Uustal's decision-making model for ethical dilemmas in nursing practice

Ethical Decision Making:

Uustal (1993) proposed a decision-making model that offers tangible steps for arriving at a morally acceptable solution when experiencing an ethical dilemma. Generally, nurses are usually faced with ethical dilemmas that are largely attributed to the nature of their work. One of the ethical dilemmas I have experienced as a nurse in the clinical setting is a situation involving a child diagnosed with brain tumor. Before the diagnosis, the child had been severely sick and went for several days without eating, which increased the severity of his illness. Even though the physicians were doing their best to save the child's life, the family became extremely worried. As a result, his parents gave him marijuana because of their extensive knowledge regarding his medical benefits. While the decision proved beneficial, the faces the risk of experiencing a recurrence of the brain tumor (James, 2011).

Uustal's model of decision-making can be applied to this dilemma by applying the nine steps effectively. The ethical ramifications of the situation include giving illegal drugs to a child, carrying out treatment procedures without physician's consent, and probable lack of trust in the health care facility and its personnel. Based on Uustal's model, the first step in resolving the issue is identifying the problem, which is giving a child illegal drugs without the doctor's knowledge and consent. Secondly, my personal ethical position that is relevant to this situation is virtue ethics theory, which is based on values like self-control, compassion, trustworthiness, integrity, honesty, courage, and prudence. Therefore, the parents should have notified the physicians and nurses regarding the decision to give him marijuana in order for the health care personnel to evaluate him thoroughly.

Third, there are several alternatives to this situation including holding consultations with the physicians about the marijuana procedure, trusting the physician's judgment and following the existing treatment plan, and taking the child to a facility where the drug is legally used for medical purposes. Fourth, the most important alternative would be to consult the physicians about the marijuana, which would be followed by taking the child to a hospital where medical marijuana is legalized if the physicians disagree. The need for consultation is stimulated the need for honesty because the physicians mistakenly thought the child's recovery was due to their treatment plan and procedures. Fifth, the first alternative would result in cooperation from the hospital's health care team including the physician and would enable the child to be monitored accordingly. However, transferring the child to a hospital where medical marijuana is legalized would have increased risks because of the time it would have taken before he receives treatment.

Sixth, the most appropriate or acceptable option would be to hold consultations with the physician about marijuana in order to improve treatment. Due to the risks involved, the second alternative is the least acceptable course of action. Seventh, the most appropriate plan of action to implement the acceptable alternative is to hold meetings with the physician and nursing personnel to discuss the patient's prognosis and treatment plan. This meeting would involve evaluation of marijuana use on the patient's condition based on its advantages and disadvantages. The eighth step is to implement the plan by involving the health care team in giving the drug in a manner that does not result in severe complications. As the last step in this process, the effectiveness of the action is based on its ability to lessen serious ramifications, providing improved examination of the patient, and promoting honesty.