What are the ethical considerations in evaluating a patient’s failure to adhere to a prescribed therapy?

Bioethics Case Study

1.  Bioethics Case Study: This assignment asks you to examine a current ethical controversy case study. The paper should be in APA  style, and does not need an abstract or cover page. With a minimum of two pages and a maximum of four pages A reference page is needed. In-text citations should be in APA format. Papers will be graded on a 0 to 25-point scale.

Case Study in Primary care:

One hypothetical case study involves Jim a 54, year old patient who has recently diagnose with hypertension and his Creatinine and BUN laboratory results are elevated, if left untreated, will result in kidney failure. The patient refuses to take the medication because he said it will affect his sex life The Nurse Practitioner must work with the patient to respect the fact that he doesn’t want the medication (autonomy), and needs to find a solution that would prevent him from going into kidney failure and other complications, which is in his best interest (beneficence). Although medications are the best choice, forcing the patient to accept the medication will result in probably patient leaving the care (non-maleficence). Finally, the NP needs to consider the impact that the patient’s choices might have on others if he starts to go into preventable kidney failure, he’ll need dialysis, which affects other people who need the same treatment (justice). So before making the final decision the NP must consider all four principles of health care ethics, which will help the NP make the choice that will have the best possible benefits for both the patient and society.

Questions?

1. What are the skills necessary for the provider to identify, address, and assess this clinical ethical issue?
2. What are the provider’s obligations when a patient discloses does he not intent to follow the treatment?
3. What are the ethical considerations in evaluating a patient’s failure to adhere to a prescribed therapy?
4. Will you terminate care for this patient? What are the implications?

Case Study Rubric

Criterion

Outstanding  (25)

Very Good  (22)

   Average (18)

Unacceptable (15)

Score

Completeness

Complete in all respects; reflects all requirements

Complete in most respects; reflects most requirements

Incomplete many respects; reflects few requirements

Incomplete in most respects; does not reflect requirements

Understanding

Demonstrates excellent understanding of the topic(s) and issue(s)

Demonstrates an accomplished understanding of the topic(s) and issue(s)

Demonstrates an acceptable understanding of the topic(s) and issue(s)

Demonstrates an inadequate understanding of the topic(s) and issue(s)

Analysis

Presents an insightful and through analysis  of the issue (s) identified

Presents a thorough analysis of most of the issue(s) identified

Presents a superficial analysis of some of the issue(s) identified

Presents an incomplete analysis of the issue(s) identified.

Evaluation

Makes appropriate and powerful connections between the issue(s) identified and the concept(s) studied

Makes appropriate connections between the issue(s) identified and the concept(s) studied

Makes appropriate but somewhat vague connections between the issue(s) identified and the concept(s) studied

Makes little or no connection between the issue(s) identified and the concept(s) studied.

Opinion

Supports opinion with strong arguments and evidence; presents a balanced and critical view; interpretation is both reasonable and objective

Supports opinion with reasons and evidence; presents a fairly balanced view; interpretation is both reasonable and objective

Supports opinion with limited reasons and evidence; presents a somewhat one-sided argument

Supports opinion with few reasons and little evidence; argument is one-sided and not objective.

Recommendations

Presents detailed, realistic, and appropriate recommendations clearly supported by the information presented and concepts studied

Presents specific, realistic and appropriate recommendation supported by the information presented and the concepts studied

Presents realistic or appropriate recommendation supported by the information presented and the concepts studied

Presents realistic or appropriate recommendation with little, if any, support from the information and the concepts studied.

Grammar and Spelling

Minimal spelling and grammar errors

Some spelling and grammar errors

Noticeable spelling and grammar errors

Unacceptable number of spelling and grammar errors

APA guidelines

Uses APA guidelines accurately and consistently to cite sources

Uses APA guidelines with minor violations to cite sources

Reflects incomplete knowledge of APA guidelines

Does not use APA guidelines