Informed Consent And Cultural Competence

Case Study:Dr. Emily Clark, a seasoned cardiologist at Mercy General Hospital, is presented with a challenging case involving Mr. Rajan Patel, a 58-year-old man who recently immigrated from India. Mr. Patel has been diagnosed with a significant heart condition that requires a surgical procedure. While the surgery has a high success rate, like all medical procedures, it comes with its own set of risks and benefits. Mr. Patel, whose primary language is Gujarati, has limited proficiency in English. He nods and smiles politely during consultations, giving Dr. Clark the impression that he understands. However, when asked to explain the procedure back to her, it becomes evident that he does not fully grasp the intricacies of the surgery or its potential complications. Dr. Clark recognizes the importance of informed consent and wants to ensure that Mr. Patel truly understands the procedure, its risks, and its benefits. She believes in the ethical principle of autonomy, which dictates that every patient has the right to make decisions about their own body and health. However, she also acknowledges the principle of beneficence, which compels her to act in the best interest of her patient. Instructions Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:1. briefly summarize the facts surrounding the case study. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge. Identify who is involved or affected by the ethical problem or issue. Access and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues. Apply the three components outlined in the Ethical Decision-Making Model media. Analyze the factors that contributed to the ethical problem or issue identified in the case study. Describe the factors that contributed to the problem or issue and explain how they contributed. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case. In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references. Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue. Review the Think Critically About Source Quality resource. Assess the credibility of the information source. Assess the relevance of the information source. Discuss the effectiveness of the communication approaches present in a case study. Describe how the health care professional in the case study communicated with others. Assess instances where the professional communicated effectively or ineffectively. Explain which communication approaches should be used and which ones should be avoided. Describe the consequences of using effective and non-effective communication approaches. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study. Describe the actions taken in response to the ethical dilemma or issue presented in the case study. Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.

Summary of Facts

Dr. Emily Clark, a cardiologist at Mercy General Hospital, is treating Mr. Rajan Patel, a 58-year-old man who recently immigrated from India. Mr. Patel has been diagnosed with a significant heart condition that requires a surgical procedure. The surgery has a high success rate, but it also comes with risks and benefits. Mr. Patel's primary language is Gujarati, and he has limited proficiency in English. While he nods and smiles during consultations, it is clear that he does not fully understand the intricacies of the surgery or its potential complications.

Ethical Dilemma

The ethical dilemma in this case arises from the conflict between the principles of autonomy and beneficence. On the one hand, Dr. Clark has a duty to respect Mr. Patel's autonomy and allow him to make his own decisions about his care. This means ensuring that he fully understands the risks and benefits of the surgery before he consents to it. On the other hand, Dr. Clark also has a duty to act in Mr. Patel's best interests. This may mean recommending the surgery even if Mr. Patel does not fully understand the risks.

People Involved

The people involved in this ethical dilemma are:

Dr. Emily Clark, the cardiologist
Mr. Rajan Patel, the patient
Mr. Patel's family

Moral Awareness

The first step in the ethical decision-making model is moral awareness. This involves recognizing that there is an ethical issue at stake. In this case, the ethical issue is the conflict between the principles of autonomy and beneficence.

Moral Judgment

The second step in the ethical decision-making model is moral judgment. This involves identifying the relevant ethical principles and applying them to the situation. In this case, the relevant ethical principles are autonomy and beneficence.

Ethical Behavior

The third step in the ethical decision-making model is ethical behavior. This involves taking action that is consistent with the ethical principles that have been identified. In this case, the ethical behavior would be to ensure that Mr. Patel is able to make an informed decision about his care.

Factors that Contributed to the Ethical Problem

The following factors contributed to the ethical problem in this case:

Mr. Patel's limited English proficiency
The complexity of the medical information
The time constraints of the medical setting

Academic Peer-Reviewed Journal Article

The following academic peer-reviewed journal article is relevant to the ethical problem in this case:

Hoffenberg, J., & Gallagher, T. H. (2009). Informed consent in patients with limited English proficiency: A review of the literature. Journal of General Internal Medicine, 24(1), 133-138.

This article reviews the literature on informed consent in patients with limited English proficiency. The authors found that there is a lack of research on the best practices for obtaining informed consent from these patients. They also found that there are a number of barriers to obtaining informed consent from patients with limited English proficiency, such as:

Language barriers
Cultural differences
Lack of access to qualified interpreters

Effectiveness of Communication Approaches

Dr. Clark's communication with Mr. Patel could be improved in a number of ways. For example, she could:

Use simpler language and avoid medical jargon
Speak slowly and clearly
Use visuals such as diagrams or pictures
Ask Mr. Patel to repeat back what he has heard to ensure that he understands
Enlist the help of a qualified interpreter

Conclusion

The ethical dilemma in this case is a complex one. There is no easy answer to the question of how to balance the principles of autonomy and beneficence. However, by carefully considering the relevant ethical principles and the factors that contributed to the problem, Dr. Clark can make an informed decision about how to proceed.

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