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1. NHS FPX 4000 Assessment 3 Applying Ethical Principles
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Capella university
NHS FPX 4000
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NHS FPX 4000 Assessment 3

2. Applying Ethical Principles
Healthcare professionals frequently face ethical dilemmas that arise from diverse factors such as
financial constraints, limited resources, patient autonomy, and conflicting professional values.
Ethical decision-making plays a critical role in ensuring fairness, equity, and patient safety in
healthcare delivery. This assessment examines the Incident of the Missing Needle Protector case
study and applies core ethical principles to analyze the ethical issues involved, evaluate
communication effectiveness, and propose a principled resolution to the dilemma (Robert et al.,
2020).
The purpose of this paper is to analyze the facts of the case, evaluate communication strategies,
and apply ethical principles to formulate a defensible and fair solution that aligns with
professional healthcare ethics.

Facts of the Case Study
The Incident of the Missing Needle Protector presents multiple ethical challenges, primarily
involving the unreported medical error of a missing needle protector left in a patient’s abdomen.
The hesitation among the healthcare professionals to disclose this error raises serious ethical
concerns, particularly regarding patient safety, accountability, and transparency (Weprin et al.,
2021).



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3. Medical Error
According to Grossman et al. (2020), physicians have an ethical and moral responsibility to
disclose medical errors, regardless of their severity, to maintain patient trust and uphold
autonomy. In this case, Dr. Cutrite’s reluctance to inform Mrs. Jameson about the missing needle
protector violated the ethical principle of autonomy, which ensures that patients have the right to
make informed decisions regarding their care. Withholding this information undermines patient
trust and violates professional integrity.
Reducing Medical Errors
Rodziewicz et al. (2022) emphasize that healthcare systems should adopt systemic strategies to
minimize medical errors through improved communication, procedural standardization, and
organizational transparency. The surgical count discrepancy in this case highlights a systemic
failure in procedural checks and communication protocols, emphasizing the need for institutional
measures to prevent recurrence.
Moral Distress Among Healthcare Professionals
Dodek et al. (2022) discuss moral distress as a condition where healthcare professionals
experience ethical discomfort when unable to act according to their moral values. The operating
room supervisor’s reluctance to report the incident indicates potential moral distress. Addressing
this through ethical support programs and an open reporting culture can foster a healthier ethical
climate within healthcare institutions.

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4. Effectiveness of Communication
Communication in the Missing Needle Protector case was notably ineffective. The operating
room supervisor’s informal and unstructured communication approach failed to convey the
urgency and seriousness of the issue, resulting in delays in patient care (Etherington et al., 2019).
Similarly, E.L. Straight’s response was inadequate and unethical; rather than prioritizing patient
safety, he suggested a misleading reason to recall the patient for further examination (Waheed &
Council, 2019). Dr. Cutrite’s refusal to disclose the incident was a direct violation of informed
consent and veracity—two fundamental ethical obligations in healthcare (Gossman et al., 2022).
To ensure ethical and effective communication, healthcare professionals must practice openness,
maintain professionalism, promptly report errors, and adhere to both legal and ethical standards
(Roodbeen et al., 2020).

Effectiveness of the Approach
The healthcare professionals’ approach in this case reflects deficiencies in moral awareness,
ethical behavior, and moral judgment.
Moral Awareness
The professionals recognized the potential harm to the patient but failed to act in accordance
with ethical obligations. Limited moral awareness prevented them from appreciating the full
ethical implications of their inaction (Čartolovni et al., 2021).
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5. Ethical Behavior
By withholding information from the patient, the healthcare professionals violated ethical
principles such as honesty, integrity, and respect for autonomy. The decision not to inform the
patient prioritized professional reputation over patient safety, directly conflicting with ethical
standards (Poruţiu et al., 2019).
Moral Judgment
The professionals exhibited poor moral judgment by choosing deception and concealment over
transparency and patient welfare. Their decision lacked ethical reasoning based on beneficence
and non-maleficence—the duty to do good and avoid harm (Hamer, 2019).

Ethical Decision-Making Model
An ethical decision-making model involves the integration of moral awareness, moral judgment,
and ethical behavior. Applying this framework to the case enables a structured resolution of the
ethical dilemma.
By recognizing the issue (moral awareness), evaluating the ethical consequences (moral
judgment), and acting with integrity (ethical behavior), healthcare professionals can make
patient-centered decisions that align with both ethical and professional standards (Van Der Zee et
al., 2021).
This structured model reinforces accountability, transparency, and patient safety—key
components of ethical healthcare practice.
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6. Effective and Ineffective Approaches
Effective Approach
An effective approach, grounded in ethical principles, would involve promptly reporting the
incident, disclosing it to the patient, and implementing corrective measures. Such transparency
would protect the patient, preserve the hospital’s reputation, and reinforce professional
credibility (Torabi et al., 2019).
Ineffective Approach
Conversely, concealing the incident, falsifying records, or ignoring the surgeon’s refusal to
disclose the error would lead to ethical, legal, and professional consequences. The patient could
experience harm, the hospital could face malpractice charges, and the professionals involved
could lose their integrity and public trust (Searle & Rice, 2020).

Ethical Principles Solution
The most ethically sound solution would be for E.L. Straight, the Director of Clinical Services,
to report the incident to the hospital’s risk management department and follow established
adverse event reporting protocols.


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7. This approach aligns with the ethical principles of:
 Beneficence: Acting in the best interest of the patient by ensuring appropriate care.
 Non-Maleficence: Preventing further harm through prompt reporting and intervention.
 Justice: Ensuring fair treatment and equal consideration for all patients (Varkey, 2021).
 Autonomy and Veracity: Upholding the patient’s right to know and make informed
choices while maintaining honesty and transparency (Olejarczyk & Young, 2022).
Following this ethical course of action fosters accountability, preserves trust, and ensures
compliance with both ethical and legal standards.

Conclusion
The Incident of the Missing Needle Protector underscores the essential role of ethical principles
in healthcare practice. Effective communication, transparency, and adherence to ethical
standards are vital in addressing medical errors. By applying principles such as beneficence, non-
maleficence, autonomy, justice, and veracity, healthcare professionals can navigate ethical
dilemmas while prioritizing patient well-being.
Commitment to these values strengthens professional credibility, enhances patient safety, and
ensures that healthcare decisions remain morally and legally defensible. Ethical decision-making
and integrity are, therefore, the cornerstones of professional nursing practice.


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