How Should Emergency Department Clinicians Respond to Unmet Dental Needs?
Choose a case from the AMA Journal of Ethics Case Index- ( How Should Emergency Department Clinicians Respond to Unmet Dental Needs? ( https://journalofethics.ama-assn.org/article/how-should-emergency-department-clinicians-respond-unmet-dental-needs/2022-01) and take a position ( clinicians should respond to it). For this assignment, you will evaluate the ethical arguments for or against the issue. Identify the potential legal arguments (consider current federal guidelines), indicate any potential professional code conflicts you foresee, and support your position with an explanation of your own ethical/moral foundation.
In your 2-3 page paper:
Identify the issue and state your ethical position.
How might this scenario play out or impact you in your role as a nurse practitioner?
Defend your position with legal, ethical, and professional evidence.
As part of your position, propose strategies and solutions for addressing the issues.
What other ethical issues does this case bring to light, if any?
Support your position with at least one scholarly source (it may be your text). Be sure to cite the article you choose, use APA format, and include a title page and reference page.Review the rubric for further information on how your assignment will be graded.
Rubric
NURS_521_DE – Paper/Essay Rubric (2)
NURS_521_DE – Paper/Essay Rubric (2)
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Content
20 to >17.2 pts
Proficient
The writer clearly and effectively responds to the assignment.
17.2 to >15.0 pts
Approaches Proficiency
The response to the assignment is generally adequate, but may not be thorough.
15 to >0 pts
Does Not Meet Expectations
The writer does not respond to the assignment.
20 pts
This criterion is linked to a Learning Outcome Focus and Detail
18 to >15.48 pts
Proficient
There is one clear, well-focused topic. Main ideas are clear and are well supported by detailed and accurate information.
15.48 to >13.5 pts
Approaches Proficiency
There is one clear, well-focused topic. Main ideas are clear but are not well supported by detailed information.
13.5 to >0 pts
Does Not Meet Expectations
The topic and main ideas are not clear.
18 pts
This criterion is linked to a Learning Outcome Organization
14 to >12.04 pts
Proficient
The introduction is inviting, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong.
12.04 to >10.5 pts
Approaches Proficiency
The introduction states the main topic and provides an overview of the paper. A conclusion is included.
10.5 to >0 pts
Does Not Meet Expectations
There is no clear introduction, structure, or conclusion.
14 pts
This criterion is linked to a Learning Outcome Mechanics and APA
8 to >6.88 pts
Proficient
The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.
6.88 to >6.0 pts
Approaches Proficiency
The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are cited and referenced correctly.
6 to >0 pts
Does Not Meet Expectations
The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Many sources are cited and referenced incorrectly, or citations and references are missing.
8 pts
Total Points: 60
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Solution
Unmet Dental Needs
Identify the Issue and State your Ethical Position
The issue relates to a patient who is not able to afford dental care and therefore keeps visiting the emergency department with a complaint of a severe toothache with at least three visits in the past month. However, the physician in the emergency department has already referred the patient to a dentist. The patient clearly states that she cannot be able to afford to see a dentist. The patient keeps getting medication to manage her toothache, with the medication not being sufficient to treat the root cause of her toothache, which is tooth decay in the emergency department (Curt, 2022). The patient’s consistent visit to the emergency department where she does not receive sufficient health raises several issues related to the delivery of healthcare. One of the central issues related to the patient who visits the emergency department for issues related to her toothache relates to the wastage of healthcare resources as the patient utilizes both the physician’s time and other healthcare resources such as medications which cannot assist them in their healthcare problem. Another central issue in the case study where a patient is not able to afford a dentist relates to the affordability and accessibility of dental health care services in the US among individuals in low-income groups (Curt, 2022).
