Case Study in Primary care:
One hypothetical case study involves Jim a 54, year old patient who has recently diagnose with hypertension and his Creatinine and BUN laboratory results are elevated, if left untreated, will result in kidney failure. The patient refuses to take the medication because he said it will affect his sex life The NP must work with the patient to respect the fact that he doesn’t want the medication (autonomy), and needs to find a solution that would prevent him from going into kidney failure and other complications, which is in his best interest (beneficence). Although medications are the best choice, forcing the patient to accept the medication will result in probably patient leaving the care (non-maleficence). Finally, the NP needs to consider the impact that the patient’s choices might have on others if he starts to go into preventable kidney failure, he’ll need dialysis, which affects other people who need the same treatment (justice). So before making the final decision the NP must consider all four principles of health care ethics, which will help the NP make the choice that will have the best possible benefits for both the patient and society.
- What are the skills necessary for the provider to identify, address, and assess this clinical ethical issue?
- What are the provider’s obligations when a patient discloses does he not intent to follow the treatment?
- What are the ethical considerations in evaluating a patient’s failure to adhere to a prescribed therapy?
- Will you terminate care for this patient? What are the implications?
- Case Study Rubric
CriterionOutstanding (25)Very Good (22) Average (18)Unacceptable (15)ScoreCompletenessComplete in all respects; reflects all requirementsComplete in most respects; reflects most requirementsIncomplete many respects; reflects few requirementsIncomplete in most respects; does not reflect requirements UnderstandingDemonstrates excellent understanding of the topic(s) and issue(s)
Demonstrates an accomplished understanding of the topic(s) and issue(s)Demonstrates an acceptable understanding of the topic(s) and issue(s)Demonstrates an inadequate understanding of the topic(s) and issue(s) AnalysisPresents an insightful and through analysis of the issue (s) identifiedPresents a thorough analysis of most of the issue(s) identifiedPresents a superficial analysis of some of the issue(s) identifiedPresents an incomplete analysis of the issue(s) identified. EvaluationMakes appropriate and powerful connections between the issue(s) identified and the concept(s) studiedMakes appropriate connections between the issue(s) identified and the concept(s) studiedMakes appropriate but somewhat vague connections between the issue(s) identified and the concept(s) studiedMakes little or no connection between the issue(s) identified and the concept(s) studied. OpinionSupports opinion with strong arguments and evidence; presents a balanced and critical view; interpretation is both reasonable and objectiveSupports opinion with reasons and evidence; presents a fairly balanced view; interpretation is both reasonable and objectiveSupports opinion with limited reasons and evidence; presents a somewhat one-sided argumentSupports opinion with few reasons and little evidence; argument is one-sided and not objective. RecommendationsPresents detailed, realistic, and appropriate recommendations clearly supported by the information presented and concepts studiedPresents specific, realistic and appropriate recommendation supported by the information presented and the concepts studiedPresents realistic or appropriate recommendation supported by the information presented and the concepts studiedPresents realistic or appropriate recommendation with little, if any, support from the information and the concepts studied. Grammar and SpellingMinimal spelling and grammar errorsSome spelling and grammar errorsNoticeable spelling and grammar errorsUnacceptable number of spelling and grammar errors APA guidelinesUses APA guidelines accurately and consistently to cite sourcesUses APA guidelines with minor violations to cite sourcesReflects incomplete knowledge of APA guidelinesDoes not use APA guidelines Total