PSYC FPX 4300 Assessment 2: Applying Ethical Principles | Capella Guide

Applying Ethical Principles in Specialized Clinical Settings

Introduction to Advanced Ethical Practice

In senior professional practice, Applying Ethical Principles is the primary mechanism for maintaining the integrity of the clinical relationship. As practitioners move into specialized fields, they often encounter “gray areas” where legal requirements and professional codes of conduct are in direct tension. This assessment analyzes a complex case involving an elderly patient who refuses surgery for a malignant tumor due to a desire to maintain quality of life over quantity, exploring the conflict between the practitioner’s duty to preserve life and the patient’s right to a dignified death.

PSYC FPX 4300 Assessment 2:Identification of the Ethical Dilemma

The main problem in this situation is the conflict between Autonomy and Beneficence. The patient, a 78-year-old with early-stage dementia but adequate decisional capacity, opts for comfort care rather than aggressive intervention. When applying ethical principles, the practitioner must ascertain whether the patient’s diagnosis of “dementia” inherently nullifies their refusal of life-saving treatment. The patient’s family is divided on whether to respect the patient’s wishes or ask the court to step in, which makes the situation even more difficult.

Applying Ethical Principles: The Pillars of Bioethics

The framework for this analysis relies on the four primary pillars of bioethics:

• Autonomy: Respecting the patient’s self-determination and their specific “values” regarding end-of-life care.
• Beneficence: The duty to act in the patient’s best interest, which might include aggressive treatment if it leads to a cure.
• Non-maleficence: Avoiding the “harm” of the physical trauma and recovery time associated with major surgery in an elderly patient.
• Justice: Ensuring the patient is not discriminated against or dismissed simply because of their age or cognitive diagnosis.

Comparison of Ethical Theories: Theoretical Justification

A hallmark of Applying Ethical Principles at the 4300 level is the ability to contrast normative theories with clinical evidence:

1. Deontological Analysis (Duty-Based Ethics)

A Deontologist, following the work of Immanuel Kant, would argue that the practitioner has an “absolute duty” to respect the patient’s autonomy if they possess capacity. In this view, treating the patient against their will—even to save their life—is a violation of the categorical imperative. The focus remains on the morality of the action (respecting the individual) rather than the physical outcome (the patient’s death).

2. Utilitarian Analysis (Consequence-Based Ethics)

A Utilitarian would look at the “Greatest Good for the Greatest Number.” They might initially argue for the surgery if it prolongs life. However, a “Rule Utilitarian” would consider the long-term impact on the healthcare system. If patients fear that their end-of-life wishes will be ignored, it creates a massive societal loss of trust in medicine, which is a greater “negative utility” than the loss of one life.

Proposed Resolution and Justification

The suggested solution includes a “Ethical Palliative Pathway.” The practitioner should first do a formal capacity assessment using ethical principles. If the patient is competent, their refusal must be respected. The practitioner should then hand off the care plan to palliative services to meet Beneficence (by lessening pain) and Autonomy (by respecting the choice). This resolution is backed by APA Standard 3.10 on informed consent and ANA Code of Ethics Provision 1.4, which stresses the right to make one’s own choices.

Evaluation of Professional Responsibilities

Senior-level practice requires the practitioner to set aside personal “paternalism”—the urge to make decisions for others “for their own good.” Applying Ethical Principles correctly means acting as an advocate for the patient’s voice within a complex medical and legal system.