NHS FPX 4000 Assessment 3 Applying Ethical Principles

NHS FPX 4000 Assessment 3 Applying Ethical Principles

NHS FPX 4000 Assessment 3 Applying Ethical Principles

Applying Ethical Principles

Healthcare professionals face numerous ethical dilemmas in their day-to-day practice. These dilemmas can arise due to various factors such as financial constraints, resource allocation, patient autonomy, and conflicting values. Ethical decision-making is a critical aspect of healthcare practice as it involves balancing the interests of patients, healthcare providers, and society at large. This assessment focuses on a case study of the Incident of the Missing Needle Protector and requires the application of ethical principles to propose a solution to the ethical dilemma faced by the healthcare professionals involved (Robert et al., 2020).

The assessment will analyze the facts of the case, discuss the effectiveness of communication approaches used, and apply ethical principles to a possible solution to the proposed problem or issue. The ultimate goal is to develop a method for formulating ethical decisions in healthcare practice that is fair, equitable, and defensible.

Facts of a Case Study

The Incident of the Missing Needle Protector case study raises several ethical dilemmas, including the potential harm caused by the needle protector left inside the patient’s belly and the reluctance of healthcare professionals to report the error. To assess the facts of the case study, the following peer-reviewed articles provide evidence to support the analysis (Weprin et al., 2021).

Medical Error

The first article, Ethical Issues for Physicians, by Grossman et al., (2020), highlights the ethical principles involved in medical errors. According to the article, physicians have a moral duty to disclose errors to their patients, including any potential harm caused by the error. In this case study, Dr. Cutrite’s reluctance to inform Mrs. Jameson about the missing needle protector violates the ethical principle of patient autonomy, which involves respecting patients’ right to make informed decisions about their healthcare.

Reducing Medical Errors

The first article, A Systematic Review of the Evidence, by Rodziewicz et al., (2022), discusses the importance of a systems approach to reducing medical errors. The article argues that healthcare organizations should implement measures such as standardizing procedures and improving communication to reduce the risk of errors. In this case study, the discrepancy in the surgical count suggests a breakdown in the healthcare system’s processes, indicating a need for a systemic approach to error prevention.

Moral Distress in Healthcare Professionals

The third article, A Call to Action by Dodek et al., (2022), discusses the ethical implications of healthcare professionals’ moral distress, which can occur when they are unable to provide care that aligns with their ethical values. In this case study, the operating room supervisor’s reluctance to report the error suggests that she may be experiencing moral distress. Addressing moral distress in healthcare professionals can improve the ethical climate of healthcare organizations and reduce the risk of errors.

Effectiveness of the Communication

The communication approaches in the case study Incident of the Missing Needle Protector are inadequate and ineffective. In the case study, the operating room supervisor appeared at Straight’s office to report the problem of the missing needle protector in a patient’s belly. However, the communication approach used by the supervisor was nonchalant and lacked professionalism. This approach can lead to misunderstandings and delays in addressing the problem (Etherington et al., 2019). NHS FPX 4000 Assessment 3 Applying Ethical Principles.

Straight’s response to the situation was also inadequate. Instead of immediately taking action to retrieve the needle protector, he suggested that they bring the patient back to the hospital under the guise of checking her incision and deep sutures. This approach was unethical and could lead to further complications for the patient (Waheed & Council, 2019).

Dr. Cutrite’s approach to the situation was also unethical. He refused to tell the patient about the problem and claimed that leaving the needle protector in her belly would not hurt her. This approach is not only unethical but also illegal. It violates the principle of informed consent, which requires healthcare professionals to inform patients of any potential risks associated with their treatment (Gossman et al., 2022).

The communication approaches used in the Incident of the Missing Needle Protector case study were ineffective and unprofessional. To improve communication, healthcare professionals should prioritize patient safety, use a clear and direct approach when reporting problems, follow ethical and legal guidelines, inform patients of any potential risks, involve patients in the decision-making process, and work together to find solutions to problems (Roodbeen et al., 2020).

