Overview
Final/Research/ Portfolio Paper: Submit by Saturday 11:59 p.m.
- Assignment (250 points)
Your paper should be based on the following scenario:
You are the director of respiratory therapy at a large regional medical center. There is an 85-year-old female Hispanic patient in the adult intensive care unit. The admitting diagnosis for the patient is "stroke." Prior to admission, the patient had a history of heart and pulmonary problems and lung cancer (successfully treated by surgery and radiation 10 years ago). Tests conducted since admission have discovered early-stage liver cancer. The patient has been in a comatose state ever since admission, unable to communicate or move. Since the patient is unable to breathe on her own, she is also on a ventilator.
The patient was admitted 15 days ago; she is without insurance and has no proof of citizenship. The hospital business office wants to know if she can be discharged from AICU, which costs the hospital $20,000 per day, or if the family will agree to disconnect the ventilator. The attending physician is new on the medical staff and is unsure of the patient's prognosis.
The AICU is full, so the discharge planner is under pressure from his supervisor to free up the bed needed for other critical patients. The patient's family is strongly against withdrawal of any life support or reducing any care standard. They have been adamant that God will perform a miracle and the patient will walk out of the hospital. The patient's children are all adults, natural-born citizens of the U.S. who own a successful, well-known local business.
A local TV station has been 'covering the story' although they have not publicly disclosed the patient's name. The state governor has come out publicly stating that illegal aliens are a drain on our state's resources and should be sent back to their countries of origin. The governor's challenger (whose daughter is a nursing student in AICU) says there is a moral duty to care for everyone.
You are scheduled to meet with the hospital ethics committee tomorrow. After the meeting, you, the physician, and the AICU chaplain are to meet with the patient's family regarding the patient's course of care.
How will you prepare for the upcoming meeting with the hospital ethics committee? What issues do you expect will come up during that meeting? What will you say to the patient's family?
Prepare the portfolio paper using the following guidelines:
- A minimum of 8 pages not to exceed 12, typed, double-spaced, Times New Roman font, using APA standard.
- Title page, including title of paper, your name, course name and course number, date of submission (page 1).
- A minimum of 8 pages, including a summary of your understanding of the biblical implications for the topic (pages 2-11).
- Apply the "model for making moral decisions" studied in Chapter 4 of Moral Choices.
- Include an analysis of patient autonomy.
- Include an analysis of rationing of health care resources.
- Apply ethical considerations regarding end-of-life care.
- Include your ethical obligations to the institution.
- Include your ethical obligations to hospital staff.
- Include your ethical obligations to the patient.
- Include your ethical obligations to other patients and the community.
- What documents could the patient have been prepared to make this situation easier?
- Address and analyze privacy issues.
- Are there any federal laws that are relevant to this patient's care?
- Does anything change if your hospital: (a) is a state-owned facility; or (b) is affiliated with a certain Christian denomination; or (c) if it is a private for-profit facility?
- Include anything else you think to be relevant.
- Be sure to support all your ideas with citations from both of our textbooks, and use your outside sources as well.
- A reference page (page 12).
- A minimum of 8 references are required, including the text, the Holy Bible, books and articles from academic sources (Net Library), and other periodicals.
