APPLYING ETHICAL PRINCIPLES

According to the ethical decision-making model, moral awareness is the recognition that
an ethical issue exists. When he first took the clinical director position, E.L. Straight realized
Hopewell Hospital, just like many other hospitals, employed physicians that did not provide
quality patient care; specifically, the general surgeon Dr. Cutrite. Using his moral judgement,
Mr. Straight filed paperwork to limit Dr. Cutrite’s practicing privileges to avoid future patient
harm. Now, based on the information he has received, Mr. Straight is in a position where his

APPLYING ETHICAL PRINCIPLES
ethical behavior has the potential to either cause harm to his career or act in the best interest of
the patient.
Communication for Prevention
Based on the information provided in this case study, it is quite possible the event could
have been avoided had the nurse circulator communicated the need to perform a “time-out”
during the procedure. This is a standard occurrence where all surgical activity is placed on hold
and a checks and balances of all instruments used are counted. Another missed opportunity for a
successful encounter occurred at the conclusion of the surgery. The nurse did not question the
whereabouts of the cap to an inventoried syringe that had been used by Dr. Cutrite.
Ethical Principles for a Resolution
Healthcare is considered ethical if it involves four principles; autonomy, justice,
beneficence, and non-maleficence. Before being told Mrs. Jameson had already been discharged
from the hospital, E.L. Straight suggested taking the patient back into surgery to look for the
needle cover under the guise her incision and deep sutures required a second check. This
approach violates the patient’s right to autonomy and justice by impeding their decision-making
process. In addition, the intent of beneficence and non-maleficence can also be called into
question. Prior to Mrs. Jameson’s abdominal surgery, previous concern had been raised
regarding the declining skills and knowledge of her surgeon, Dr. Cutrite.
The solution to the ethical dilemma in this case study is never revealed. However, the
expectation is every detail was taken into consideration and someone in Mr. Straight’s chain of
command realized there was a duty to inform the patient. There would be no need to assign
individual blame, but the organization has a moral obligation to take responsibility