NHS FPX 4000 Asessment 3 Applying Ethical Principles

NHS FPX 4000 assessment 3 Applying Ethical Principles


Capella university

NHS FPX 4000 Developing a Health Care Perspective

Prof. Name


Applying Ethical Principles

In the case study of Timothy Collins, a 16-year-old battling aggressive leukemia, he expresses a desire to discontinue treatment and enter hospice care while his parents, Mr. and Mrs. Collins, seek alternative options. Dr. Angela Foster, his oncologist, must balance Timothy’s autonomy with his parent’s wishes, navigating conflicting ethical principles of beneficence and autonomy (Capella University, 2023). This assessment will delve into creating a possible ethical solution to tackle the moral dilemma raised in Timothy’s case.

Case Study Facts

In Timothy Collins’s case study, the stakeholders involved include Timothy himself, his parents, Mr. and Mrs. Collins, and Dr. Angela Foster, his primary oncologist. Timothy’s decision to discontinue treatment and enter hospice care, despite his parents’ desire to pursue alternative therapies, presents a complex ethical dilemma. The following facts are gathered by analyzing the case study, which has created an ethical dilemma:

Emotional Toll and Personal Beliefs

Timothy’s decision is influenced by the emotional toll of his illness and the desire for quality of life in his remaining time. Research in pediatric oncology emphasizes the significant emotional burden patients and families face in navigating end-of-life care decisions (Snaman et al., 2020). This evidence supports the analysis by highlighting the emotional complexities inherent in Timothy’s decision-making process. Additionally, Timothy’s personal beliefs and desires are pivotal in shaping his decision, underscoring the importance of respecting his autonomy and individual values in ethical decision-making.

Family Dynamics and Conflict

The Collins family dynamics contribute to the ethical dilemma, with Timothy’s parents advocating for continued treatment while Timothy desires to enter hospice care. Studies in pediatric oncology emphasize the importance of family-centered care and effective communication in navigating end-of-life decisions (Sansom-Daly et al., 2020). This research supports the analysis by highlighting the challenges posed by conflicting desires within families facing pediatric cancer, underscoring the need for open dialogue and shared decision-making.

Ethical Obligations of Healthcare Providers

Dr. Foster faces a complex ethical dilemma due to her dual obligation to respect Timothy’s autonomy while considering his parents’ wishes and the principles of beneficence and non-maleficence. Research on ethical decision-making in pediatric oncology underscores healthcare providers’ challenges in balancing patient autonomy with beneficence and non-maleficence (Akdeniz et al., 2021). This evidence supports the analysis by highlighting the ethical complexities inherent in Dr. Foster’s role, emphasizing the need to carefully consider Timothy’s best interests while respecting his autonomy and his family’s wishes.

Effectiveness of Communication Approaches in the Case Study

In the case study of Timothy Collins, Dr. Angela Foster, the primary oncologist, communicates with Timothy, his parents Mr. and Mrs. Collins, and potentially other healthcare professionals involved in Timothy’s care. Dr. Foster engages in open and empathetic dialogue with Timothy and his parents, acknowledging Timothy’s wishes and the concerns of his parents with compassion and understanding. She provides clear and comprehensive information about Timothy’s prognosis, treatment options, and the potential benefits and risks associated with hospice care and experimental treatments overseas.

Dr. Foster demonstrates effective communication by actively listening to Timothy and his parents, validating their emotions, and fostering a collaborative decision-making process. However, there may be instances where Dr. Foster’s communication is challenged, mainly when Timothy’s parents express their desire to pursue alternative treatments despite Timothy’s wishes. In such cases, Dr. Foster must navigate conflicting perspectives and ensure all parties feel heard and respected.

Practical communication approaches that should be emphasized include:

  • Empathetic listening: Dr. Foster should continue to listen attentively to Timothy and his parents, validating their emotions and concerns (Lizotte et al., 2020).
  • Transparency: Dr. Foster should provide clear and honest information about Timothy’s prognosis and treatment options, fostering informed decision-making (Gerber et al., 2020).
  • Shared decision-making: Dr. Foster should facilitate collaborative decision-making, ensuring that Timothy and his parents actively participate in the care process (Gerber et al., 2020).

NHS FPX 4000 assessment 3 Applying Ethical Principles

Conversely, communication approaches that should be avoided include:

  • Imposing judgments or biases: Dr. Foster should refrain from imposing her beliefs or values onto Timothy and his parents, ensuring their autonomy and preferences are respected (Carpenter & Vivas, 2020).
  • Ignoring or dismissing concerns: Dr. Foster should address any concerns or questions Timothy and his parents raised, demonstrating a willingness to engage in dialogue and address their needs (Carpenter & Vivas, 2020).

The consequences of using practical communication approaches include fostering trust and rapport between Dr. Foster and Timothy’s family, enhancing the quality of decision-making, and promoting Timothy’s well-being. Conversely, the consequences of using ineffective communication approaches may include undermining trust and rapport, exacerbating conflict or misunderstanding, and potentially compromising Timothy’s care and emotional well-being. Therefore, Dr. Foster must continue employing effective communication strategies to navigate the complex ethical dilemmas inherent in Timothy’s end-of-life care.