- Refer to the rubric in Appendix B
Week 7 Portfolio Paper Rubric
| Criteria | Ratings | Points |
Understanding of Scenario & Ethical Dilemmas | ExceptionalDemonstrates an in-depth understanding of the multifaceted scenario, identifying and dissecting the complex ethical, legal, and healthcare challenges. Provides nuanced interpretations and connections to all elements of the scenario, showcasing a thorough grasp of the situation. 25 pts ProficientShows a clear understanding of most elements of the scenario and the ethical dilemmas they present, albeit with some gaps or lack of depth in certain areas. Makes connections but might miss subtleties in the scenario. 21.25 pts BasicPresents a basic understanding of the scenario but lacks depth in explaining or identifying all key ethical, legal, and healthcare issues. Limited interpretations and connections, missing significant components of the scenario. 17.5 pts MinimalDemonstrates a limited or incorrect understanding of the scenario, failing to explain or identify crucial ethical, legal, and healthcare issues. Lacks clarity or coherence in discussing the scenario elements. 13.75 pts | /25 pts |
Application of Ethical Decision- Making Model | ExceptionalEffectively applies the ethical decision-making model outlined in Moral Choices (Chapter 4) to systematically address the complex ethical dilemmas in the scenario. Demonstrates a clear path to ethical decision-making, applying the model coherently to various aspects of the scenario. 25 pts ProficientMostly applies the ethical decision-making model studied in Moral Choices (Chapter 4) to address ethical dilemmas but with minor inconsistencies or gaps in the application of the model. Some areas lack depth or clarity in ethical deliberation. 21.25 pts BasicAttempts to apply the ethical decision-making model but lacks depth or coherence in addressing the ethical dilemmas in the scenario. Shows inconsistencies or errors in applying the model to different aspects of the scenario. 17.5 pts MinimalProvides a superficial or incorrect application of the ethical decision-making model, lacking clarity or coherence in ethical deliberation across different aspects of the scenario. 13.75 pts | /25 pts |
Patient Autonomy | ExceptionalProvides an exhaustive analysis of patient autonomy within the scenario, addressing its complexities and implications thoroughly. Offers multifaceted insights and well-supported arguments, considering various perspectives. 25 pts ProficientOffers a comprehensive analysis of patient autonomy in the scenario, discussing its relevance and implications, but may lack depth in exploring all facets or perspectives. Provides well-supported arguments. 21.25 pts BasicPresents a basic analysis of patient autonomy, acknowledging its relevance, but lacks depth in exploring various facets or perspectives. Offers limited or underdeveloped arguments. 17.5 pts MinimalProvides a superficial or incorrect analysis of patient autonomy, lacking relevant insights or arguments, or misunderstands its significance in the scenario. 13.75 pts | /25 pts |
Healthcare Resource Allocation | ExceptionalProvides an in-depth analysis of healthcare resource allocation concerns in the scenario, considering fairness, equity, and ethical implications thoroughly. Offers well-supported arguments with multiple viewpoints. 25 pts ProficientOffers a solid analysis of healthcare resource allocation concerns, discussing their relevance and ethical implications, but may lack depth or consideration of various viewpoints. Provides decently supported arguments. 21.25 pts BasicAttempts to analyze healthcare resource allocation concerns but lacks depth or consideration of various viewpoints, offering limited or underdeveloped arguments. 17.5 pts MinimalProvides a superficial or incorrect analysis of healthcare resource allocation concerns, lacking relevant insights, arguments, or misunderstands their significance in the scenario. 13.75 pts | /25 pts |
End-of-Life Care | ExceptionalDelivers a comprehensive analysis of end-of-life care considerations in the scenario, addressing complexities and ethical dilemmas thoroughly. Offers nuanced insights and well-supported arguments from multiple angles. 25 pts ProficientOffers a detailed analysis of end-of-life care considerations, discussing their relevance and ethical dilemmas, but may lack depth in exploring various angles. Provides adequately supported arguments. 21.25 pts BasicAttempts to analyze endof- life care considerations but lacks depth or consideration of various angles, offering limited or underdeveloped arguments. 17.5 pts MinimalProvides a superficial or incorrect analysis of endof- life care considerations, lacking relevant insights or arguments, or misunderstands their significance in the scenario. 13.75 pts | /25 pts |
Institutional Obligations | ExceptionalProvides an exhaustive analysis of institutional obligations within the scenario, addressing ethical responsibilities comprehensively. Offers well-supported arguments considering the institution's ethical duties. 25 pts ProficientOffers a comprehensive analysis of institutional obligations, discussing ethical responsibilities, but may lack depth or consideration of various aspects. Provides decently supported arguments. 21.25 pts BasicAttempts to analyze institutional obligations but lacks depth or consideration of various aspects, offering limited or underdeveloped arguments. 17.5 pts MinimalProvides a superficial or incorrect analysis of institutional obligations, lacking relevant insights or arguments, or misunderstands their significance in the scenario. 13.75 pts | /25 pts |
