principles of Beneficence
Jonsen, Diegler and Winslade (2010) have created four main topics of medical ethics. In their first section, medical indications, they look at the principles of beneficence, or the act of doing good. Initially the authors as us five different questions: “What is the patient’s medical problem? What are the goals of treatment? In what circumstances are medical treatments not indicated? What are the probabilities of success of various treatment options? How can the patient benefit by medical care and how can harm be avoided” (Jonsen, Diegler & Winslade, 2010)? Initially, the patient was in the hospital for a medical problem and ended up rupturing his/her bowel. It is unclear if there is underlying problems going on, but it would be assumed that this is an acute issue. Once surgery is over, after the complication, the patient had a creatinine level that is elevated and needs to be addressed, or at least admitted to and resolved. The second question addressed the goals of treatment. The goals of the patient’s surgery was to close the ruptured bowel. During that procedure the left ureter was nicked and now the patient has a high creatinine level that needs to be addressed.
The next question, determining when treatment is not indicated should have been taken into account when the patient was brought into surgery. It is hopeful that the patient is a surgical candidate and did not have any contraindication to the surgery before the patient was brought to the ER. Other than general contraindications of surgery, I do not know of other contraindications of ruptured bowel surgery that would have stopped the procedure. The probability of success of this kind of procedure should be relatively high since the surgery was done and the patient’s mortality of having a ruptured bowel go unrepaired is high so it was a surgery that needed to be done. Otherwise, these last two questions do not really apply to this dilemma because the surgery has...