Decision-making in the healthcare sector

Choose an ethical decision-making model from among the following three
discussed in the lecture and other readings: Nash’s 12 Questions for Moral Choices,
Kidder’s Ethical Checkpoints, and Uustal’s Ethical Decision-Making Model. Apply your
chosen model to the following ethical dilemma:
Your terminally ill patient told you at her last visit that, since her pain could no
longer be completely controlled by any means, and in her opinion she was just waiting
to die, she was going to Holland to participate in its physician-assisted suicide program.
What would your advice to this patient be? In a 500-750 word paper, include a
letter to your patient offering your insights and recommendations regarding this
decision.
In addition, following your letter, include a subsection in which you address the
following when completing this assignment:
1.Explain the theory of the chosen ethical decision-making model as it relates to
this scenario. What effect have this and other models had on medical practice over the
years?
2.Should a doctor be able to end the life of an individual who is suffering and
who has no hope of recovery? Why or why not?
3.How might a living will be used, or not, to guide an individual’s end of life
decisions?
4.How does the use of technology complicate the dying process?

Decision-making in the healthcare sector

Halison Hospital
235 Derigr drive
Los Angeles, California
September 7, 2017
Mrs.Alison Rivera
1234, ABCD,
Los Angeles, California
SUBJECT: DECISION EVALUATION

APPLYING DECISION-MAKING MODELS IN HEALTHCARE 2
Dear Mrs. Alison Rivera,
We have gone through this journey together, and I understand the challenges that you have
had to undergo to treat the illness and lessen the pain. I listened to your desire to take part in
the physician-assisted suicide program in Holland, but I have some recommendation before
you make a final decision. I would suggest you look for a second opinion from another expert
on ways to minimise the pain.
Besides, consult with your loved ones, as this will provide more clarity on the decision that
you want to make. After going through these two suggestions, when we meet in the next
session we can go through your decision. Do not lose hope; continue taking the medication as
this will help lessen the pain.
I am looking forward to our next session.
Regards,
Doctor Martinez

Section 2

The Ussual’s ethical decision-making model has nine steps. The first step deals with
determining the objective that will be achieved if the patients take part in the physician-
assisted program. The second step deals with carrying out a preliminary survey of the option
present to decide the variability of the option. The third step deals with determining the
associated values that the decision will have on you and your loved ones. The fourth step
deals with concentrating on the importance of the decision (Ahmed and Ali, 2013).
The fifth principle deals with budgeting on ones’ time and energy. The sixth principle
deals with choosing a decision-making strategy. This can be done by researching on other
options that the patient has. The seventh step deals with identifying your options, and

APPLYING DECISION-MAKING MODELS IN HEALTHCARE 3
engaging a different expert to get their opinion on the physician-assisted suicide program can
do this. The eighth step deals with evaluating the options presented to me by different parties
and the last step deals with making a decision that is based on time and budget (Ahmed and
Ali, 2013).
This and other ethical models have a series of steps that guide the patient and doctors
in making a sound decision in the case of dilemmas. The steps that they go through provide
clarity to the parties involved as they evaluate various options that they have in place. This is
important especially on controversial issues like the physician-assisted suicide program.
Doctors should ensure that they end the suffering of their patients. At times, when all
forms of treatment have failed and the patient is in immense suffering with no hope, ending
their life is justified. Assisting the patient to end their life with their consent is a form of
compassion, which is a value that doctors need to have in their profession (Ahmed and Ali,
2013).
Living wills are used to decide how a person wants to end their life. This occurs
especially when they reach a point in their life due to illness, that they are unable to decide
for themselves. It is a legal binding document that dictates the process to be followed when
ending the life of a patient when all forms of treatment have failed (Brinkman-Stoppelenburg
et al., 2014).
The dying process has become complicated because the use of machines can keep the
person alive while their brain is dead. This leads to a complication for doctors on what
definition to use to pronounce a person dead. Technology can keep a person alive despite
their brain being dead, in the case their families decide to use the life support machines. The
machines continue to pump blood in a patient giving them a pulse despite the fact that their

APPLYING DECISION-MAKING MODELS IN HEALTHCARE 4
brain cannot function. This does call for a redefinition of the term death in legal and medical
fields to avoid any dilemmas for the doctors (Ryan- Harhman, 2016).
In conclusion, ending a patient’s life has posed an ethical dilemma for most doctors.
The ethical models and living will do help in making the decision and remove the burden
from the doctors.

References

Ahmed, Y., & Ali, T. (2013). End of life ethics in cancer patients: Conflicts and dilemmas.
International Journal of Medical Research, 1(2), 7-12.
Brinkman-Stoppelenburg, A., Rietjens, J. A., & Van der Heide, A. (2014). The effects of
advance care planning on end-of-life care: a systematic review. Pallative medicine, 28 (8),
1000-1025.
Ryan- Harhman, M. (2016). Refusing Technology, Accepting Death: My Father’s Story.
Perspective in Biology and Medicine, 59(2), 198-205.

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