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The Dowd Model of Ethical Decision Making in Medical Imaging: Two Dilemma Cases
An honest dilemma is raised in a situation where two “right” methods of action are normally found to be contradictory of each additional; that is, when doing one “right” thing necessarily leads to departing the different “right” thing undone or maybe contravening this kind of “right” and doing the alternative (Towsley-Cook Youthful, 2007). A scenario through which an employee’s rights must be weighed against those of the patient/consumer typifies this type of issue, and this is found in the current circumstance: a medical imaging specialist suspected of getting alcohol problems comes to use the smell of alcohol on his breath of air and shows some problems walking directly and enunciating clearly. After a confrontation by the supervisor, this kind of employee will not take a blood vessels test intended for drugs and alcohol. The dilemma is present in deciding whether this is certainly insubordination, or whether the test would break the employee’s privacy rights.
According to the Dowd model of moral analysis, evaluation is the first step (Towsley-Cook Young, 2007; Wilson, 2010). The standard problem here is, of course , the possibility of impairment with the employee’s potential due to his alcohol use; it is normal to expect employees in any and all industries to reach for their operate shifts sober and to stay so over the workday. Intended for medical professionals of any kind as well as in certain other crucial occupations, there is certainly an even greater responsibility for sobriety as the particular lives of countless individuals can depend on deficiency of impairment in such specialists.
This potential clients directly to the second step in the Dowd model, isolation from the issue (Wilson, 2010). The risk to patients that the worker presents must be weighed resistant to the danger to privacy rules and a good and even-handed work environment which a drug-test-on-demand might entail. This matter is not, that is, whether or not it is ethically appropriate for the employee to show up to work intoxicated, but whether or not the ethical danger of applying a medicine test outweighs the danger of either acting on unconfirmed suspicions or allowing for the employee to carry on working inspite of these unconfirmed suspicions.
Examining the data is definitely the next step inside the Dowd style, and it is below that items become more complex (Wislon, 2010). Studies have shown that among radiologic technicians particularly as well as amidst nursing personnel generally, substance abuse problems are most likely an issue for three to 4 percent of most professionals, while using rate of alcohol abuse above that of any other substance or perhaps substance category (Van Valkenberg et al., 1998). These kinds of abuse, then simply, presents a significant risk to patients. It truly is impossible, however , to immediately compare this data to the highly very subjective and non-empirical data that can be derived from a great examination of drug tests and privacy regulations. One could conduct such an research from a great ultra-pragmatic practical perspective, looking to weigh the added costs in efficiency, turnover, and decrease staff-patient ratios that are caused by drug assessments and their outcomes, but this ignores the imperative of nonmaleficence at the job in the medical profession (Towsley-Cook Young, 2007). Allowing damaged individuals to execute medical procedures may not be compared to the right to privacy for the individuals in any direct method.
Developing a program is the next thing in honest action based on the Dowd model, and this is in fact relatively easy because of the facts and evaluation described over (Wilson, 2010). As there may be no direct comparison between the two ethical rights in this dilemma, one of these rights must be selected low cost over the various other by identifying which in the rights much more closely in-line with the imperatives of the community and persons involved. Moral decision just make sense inside the context of specific areas and the application of specific principles, and the medical community definitely defines these types of values within a clear-cut and unequivocal manner (Towsley-Cook Young, 2007). Inspecting the values of the medical imaging community and making use of them to the two rights inside the dilemma is the proposed course of action at this point.
Program implementation comes next, in addition to this case it must first consist of identifying the core ideals of the medical community. Nonmaleficence towards the sufferer is the major goal of most medical practitioners, which is even mentioned as such in the Hippocratic pledge (Towsley-Cook Young, 2007). The chance of doing damage exists, yet , in most surgical procedures, and therefore the very important of nonmaleficence must be considered against the top priority of beneficence (Towsley-Cook Young, 2007). In this case, there is a obvious risk of harmful by permitting the quite possibly inebriated employee to perform his duties, as well as the potential beneficence of allowing him to work irrespective of refusing a drug test out is decidedly minimal, specially in an organization to people that is capable of doing his responsibilities. As the individual must be the most respected and valued person in the purchase, the decision right here seems clear.
Analyzing the results of the program, as is defined in the last step with the Dowd model of ethical decision making, leads to the conclusion that the intoxicated employee must not be allowed to carry out his obligations without initial proving that he is certainly not intoxicated through submitting into a drug and alcohol blood test. During your stay on island is certainly a right to privacy on the part of the employee, the right of the sufferers at the medical facility to receive the highest quality of care together with the most lowered potential for damage possible features paramount importance in the medical profession. The employee’s right to privacy is outweighed by the patients’ directly to safety from this dilemma. The employee is still liberal to exercise his right to level of privacy by neglecting to submit for the drug test out, but this individual cannot be allowed to perform his duties when inebriated, as well as the circumstantial proof that implies this inebriation is definitely strong enough to demand direct facts via a bloodstream test. His right to privateness in this subject ends once his personal decisions continue to affect others; this is not anymore a question of autonomy, although of the strident attempt at nonmaleficence that must be at the heart of all moral decision making inside the medical professions.
When there exists a clear course of “right” and ethical action, but you will find practical boundaries that avoid the successful completing this course of action as well as the ethical proficient at the end than it, there is thought to exist a situation of “ethical distress” (Towsley-Cook Young, 2007). Such circumstances can be to some degree more complex than ethical problems, where clashes between two ethical imperatives exist, nevertheless they can be assessed in mainly the same manner. For example , an instance in which a medical imaging person has published to a random drug evaluation at work and has been advised that launch proceedings happen to be underway due to a positive effect finds him or himself in a express of honest distress if they have never employed drugs or alcohol inside their entire lives. The very clear ethical aim is retaining the work position and having the confident result removed from the specialist record, nevertheless this is much easier said than done. Making use of the Dowd model permits a clear alternative to be determined.
The Dowd model starts with an analysis in the issue (Wilson, 2010). In cases like this, this examination is incredibly basic: the individual is approximately to lose all their job, the cabability to receive work in the same career/profession, significant amounts of social position, and likely a lot of faith in the justice on the planet based on an incorrect positive over a drug test. By saying yes to take a random medication test that was not actually mandatory (depending on the laws and regulations of the condition in which the company was located), this individual has become being reprimanded for actions that they hardly ever took (Moeller et approach., 2008). This example is the two ethically unfair and positions a massive useful risk to the individual offender of medication use.
Separating the issue is the next measure in the Dowd model, and this case this allows for a removing of a great deal of emotional and ethical clutter that is out there in the situation (Wilson, 2010). There is not really a personal privacy issue at stake here, since the individual consented to take the medication test in the first place and you possibly can hardly state feelings of an invasion of autonomy after the fact. What are at stake listed below are issues of veracity and justice – the individual should ethically always be treated as a non-drug-user, which is what actually the person can be, and in order to acquire this just treatment they must prove the veracity with their non-drug-user status. The issue is the supervisor/manager’s belief in the great result, and not truly the actual result itself, that triggers an moral rather than a just practical problem in this scenario.
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