Today, society requires more accountability form of professionals. As a result, there is an increased need for greater training and education in addressing ethical challenges in areas of work. There are numerous ways through, which professionals can come up to sound and ethical decisions in health care. An example of one of these ways that can be useful in making decisions that are ethical and appropriate is the use of the Down Model. This model of making an ethical decision was established and presented by Down and his colleagues who came up with a step- by- step method of helping professionals in making decisions that are ethical. The Down Model specifically provides professionals with ways to address challenges that affect solving professional problems ethically as the model closely resembles or relates to those found in the medical imaging profession. This model is made of at least six steps which have been adjusted for the appropriate use by the user in responding to a number of hypotheticals. This paper will utilize the Down Model to address or to respond to two particular cases by analyzing them and solving them through the use of the six steps in the Down model.
Before looking at the specific cases, it is essential that we look at and familiarize ourselves with the six steps of the Down Model. The first step in the model is the step that deals with assessing the problem by considering what ethical contexts are present in which the situation took place. This step requires the user to determine what kind of ethical challenge took place- the ethical dilemma of justice, ethical dilemma, locus of authority issue or ethical distress. The second step requires the user to isolate the issues. During this point, the user must be able to differentiate the issues that are essential to the situation from those that are not as essential. The user must also determine what values should be utilized. The user of the model should, at this stage, consider which ethical principles the cases or situations involve or use, they must also consider which rights an organization is violating or compromising, and which area or principle of the professions code of conduct or ethics covers the behavior in the situation. The third step of the model involves the user analyzing the data. It is during this stage that the user separates al the pertinent information from the pure conjecture. In this stage, the user should only examine the facts that relate to the problem and eliminate the rest. The fourth stage of the Down model involves the development of an action plan by the user. During this stage, the user makes a decision depending on what options are available for addressing the problem. The last essential stage in the model is the institution of the plan, which involves the user proceeding with the implementation of the solution.
The first case that we are going to look at in this case is the first case is Case 1, which deals with the medical imaging professional. The case tells us that the supervisor and the co-workers of the medical imaging professional have been suspecting that the individual has a problem controlling his drinking problem. The person in question comes to work with breath that smells of alcohol, with a compromised gait, and speech that is slightly slurred. The supervisor pulled him aside recently, as a result of these observations, and was able to confirm the signs that he had noticed earlier. The supervisor then warns the professional that according to the substance abuse policy that the observations that he has made are enough to warrant for a drug test, and requests that the imaging professional must undergo a blood test for confirmation. The imaging professional, however, refuses to do as directed. The question here is whether the way the professional acted was a way of insubordination or whether making him go for the test would be a violation of the rights of the imaging professional.
To answer this question comprehensively, it is essential to submit it to the Down model of aiding individuals to make decisions that are ethical. The first step of the model is to assess the problem. The problem or dilemma, in this case, occurred when the supervisor asked the imaging professional to take a blood test because there were numerous signs that the employee was drunk. The supervisor and the co-workers of the professional had observed a number of signs repeatedly to indicate that the imaging professional was abusing substance or alcohol. According to the substance abuse policy of the hospital, anyone who shows such signs has to submit test results that indicate otherwise. This is a case of locus of authority issue. This is because, the supervisor noticed that the imaging professional had a problem with alcohol, and even noticed some signs that might have been enough to show that indeed the professional was abusing substances. Though the supervisor could have done that, he did not because the use of a blood test would have been the best judge or maker of the decision as to whether the professional had drug problems or not. In this case, the supervisor felt that he needed to test the professional to get the best basis on what to base his decisions.
The second step in answering the questions of the case study is isolating the issues involved in the case. In this case, we will have to separate the most essential issues from the less significant ones, in addition to identifying the significant values. In analyzing the issues involved in this stage, we have to decide what implications the behavior of the imaging professional might have on patients in case the assumptions of the supervisor are right. The professional is involved with work in the health care that is extremely sensitive, and that which requires undivided attention for best results. Therefore, if the professional shows up to work on his sensitive job drunk, it is only safe to conclude that this behavior can negatively affect his work. For instance, he might provide patients with the wrong diagnosis leading to the wrong treatment and eventually serious health implications.
At this point, it is essential to note that the health and the safety of the patients are the two topmost issues that the behavior of the imaging professional might affect. In addition to this, the behavior of the professional might also violate the rights that the patients have to get an able person to treat or attend to them. Furthermore, the hospital has ethical codes that require its workers not to be intoxicated while working. In this case, therefore, it is essential to note that the professional should go for the blood test because the long- term interests of the professional, the patient and the hospital depend on it.
Generally, there are a number of ethical values compromised by the refusal of the professional to take a blood test. One of the major ones is that the professional risks endangering the lives and the license of the patients and the hospital respectively if he keeps on working while under the influence. The patient also has the right for the best treatment available, and the right they have to get an able person to treat them. With the professional working, while intoxicated, he breaches these rights. The professional also violates the hospital’s code of conduct or ethics, which requires him not to work while under the influence of any substance. As a result, all of these violations will violate the policies and the procedures of the hospital with the professional refusing to take the drug test.
The third step requires us to analyze the data obtained from the first two steps. In this case, we will only look at the information that is essential and relevant; we will ignore or eliminate the rest of the information. From the above steps, we have found out that one of the main ethical values that the behavior of the imaging professional violates are endangering the lives of the patients, and violating their rights. From the analysis of the data above, we have also found that his refusal to take a blood test violates the rights the patients have to have a capable physician attend to them. The behavior of the professional also violates the code of conduct or ethics of the hospital, and, therefore, desecrates the policies and procedures of the institution. The fourth step in Down Model requires us to develop an action plan.
According to the information derived from the previous steps, it is clear that the imaging professional should not have declined to undertake a blood test because it was the right thing to do for him, the hospital and for the patients. It is also clear that the professional cannot continue to work in the hospital in his condition. Therefore, the hospital has to make him to take that blood test so that the institution can make further decisions regarding his suitability for the job. Alternatively, since the supervisor has enough evidence that the professional is violating all these rights, he should require that he go for a suspension during which he should seek some help for his problem.
The last solution is the best since the hospital will give the professional some time off to put his matters in order so that he can become safe once more to handle patients. The last step in the model encompasses the institution of the plan. From the two solutions proposed above, the best solution seems to be suspending the professional for punishment and for giving him time to address his problems so that he can be suitable to handle critical tests again. The reason why I thought this solution or plan to be the best is that it is the best considering that firing him would be against the law, and retaining him in the hospital would be endangering the lives of the patients.
The second case that we are going to look at in this paper is Case 6, which involves false charges that lead to inappropriate dismissal. Our employer does periodic random drug testing, and recently we took one such test. When my results came back, my supervisor let me know that they were arranging for my dismissal because apparently, my tests had come out positive. I have never taken any drugs in my life, as well as, tobacco and alcohol, so the fact that my supervisor implied that the hospital was dismissing me on these grounds was extremely disturbing. The question, in this case, is what such an individual would do. To answer this question, we will go back to Down model of making ethical decisions. The first step would be to assess the problem.
In this case, the ethical context has to do with the fact that the hospital dismissed me on false grounds. I have never taken drugs, alcohol or tobacco and my tests came positive for these substances. As a result, of these test outcomes, the institution was terminating my job. My case is an ethical dilemma of justice. The second step would involve the isolation of the main issues. At this point, there are a number of issues of concern that present themselves. For instance, there are a number of ethical issues involved here. One issue is that I am being wrongfully accused; the second issue is that my job is being terminated based on these false claims. Other issues involve tarnishing of my reputation and risking my practice license in case my employer terminates my job. The institution compromises my future and my rights. It is also possible that someone interfered with the tests or the samples. In addition to all these values and ethical issues involved, the accusation could also mean other things to the individuals involved. For example, it could affect my profession if my employer leaves me with this kind of reputation; this would affect my income meaning that I would not be able to take care of those who depend on me.
The third step in the model is the analysis of data, which requires one to isolate the most essential issues from the less significant ones. There are a number of significant facts that we can derive from the above information. For instance, it is clear that the accusation by my employer compromises many ethical values. For example, the institute has compromised my survival, as well as, my career. This decision also violates my rights to have my employer fire me based on false accusations. Though this move by my employer to dismiss me from my job because of working under the influence supports the professional code of conduct or ethics, it violates my rights as a worker not to be harassed. The decision by my employer also supports the procedures and the policies of the institution on working under the influence but it desecrates the policies and procedures that should be followed in concluding that an employee is dependent on substances.
The fourth stage involves the development of an action plan. In my case, there are a few choices that I can follow to solve my problem. The first solution is that I can accept the dismissal letter and do nothing about it, and the second solution would be to sue the company for wrongful dismissal. The final step in Down model would be to implement the solution or the plan. I would implement the second solution, which directs that I sue the company for wrongful termination. This is the best solution because my employer has accused me of falsely and wrongfully, and, because of these false claims, my employer has terminated my job.
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