Torrino, Deejune BSN 2D

NCM 108: Health Care Ethics

Situational Analysis

1. A nursing student is taking part in a health fair in a community. She takes blood pressures with a cuff
that has not been calibrated in a long time. Despite this, she suggests that those with borderline and
high readings visit their family physicians. She also does simple checks for blood sugar and makes
referrals where indicated. She has no idea whether the machine has been calibrated and what its
margin of error is.
What is the health care professional’s duty with regard to the calibration of instruments? Is
it ethical to use a cuff that has not been calibrated for a long time? What harms can follow from
inaccurate test results? What are the professional’s responsibilities to individuals during such
screenings?
A practicing healthcare professional must ensure that all instruments used to gather
patient information should be up to date and as accurate as possible because these data will
be used to determine the patient’s treatment. Therefore, it is quite unethical to use a medical
device that is not functioning at its full capacity as this could lead to inaccuracy not only with
the data but also with the actions of healthcare professionals regarding the patient’s case. It
is part of the healthcare professional’s responsibilities to ensure that they give proper care to
their patient and it is part of the patient’s right to receive the highest quality of care possible.
In addition, the instructors should also ensure that the students are holding up these
responsibilities as part of their training to become competent professionals. Ultimately, the
healthcare professional must ensure that the care given to the patient is appropriate and just.

2. A doctor sees a 62-year-old male patient for a routine visit. The patient has no history family history
of cancer. The physician does the physical examination and prostate exam that came out as normal.
He later on recommended that the patient will have a lipid panel, a colonoscopy, in which the
patient has never done, and a PSA (Prostate Specific Antigen) tested. The patient stated that he
heard of PSAs no longer being recommended for general screening, but the physician replies that he
has seen this recommendation change constantly. The doctor added that he even gets these tests
himself and feels that many in his practice have been cured as a result of this test.
Should the physician go against currently accepted guidelines? What if the test results in a
complication? What if he did not recommend it and the patient develop prostate cancer two years
later?
As a healthcare professional, one must act for the benefit of the patient while still
upholding the proper standards and guidelines of their profession. Therefore, the physician
should follow guidelines and although these might be constantly changing, these guidelines
are not established without proper background. In addition, there are alternatives for
diagnostic procedures and with constant monitoring of the patient, the physician can act
accordingly. Furthermore, if the patient is ultimately against the procedure, then the physician
must respect the decision of the patient. Therefore, the actions of the physician will rely on the
decision of the patient and it is the patient’s right and autonomy to reject any treatment or
procedure if they see it fit.
Torrino, Deejune BSN 2D

3. As part of a nontherapeutic research, researchers intend to inject dead cancer cells into seriously ill
patients. There is no danger from the dead cancer cells other than the minimal danger of infection at
the injection site. They feel that if they reveal the nature of the injection, patients and their
surrogates will refuse consent, even leading to fear when they hear the word “cancer.” As a result,
the doctors do not reveal to their patients the nature of the injection on the consent form. They
justify this on the grounds that there is no real danger to the patients and that the research is aimed
at gaining knowledge.
Were the researchers ethical in suppressing the fact that they were using cancer cells? Did
they obtain informed consent from their subjects? What should they have done?
The researchers’ decision to withhold information regarding a procedure done to a
patient is unethical. It is part of the patient’s right to have the full information on any
procedure regarding them; therefore, the researchers failed to obtain informed consent since
the patient or the family was not informed to begin with. Furthermore, the reason for
withholding the information is not justifiable and based on assumptions. The researchers
should have discussed the procedure thoroughly and, to the best of their knowledge and
ability, ensured that the patient and the family understands the purpose of the procedure.
Ultimately, it is the responsibility of a healthcare professional to maintain full disclosure with
their patients.

4. A drug wants to test drug HQ as a relief for high blood pressure. Tests have shown that the drug is not
toxic in the doses required in the research protocol. Animal tests indicate that the drug has fewer
undesirable effects than the existing treatments. Drug HQ works by opening up the veins and uses a
chemical compound produced by the heart itself. It promises to be far superior to present treatments
because it uses a chemical that is found naturally in the body.
These, including the side effects, were explained to the prospective subjects, who understand
that they will be randomly assigned to one or two groups: one will receive drug HQ and another will
receive an accepted treatment. They were also informed that it will be a double blind experiment.
The results show that drug HQ is more effective than the accepted treatment and has fewer side
effects, but the significance of this is not clear, since the probability that the difference is due to chance is
less than 10 percent and the researchers had originally decided on 5% as the cutoff figure. Despite this,
they publish an article concealing the differences in probabilities by simply not mentioning it.
Is It ethical to hide a key bit of information that would aid in interpreting the results? Are further
tests needed to see if the drug meets the requirements? What is the utility of publishing studies with
negative results?
One of the most important aspect that a healthcare professional must uphold even in the
terms of medical research is transparency; therefore, it is quite unethical to hide or conceal a key
information aiding the interpretation of results. Furthermore, the research/test of the drug
involves real patients who received the treatment so they must have the full information given
that it was their data that was used. If necessary, further tests should be undertaken to ensure the
credibility of the drug and to avoid any unprecedented side effects. Moreover, publishing negative
results is also important to for further research within the scope of the subject matter and to allow
other researchers to access credible data resource. Drug study is an important aspect of medical
research; therefore, proper protocol and standards must be upheld for the benefit of all.