Effectiveness of the Approach

The approach used by the professional in the case study of the Missing Needle Protector can be analyzed in terms of moral awareness, ethical behavior, and moral judgment. In terms of moral awareness, the professional was aware of the ethical implications of the missing needle protector but failed to address the issue directly with the surgeon or the patient. The professional’s moral awareness was limited, and they failed to recognize the potential harm to the patient and the ethical responsibilities that come with their profession (Čartolovni et al., 2021).

Ethical Behavior

In terms of ethical behavior, the professional’s approach was ineffective and unprofessional. The surgeon did not acknowledge the autonomy of the patient and took the decision on her behalf and did not tell her about the missing needle.  This approach violates ethical principles such as honesty, and integrity. The professional’s behavior was not consistent with the ethical standards expected of healthcare professionals, and it potentially put the patient’s well-being at risk (Poruţiu et al., 2019).

Moral Judgment and Awareness

In terms of moral judgment, the professional’s approach can be considered deficient. Their actions were not based on moral principles like doing good, not doing harm, and respecting people’s rights. The professional’s decision to revise the medical record and ignore the surgeon’s refusal was not based on sound ethical reasoning and did not consider the potential harm to the patient. This approach lacked moral judgment and was not consistent with the ethical decision-making model (Hamer, 2019). By being morally aware, the doctor and hospitals’ staff can make the right decision.

Ethical Decision-Making Model

The ethical decision model involves moral awareness, ethical behavior and moral judgment The case study of the Lost Needle Protector demonstrated the successful application of the ethical decision-making methodology.  The healthcare professional demonstrated moral awareness by recognizing the ethical dilemma, moral judgment by weighing the potential consequences of each possible solution, and ethical behavior by proposing a solution that prioritized the patient’s well-being and autonomy while upholding professional responsibilities and ethical obligations. The consequences of using effective and ineffective approaches were also discussed, highlighting the importance of ethical decision-making in healthcare to ensure patient safety, uphold professional responsibilities and obligations, and maintain the credibility of the healthcare profession (Van Der Zee et al., 2021).

Effective and Non-Effective Approaches

The consequences of using an effective approach based on the ethical decision-making model could have been positive for the patient, the hospital, and the healthcare professional. The patient would have received the necessary medical attention to remove the missing needle protector, and the hospital would have avoided the legal and ethical consequences of malpractice. NHS FPX 4000 Assessment 3 Applying Ethical Principles. Moreover, the healthcare professional would have upheld her professional and ethical responsibilities and avoided violating the ethical principles of honesty, integrity, and beneficence (Torabi et al., 2019).

On the other hand, the consequences of using an ineffective approach, such as revising the patient’s medical record or ignoring Dr. Cutrite’s refusal, could have been detrimental to the patient, the hospital, and the healthcare professional’s reputation. The patient could have suffered from health complications, and the hospital could have faced legal and ethical consequences of malpractice. Furthermore, the healthcare professional could have violated her professional and ethical responsibilities, which could have damaged her reputation and credibility in the healthcare profession (Searle & Rice, 2020). NHS FPX 4000 Assessment 3 Applying Ethical Principles

Ethical Principles Solution

A possible solution to the issue presented in the case study Incident of the Missing Needle Protector would be for the director of clinical services, E.L. Straight, to report the Incident to the hospital’s risk management team and to follow the hospital’s established protocol for reporting adverse events to the patient and their family.

NHS FPX 4000 Assessment 3 Applying Ethical Principles

This solution is based on ethical principles of beneficence, non-maleficence, and justice. To ensure the safety and well-being of patients, healthcare professionals must act in the best interest of their patients and report the Incident to their families. Non-maleficence requires healthcare professionals to not harm, and reporting the Incident can prevent potential harm to the patient. All patients should be treated fairly and equally by healthcare professionals. Reporting the Incident and following established protocols are important to make sure that all patients get the same level of care (Varkey, 2021).

Furthermore, this solution is consistent with the ethical principles of autonomy and veracity. Patient autonomy requires healthcare professionals to respect their right to make their own healthcare decisions, and letting the patient and their family know about a medical incident allows them to make an informed decision. Veracity requires healthcare professionals to tell the truth and not withhold information, and reporting the Incident is necessary to ensure that the patient and their family are fully informed about the potential harm caused by the missing needle protector (Olejarczyk & Young, 2022).


