Purpose: To enable course registrants to apply their knowledge of ethical principles, skills in ethical analysis, and use of introspection to analyze an actual case that contains administrative and clinical ethics issues.

Method: Successfully completing this analysis will require that course registrants: 1. Write a case that is based on professional or personal experience (or from the literature) that contains administrative and clinical ethics issues-the case may be single spaced and should take no more than a half page; 2. State the ethics issues present in the case; 3. Analyze the ethics issues using the moral philosophies and principles enunciated in Chapter 1 of the textbook; 4. Develop solutions that will solve the ethical problems identified; and 5. Suggest means by which similar ethical issues/problems could be prevented in the future.All elements mustbeincluded.Use headings to demark sections.

Step #1: This is the gem of the paper: your personal or professional experience with an ethical dilemma. You do not have to be a practitioner to deal with a clinical case. For example, you may have been a family member involved in making a decision regarding the care of someone. Write of how you struggled with that. As a last resort, go to the literature. And if you must go there, please pick a case that has not been written about repeatedly (e.g., Karen Ann Quinlan). Reminder: the case portion (only) may be single spaced and limited to one-half page.

Step #2: Should be self explanatory. Just cite the issues. Don't overlap with step #3.

Step #3: This is the one that can be confusing. Keep in mind that the moral philosophies and principles are NOT the same thing. There are at least seven philosophies described and five principles. To say how each philosophy and principle relates to your case leads to a shallow understanding of all of them and a trite rendition in the writing. Not good. Be parsimonious in your reference to the concepts in Chapter 1. You can develop and argument, e.g., for truth-telling (or beneficence, or autonomy, and so on) based upon a personal deontological or utilitarian (or any of the other moral philosophies) philosophical point of view. So, pick a line of reasoning and follow it. Above all, do not over-simplify the terms, especially deontology and utilitarianism. Read additional material if need be to enhance your understanding.

Grading criteria: Meeting the elements listed in Method, above. In addition, the quality of analysis, organization, clarity of presentation, and correct use of English will be considered in awarding a grade.

 ETHICAL CASE BEING ANALYZED

Oliver Harris is 82 years old and has been a resident at Five Oaks Nursing Home for 7 years.  When he first sought admission, Harris had been evaluated and found to be only marginally in need of the care provided at Five Oaks.  Because he was a private-pay patient, management decided to admit him.  For 5 years his health was such that he needed minimal nursing care.  In the sixth year, he began to show evidence of dementia.  Medical evaluation found that he had experienced several small strokes.  Harris likes to visit with other residents as he walks around the facility.  His declining physical condition has resulted in several falls, which caused cuts and bruises but no broken bones. 

           Harris's case was discussed at a staff conference.  It was the consensus to physically restrain him so that he could not ambulate independently.  Under federal guidelines, this was possible only with an order from Harris's physician.  Staff doubted the physician would agree, but they believed that if Harris continued to walk unassisted, it was only a matter of time before he fell and sustained a fracture.  Staff also believed that even if his physician ordered restraints, Harris would fight them.  When the issue was discussed with Harris, he was adamant that he not be restrained.  His daughter, however, agreed that physical restraint was wise.