Ethical Obligations to Staff | ExceptionalDelivers a comprehensive analysis of ethical obligations to hospital staff within the scenario, addressing their ethical rights and considerations thoroughly. Offers nuanced insights and well-supported arguments considering staff welfare. 25 pts ProficientOffers a detailed analysis of ethical obligations to staff, discussing their rights and considerations, but may lack depth in exploring various perspectives. Provides adequately supported arguments. 21.25 pts BasicAttempts to analyze ethical obligations to staff but lacks depth or consideration of various perspectives, offering limited or underdeveloped arguments. 17.5 pts MinimalProvides a superficial or incorrect analysis of ethical obligations to staff, lacking relevant insights or arguments, or misunderstands their significance in the scenario. 13.75 pts | /25 pts |
Ethical Obligations to Patient | ExceptionalProvides an exhaustive analysis of ethical obligations to the patient within the scenario, addressing their rights, dignity, and considerations thoroughly. Offers wellsupported arguments considering various aspects. 25 pts ProficientOffers a comprehensive analysis of ethical obligations to the patient, discussing their rights and considerations, but may lack depth in exploring various dimensions. Provides decently supported arguments. 21.25 pts BasicAttempts to analyze ethical obligations to the patient but lacks depth or consideration of various dimensions, offering limited or underdeveloped arguments. 17.5 pts MinimalProvides a superficial or incorrect analysis of ethical obligations to the patient, lacking relevant insights or arguments, or misunderstands their significance in the scenario. 13.75 pts | /25 pts |
Ethical Obligations to Community and Others | ExceptionalDelivers a comprehensive analysis of ethical obligations to the community and others within the scenario, addressing societal implications thoroughly. Offers nuanced insights and well-supported arguments considering broader impacts. 25 pts ProficientOffers a detailed analysis of ethical obligations to the community and others, discussing societal implications, but may lack depth in exploring various impacts. Provides adequately supported arguments. 21.25 pts BasicAttempts to analyze ethical obligations to the community and others but lacks depth or consideration of various impacts, offering limited or underdeveloped arguments. 17.5 pts MinimalProvides a superficial or incorrect analysis of ethical obligations to the community and others, lacking relevant insights or arguments, or misunderstands their significance in the scenario. 13.75 pts | /25 pts |
Integration of Citations and References | ExceptionalEffectively integrates citations from textbooks, the Holy Bible, academic sources, and outside references to support ideas and arguments. Accurately uses APA style for citations and references, seamlessly contributing to the paper's depth and credibility. 15 pts ProficientMostly integrates citations from various sources to support ideas and arguments but with minor errors in APA style for citations and references. Citations are generally integrated but may disrupt the flow at times or lack consistency. 12.75 pts BasicAttempts to integrate citations from sources but with several errors in APA style for citations and references. Citations disrupt the flow and coherence of the paper or lack relevance. 10.5 pts MinimalLacks proper integration of citations from sources to support ideas and arguments. APA style for citations and references is absent or incorrectly applied, significantly impacting the paper's credibility. 8.25 pts | /15 pts |
Clarity, Organization, and Structure | ExceptionalPresents the paper with exceptional clarity, organization, and structure, maintaining a coherent flow of ideas throughout. Sections and ideas are logically sequenced, enhancing readability and understanding of complex ethical dilemmas. 10 pts ProficientShows good clarity, organization, and structure in presenting ideas but with occasional lapses in logical sequencing or coherence. The paper is generally readable but may lack consistency in structure or logical flow in some parts. 8.5 pts BasicPresents the paper with basic clarity, organization, and structure but lacks consistency in logical sequencing or coherence. The paper may be difficult to follow in significant parts due to disjointed structure or unclear presentation. 7 pts MinimalLacks clarity, organization, and structure in presenting ideas. Logical sequencing and coherence are significantly lacking, making the paper challenging to follow or understand. 5.5 pts | /10 pts |
MHA-1 view longer description Threshold: 3 pts | Exceeds Mastery 4 pts Mastery 3 pts Near Mastery 2 pts Below Mastery 1 pts | --/4 pts |
MHA-3 view longer description Threshold: 3 pts | Exceeds Mastery 4 pts Mastery 3 pts Near Mastery 2 pts Below Mastery 1 pts |