Mrs. M is a 60-year-old who was diagnosed with early onset dementia and has been experiencing brief moments of memory loss. She has been living with her daughter L. L has been jobless since she completed her undergraduate studies one year ago. Mrs. M does not have any other children. Recently, L got a new job in another state. She is due for relocation in a months time. To a large extent, L has been instrumental in efforts to promote the health and wellbeing of Mrs. M. In Ls opinion, as well as per a recent assessment, Mrs. M would require placement in a care home following Ls relocation. However, Mrs. M is against this suggestion. She maintains that she is capable of taking care of herself.
In basic terms, an ethical dilemma could be conceptualized as a scenario whereby one has to make a choice between two (or more) decisions in which case all the available decisions result in the compromise of a certain moral or ethical principle. More specifically, in the words of Lachman (2009), this could be described as a situation in which a difficult choice has to be made between two courses of action, either of which entails transgressing a moral principle (p. 79).
In this ethical dilemma a decision must be made to either:
1. Honor Mrs. Ms desire to live alone and compromise her safety OR
2. Place Mrs. M in a care home against her will and violate her autonomy.
Action 1: Honor Mrs. Ms desire to live alone and compromise her safety
Outcome: Honor and advance Mrs. Ms autonomy
Although safety happens to be an important consideration for all persons, it is especially instrumental for dementia patients. To a large extent, safety in this case has got to do with the prevention of injury. There are a her rightful role in the overall care equation.
Disadvantages: There is a clear risk of harm in allowing Mrs. M to live by herself. According to Brooker and Lillyman (2013), persons diagnosed with dementia happen to be at an increased risk of fall. Further, anxiety alongside forgetfulness could, according to the authors, make it risky for a person with dementia to be left unattended to for long periods of time. Zolkefli (2017) argues that in some instances, choice (in the advancement of patient autonomy) is not always a good thing in the healthcare context. In the words of the author, in seeking to ensure that patients are involved in decision making and their choices respected, one has to remember that, choice comes with a cost, and it is a colossal one; that offering everybody a greater degree of control over what they receive will create winners and losers (Zolkefli, 2017, p. 95). In the present context, Mrs. Ms long…
References
Bombard, Y., Baker, G.R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., …Pomey, M. (2018). Engaging patients to improve quality of care: a systematic review. Implement Sci., 13, 96-104.
Brooker, D. & Lillyman, S. (2013). Dementia Care. Taylor and Francis.
Frezza, E. (2018). Medical Ethics: A Reference Guide for Guaranteeing Principled Care and Quality. CRC Press.
Lachman, V. (2009). Ethical Challenges in Health Care: Developing Your Moral Compass. Springer Publishing Company.
Ubel, P.A., Scherr, K.A. & Fagerlin, A. (2018). Autonomy: What’s Shared Decision Making Have to Do With It? Am J Bioeth, 18(2), 11-18.
Wilkinson, D., Savulescu, J. & Hope, T. (2008). Medical Ethics and Law: The Core Curriculum. Elsevier Health Sciences.
Zolkefli, Y. (2017). Evaluating the Concept of Choice in Healthcare. Malays J Med Sci., 24(6), 92-96.
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