Moral Dilemmas and Ethical Decisions - Running head MORAL...

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Running head: MORAL DILEMMAS AND ETHICAL DECISIONS 1 Moral Dilemmas and Ethical Decisions Julija Petraityte Capella University BSNFP 4006 August 2018
MORAL DILEMMAS AND ETHICAL DECISIONS 2 Moral Dilemmas and Ethical Decisions Moral and ethical situations are a constant area of research in the health care field. The emergency department is specifically an area of health care that repeatedly appears to be in the center of the dilemmas. Specific reasons for this include overcrowding of Emergency Rooms (ERs), and also urgency or receiving care for the patient due to life threatening conditions (Aacharya, Gastmans & Denier, 2011). Patients usually have to wait extended periods of time before they can be seen by doctors in ERs due to the overcrowding problem. Due to this, triage systems are in place to calculate clinical risk and needs for patients, and to prioritize the cases in the most beneficial way possible. Health Care Policies Health care acts, laws, and policies are in place to define standards of care and ensure quality of health care for individuals. The Affordable Care Act (ACA) contains several portions that directly affects emergency department health care practices and expectations. As the ACA expands insurance coverage, hospitals need to continuously work on strategies to reduce crowding in Emergency Departments (EDs). The other elements of the ACA, such as patient- centered health homes and easier payment methods, will directly affect Emergency Department care (McClelland, Asplin, Epstein, Kocher, Pilgrim, Pines & Rathlev, 2014). The Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA) was established to provide emergency care for everyone, regardless of their ability to pay. This law requires that any hospital, as long as they are ‘Medicare-participating’, provide emergency health care including screening, stabilization, and sometimes even transfer of unstable patients (Rosenbaum, 2013). Since its enactment, though, the terms of this law have been relaxed due to many controversial rules and obligations that followed.
MORAL DILEMMAS AND ETHICAL DECISIONS 3 Triage Decision Making Strategies Specific guidelines have been produced to aid with the triaging of patients in emergency situations. Recent and ongoing studies have shown that five-level triage systems work best

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