My ethical position on the case study where a patient returns to the emergency department more than three times complaining of a severe toothache and only receives antibiotics because they cannot afford a dentist relates to the ethical principle of justice. Utilizing the ethical principle of justice, it is therefore clear that the economic status of the patient in the case study inhibits her access to needed health care services (Varkey, 2020). Because of the patient lacking sufficient funds and an insurance cover that includes dentist services, she is therefore not able to visit a dentist despite a referral from her physician. The patient is therefore forced to utilize short-term measures to manage her pain rather than address the root of her problem, which is tooth decay. Relying on the ethical principle of justice, an argument can therefore be made that Miss O, the patient in the case study who has a severe toothache, is denied access to needed dental health services because of her economic status. Access to dental health care services has therefore remained one of the most significant areas of concern when it comes to equality in access to healthcare services across the US (Northridge et al., 2020).
How might this scenario play out or impact you in your role as a nurse practitioner?
A scenario where a patient is not able to access needed dental health services can significantly impact my role as a nurse practitioner. In such a scenario, my main role as a nurse practitioner would therefore be the main advocate for the patient in helping her access needed dental services. To effectively advocate for the patient, I would investigate the different options that are available for the patient to be able to access dental health services, such as through local dental clinics or public dental insurance options. As a nurse practitioner, I would collaborate with either a case manager or social worker to ensure that the patient with dental health issues receives adequate guidance on which dental health services they would afford. As a nurse practitioner, I would also need to advance my advocacy efforts to improve the accessibility of dental health services, for instance, through pushing for the establishment of more local dental clinics and public dental insurance in my community. Such advocacy would take the form of lobbying the necessary authorities through the support of professional organizations such as the American Nurses Association (ANA) (Olson & Stokes, 2016).
Defend your position with legal, ethical, and professional evidence.
My ethical position to try and support patients to address dental health care services would be supported by legal, ethical and professional evidence. According to the basic human rights enumerated in the US Constitution, every individual has the right to health care. Advocating for a patient to access dental health care services will therefore be within their legal rights. On the other hand, relying on the ethical principles of justice, it is important for healthcare practitioners to ensure access to healthcare services, especially among underserved and marginalized populations. Finally, the professional code of ethics for nurses through provision 8 refers to health as a universal human right and calls on nurses to advocate for the best outcomes for their patients (Olson & Stokes, 2016). It is the duty of nurses to ensure that their patients receive quality healthcare services irrespective of their financial condition.
As part of your position, propose strategies and solutions for addressing the issues
The ideal solution for the case study highlighted is to effectively advocate for the patient. I would investigate the different options that would be available for the patient to be able to access dental health services, such as through local dental clinics or public dental insurance options. As a nurse practitioner, I would therefore collaborate with either a case manager or social worker to ensure that the patient with dental health issues receives adequate guidance on which dental health services they would afford. Health caregivers need to be the main advocates to assist patients in accessing much-needed healthcare services (Olson & Stokes, 2016).
What other ethical issues does this case bring to light, if any?
The case brings to light ethical issues related to beneficence and non-maleficence in the case study. The physician is forced to administer antibiotics to a patient with dental issues despite knowing that such treatment will not help the patient in any way while also exposing the patient to negative side effects.
References
Curt, A. (2022, January 1). How Should Emergency Department Clinicians Respond to Unmet Dental Needs? Journal of Ethics | American Medical Association. https://journalofethics.ama-assn.org/article/how-should-emergency-department-clinicians-respond-unmet-dental-needs/2022-01
Northridge, M. E., Kumar, A., & Kaur, R. (2020). Disparities in Access to Oral Health Care. Annual Review of Public Health, 41(1), 513–535. https://doi.org/10.1146/annurev-publhealth-040119-094318
Olson, L. L., & Stokes, F. (2016). The ANA Code of Ethics for Nurses With Interpretive Statements: Resource for Nursing Regulation. Journal of Nursing Regulation, 7(2), 9–20. https://doi.org/10.1016/s2155-8256(16)31073-0
Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles and Practice. https://doi.org/10.1159/000509119