In conclusion of NHS FPX 4000 Assessment 3 Applying Ethical Principles, the case study of the Incident of the Missing Needle Protector highlights the importance of ethical decision-making, effective communication, and collaboration in healthcare. Through the application of ethical principles and values, healthcare professionals can arrive at justifiable solutions that prioritize the well-being and autonomy of the patient while also respecting their professional responsibilities. Effective communication and collaboration are essential to ensure that ethical principles are upheld and ethical dilemmas are addressed appropriately. By remaining committed to ethical principles and values in their practice, healthcare professionals can provide high-quality care and promote the well-being of patients.


Čartolovni, A., Stolt, M., Scott, P. A., & Suhonen, R. (2021). Moral injury in healthcare professionals: A scoping review and discussion. Nursing Ethics, 28(5), 096973302096677. https://doi.org/10.1177/0969733020966776

Dodek, P. M., Jameson, K., & Chevalier, J. M. (2022). New approach to assessing and addressing moral distress in intensive care unit personnel: A case study. Canadian Journal of Anesthesia, 69(10), 1240–1247. https://doi.org/10.1007/s12630-022-02307-z

Etherington, N., Wu, M., Cheng-Boivin, O., Larrigan, S., & Boet, S. (2019). Interprofessional communication in the operating room: A narrative review to advance research and practice. Canadian Journal of Anesthesia, 66(10), 1251–1260. https://doi.org/10.1007/s12630-019-01413-9

Gossman, W., Thornton, I., & Hipskind, J. E. (2022, June 11). Informed Consent. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK430827/

Grossman, S. A., Gurley, K. L., & Wolfe, R. E. (2020). The ethics of error in medicine. Rambam Maimonides Medical Journal, 11(4). https://doi.org/10.5041/rmmj.10406

Hamer, K. (2019). Deficient Professional Performance. Professional Conduct Casebook. https://doi.org/10.1093/oso/9780198817246.003.0018

Olejarczyk, J. P., & Young, M. (2022, November 28). Patient Rights and Ethics. National library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK538279/

Poruţiu, C. S., Pop, C. M., & Poruţiu, A. R. (2019). Ethical Behavior in Healthcare Organizations. Applied Ethics for Entrepreneurial Success: Recommendations for the Developing World, 71–79. https://doi.org/10.1007/978-3-030-17215-2_5

Robert, R., Kentish-Barnes, N., Boyer, A., Laurent, A., Azoulay, E., & Reignier, J. (2020). Ethical dilemmas due to the Covid-19 pandemic. Annals of Intensive Care, 10(1). https://doi.org/10.1186/s13613-020-00702-7

Rodziewicz, T. L., Hipskind, J. E., & Houseman, B. (2022, December 4). Medical Error Reduction and Prevention. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK499956/

Roodbeen, R., Vreke, A., Boland, G., Rademakers, J., van den Muijsenbergh, M., Noordman, J., & van Dulmen, S. (2020). Communication and shared decision-making with patients with limited health literacy; Helpful strategies, barriers and suggestions for improvement reported by hospital-based palliative care providers. PLOS ONE, 15(6). https://doi.org/10.1371/journal.pone.0234926

Searle, R. H., & Rice, C. (2020). Making an impact in healthcare contexts: insights from a mixed-methods study of professional misconduct. European Journal of Work and Organizational Psychology, 1–12. https://doi.org/10.1080/1359432x.2020.1850520

Torabi, M., Borhani, F., Abbaszadeh, A., & Atashzadeh-Shoorideh, F. (2019). Barriers to ethical decision-making for pre-hospital care professionals. Nursing Ethics, 096973301984804. https://doi.org/10.1177/0969733019848044

Van Der Zee, C., Poplazarova, T., & Delpire, V. (2021). Foundational Elements of an Ethical Decision-Making Model Applied in the Biopharmaceutical Context. Studia Universitatis Babeş-Bolyai Bioethica, 66(Special Issue), 178–179. https://doi.org/10.24193/subbbioethica.2021.spiss.122

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119

Waheed, A., & Council, M. (2019). Wound Closure Techniques. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK470598/

Weprin, S., Crocerossa, F., Meyer, D., Maddra, K., Valancy, D., Osardu, R., Kang, H. S., Moore, R. H., