VIP treatment. Ethical dilemma for paper? - page 2

by metfan

5,697 Views | 28 Comments

I have to do a paper on an ethical dilemma for my BSN program. It seems lots of students are doing end of life care and patient autonomy. I want to do something different and maybe a little newer. We have real issues at work... Read More


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    I think you could do the VIP dilemma with what said VIP wants vs what's best for them medically. IE, they're CEO, in for an MI, and wife brought in a fish fry for dinner. How do you as the nurse recognize that they likely know they shouldn't eat that, but they still want to? How do you step in while still recognizing their autonomy?
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    Actually, it's a viable topic. Generally, it is not unethical to give someone preferential treatment. It does become an ethical issue if someone else gets Lesser treatment because of the VIP's needs getting met instead. For example, if the VIP call light must be answered first, regardless of actual needs.
    dudette10 likes this.
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    Quote from MrChicagoRN
    Actually, it's a viable topic. Generally, it is not unethical to give someone preferential treatment. It does become an ethical issue if someone else gets Lesser treatment because of the VIP's needs getting met instead. For example, if the VIP call light must be answered first, regardless of actual needs.
    In academic writing, viable topics need viable supporting literature.

    If one were to look at the topic in the abstract, healthcare is about allocating limited resources for an unlimited need. The preferred care of a person who does not consume as many resources as they provide over those who will not provide as many resources is not unethical if the lack of preferred care equates to a loss of the gross amount of resources on hand.

    More gross resources = more care given to a larger population. If one must invest a greater amount of resources on an individual venture to increase the gross availability of resources then so much the better.
    kakamegamama and NutmeggeRN like this.
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    I don't know if you already decided against it, metfan. But I thought your topic was really interesting and relevant.
    Looking at the problem in terms of ethical principles (autonomy, veracity, beneficence,...), it clearly violates the principle of justice -- fair distribution of resources. "What is fair distribution?" is of course a huge topic to discuss. If I were to write this, I would start by laying out what I believe is the fair distribution for a given hospital -- its mission statement could come into this, and describe how VIP situation violates justice and cause ethical dilemma. It would be really interesting to ask the question, "Does a large donation warrant preferental treatment at the expense of other patients, or should all patients receive treatment soley based on the necessity of their medical condition?"
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    In my experiences working at various hospitals, the VIPs were treated the exact same in regards to their care as anyone else. Care in the sense of their medical treatment plan. The only difference was they usually had a better room, and were made to feel more comfortable - like with visits from a patient relations worker, or etc... One hospital I worked at would send a package with a blanket with the hospital name on it, and maybe a gift basket with snacks. The family may have an area for them with snacks and even wine to use, instead of the waiting room.

    Cedars Sinai in LA had a "VIP floor". It was larger rooms, many with a living room type area with a couch and a full bathroom similar to what a hotel bathroom would look like. It was used for celebrities or for the entitled patient and or family who felt they deserved something.

    I never really have paid much attention to the title...they really do get the same care, which is often just as subpar and disorganized as all the other patients in the hospital. They are just made to believe they are important, so they will donate some money, if they feel like it. Maybe they feel special this way? I sure wouldn't donate 10K to some lousy hospital for a couple blankets and a bigger room.
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    I think it would be very interesting. You'll probably have to be creative with your research though. "VIP treatment" probably won't have a ton of studies, so you'll have to get creative with your search terms. I'd advise getting with a librarian at your school. People forget what a tremendous resource librarians are for finding information.
    dudette10 likes this.
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    I agree with asystole......you need to be able to work your way through the whole analysis of the situation and there are many steps/questions in the process. To do a thorough breakdown, you need to have a variety of literature and you may be lacking that. I did mine on sterilization of a person who is developmentally delayed.
    Good Luck!
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    VIP treatment is definitely a good topic for a paper, but not so sure it fits into the ethical dilemma category as it's not an ethical dilemma. VIP treatment is considered wrong by all, but it is done nonetheless for obvious reasons

    The standard of care is to provide high quality of care to all patients, not better care to Mr Lotsofdough because he donated 3 hospital wings. I give the same level of care to all patients, the kind of care I would want for my family. Mr Lotsofdough gets the same care as Mr Livesonstreet in the room next door. Lame names I came up with, I know lol, but you get the idea.

    Another ethical dilemma: Minors making medical decisions for themselves, when a minor's decision contrasts with their parent's wishes. As in chemotherapy, end of life issues, or Jehovah's witness blood transfusion issues, when a child needs one emergently, but religion says no.
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    I respectfully disagree with a PP. Preferential treatment is unethical because by the very definition, you are giving lesser treatment to another patient. Preferential treatment implies that person is getting extra attention, extra something that other patients are not getting. Of course, it is impossible to spend the same amount of time in every patient's room, but every patient should be getting the same high quality care, and no one should get anything extra just because they are a VIP or complain every other minute.

    If you're going to give preferential treatment to that person, then you should give the same level of extra attention to the rest of your patients. And, if you can't do that, which you won't be able to, then the VIP patient will survive, and maybe learn an important lesson: the other patients' comfort and lives are as important as theirs.
    blondy2061h likes this.
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    At a place I worked, VIP patients would have a room held for them and come right back, regardless of what their triage level was and what else was in the waiting room. This was in an emergency department that was often packed and rarely quiet.

    I think it's a good topic. Maybe you'll have to work more to make literature support your topic rather than have a stack of papers to point at and say "what they said," but I don't see that as a reason to avoid the topic.
    dudette10 likes this.


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