Patient D in the community is receiving complex wound care, IV medications, and monitoring intake and output- patient is on indwelling catheter. Patient has a diagnosis of CVA and Lung CA. Spouse is the primary caregiver and expresses burnout feeling and demanding home care to have 24 hours care to the patient as the patient is bedridden and total care. Spouse is not happy with the nurse and personal support worker as she reported that they rush to provide care to the patient, and they leave right away. Family members recommended moving patient to a smaller place like retirement home or long-term care placement or short stay respite care. Family found out through their neighbour that spouse goes out all the time and attends social activities with friends and has been neglecting to take care of patient. Family member confronted spouse and denied going out with friends and accuses all the workers that are taking care of the patient of neglecting patient. Patient is not well.
What is the actual moral issue?
What are the 7 ethical dilemmas?
In the scenario provided, a complex home care situation unfolds, involving a patient with multiple health conditions and a caregiver who is experiencing burnout. Ethical dilemmas arise as the caregiver demands 24-hour care for the patient while expressing dissatisfaction with the quality of care provided by healthcare professionals. The situation is further complicated by suspicions of caregiver neglect and the need to explore alternative care options. This article aims to identify the moral issue at hand and explore seven ethical dilemmas embedded within the scenario.
The moral issue in this situation revolves around the conflict between providing optimal care for the bedridden patient and addressing the caregiver’s burnout and demands for more comprehensive care. It also involves concerns about the caregiver’s commitment to fulfilling their caregiving responsibilities, given the allegations of neglect and the conflicting reports from family members and neighbors.
Autonomy vs. Beneficence: Balancing the patient’s right to receive care in their preferred setting, i.e., home, with the need to ensure the patient’s well-being and safety, which may require alternative care arrangements.
Non-Maleficence: Evaluating whether the current caregiving arrangement is sufficient to meet the patient’s complex needs adequately, or if alternative care options would better ensure the patient’s physical and emotional well-being.
Justice: Assessing the equitable distribution of caregiving responsibilities and resources among family members, considering the burden placed on the primary caregiver and the patient’s right to receive appropriate care.
Veracity: Addressing the conflicting reports and allegations of caregiver neglect by determining the truthfulness of the claims and promoting transparent communication between the family, caregiver, and healthcare professionals involved.
Paternalism: Considering whether the family’s suggestion of moving the patient to a smaller care facility aligns with the patient’s best interests and respects their autonomy and preferences.
Role Conflicts: Recognizing the potential conflicts of interest between the spouse’s role as a primary caregiver and their desire to maintain personal social activities, and evaluating how these conflicts impact the patient’s care.
Resource Allocation: Assessing the availability of community resources and support services to meet the patient’s needs adequately, considering financial constraints, and balancing the allocation of resources across various healthcare settings.
The scenario presented encompasses complex ethical dilemmas surrounding home care for a bedridden patient, caregiver burnout, and allegations of neglect. Striking a balance between patient needs, caregiver well-being, and ethical principles is crucial in making informed decisions. Healthcare professionals, in collaboration with family members and caregivers, must engage in open communication, assess the situation holistically, and seek ethical solutions that prioritize the patient’s well-being while respecting their autonomy and considering the available resources and support systems.
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