Effectiveness of the Approach to Ethical Practice in the Case Study

  • Moral Awareness: Dr. Foster demonstrates acute moral awareness by recognizing the ethical dilemma surrounding Timothy’s end-of-life care. She identifies the clash between Timothy’s autonomy and his parents’ desires for alternative treatments. Dr. Foster acknowledges that a decision must be made, setting the stage for moral judgment.
  • Moral Judgment: Utilizing moral judgment, Dr. Foster evaluates the situation based on medical evidence and ethical principles. She presents Timothy and his parents with the grim prognosis and the limited efficacy of further treatments, advocating for Timothy’s right to make decisions about his care. 
  • Ethical Behavior: Dr. Foster’s moral behavior is evident in her respect for Timothy’s autonomy and her efforts to engage in open dialogue with him and his parents. However, Dr. Foster’s ethical decision is pending and unresolved, considering the complex situation where she has 

The consequences of practical and non-effective approaches in ethical practice can be profound. Suppose Dr. Foster incorporates a more holistic and empathetic dialogue into her moral behavior. In that case, she could better understand Timothy and his parents’ perspectives, potentially leading to a resolution that respects Timothy’s autonomy while addressing his parents’ concerns. On the other hand, if Dr. Foster continues to rely solely on medical evidence without fully addressing the emotional and psychological aspects of the situation, Timothy’s end-of-life care decisions may remain unfulfilled, exacerbating the ethical dilemma and potentially impacting Timothy’s well-being (Lizotte et al., 2020). Therefore, Dr. Foster must integrate emotional intelligence and moral considerations into her practice to resolve the ethical dilemma more effectively.

Applying Ethical Principles to a Possible Solution

One possible solution to the ethical dilemma presented in Timothy Collins’ case study is to engage in a family meeting facilitated by Dr. Foster. In this meeting, Timothy, his parents, and potentially other healthcare professionals involved in his care can openly discuss their perspectives, concerns, and preferences regarding his end-of-life care (Gerber et al., 2020). During this meeting, Dr. Foster can provide clear and comprehensive information about Timothy’s prognosis, treatment options, and the potential benefits and risks associated with hospice care versus continuing aggressive treatments.

This proposed solution is based on ethical principles such as respect for autonomy, beneficence, informed decision-making, and non-maleficence. By facilitating open dialogue and shared decision-making, Dr. Foster respects Timothy’s autonomy and empowers him to participate actively in the decision-making process regarding his end-of-life care (Gerber et al., 2020). Additionally, by providing precise and comprehensive information about Timothy’s prognosis and treatment options, Dr. Foster ensures that Timothy and his parents are fully informed, enabling them to make decisions that are in Timothy’s best interests and aligned with their values and preferences (Lizotte et al., 2020).

By bringing together Timothy, his parents, and potentially other healthcare professionals, such as medical ethicists, pediatric oncologists, hospital administration, and public health representatives, in a collaborative decision-making process, Dr. Foster promotes mutual understanding, trust, and respect among team members. This collaborative approach encourages interdisciplinary communication and cooperation, ultimately enhancing the quality of care provided to Timothy. In summary, this proposed solution seeks to reconcile conflicting ethical principles and the interests of various stakeholders, offering a more nuanced and cooperative strategy for addressing the moral quandary presented in Timothy’s case.


Akdeniz, M., Yardımcı, B., & Kavukcu, E. (2021). Ethical considerations at the end-of-life care. SAGE Open Medicine9(9). https://doi.org/10.1177/20503121211000918

Capella University (2023). Ethical Case Studies. Capella Library Online.

Carpenter, T., & Vivas, L. (2020). Ethical arguments against coercing provider participation in maid (medical assistance in dying) in Ontario, Canada. BMC Medical Ethics21(1). https://doi.org/10.1186/s12910-020-00486-2

Gerber, K., Lemmon, C., Williams, S., Watt, J., Panayiotou, A., Batchelor, F., Hayes, B., & Brijnath, B. (2020). “There for me”: A qualitative study of family communication and decision-making in end-of-life care for older people. Progress in Palliative Care28(6), 1–8. https://doi.org/10.1080/09699260.2020.1767437 

NHS FPX 4000 assessment 3 Applying Ethical Principles

Lizotte, M.-H., Barrington, K. J., Sultan, S., Pennaforte, T., Moussa, A., Lachance, C., Sureau, M., Zao, Y., & Janvier, A. (2020). Techniques to communicate better with parents during end-of-life scenarios in neonatology. Pediatrics145(2). https://doi.org/10.1542/peds.2019-1925 

Sansom-Daly, U. M., Wakefield, C. E., Patterson, P., Cohn, R. J., Rosenberg, A. R., Wiener, L., & Fardell, J. E. (2020). End-of-Life communication needs for adolescents and young adults with cancer: Recommendations for research and practice. Journal of Adolescent and Young Adult Oncology9(2), 157–165. https://doi.org/10.1089/jayao.2019.0084 

Snaman, J., McCarthy, S., Wiener, L., & Wolfe, J. (2020). Pediatric palliative care in oncology. Journal of Clinical Oncology38(9), JCO.18.02331. https://doi.org/10.1200/jco.18.0233


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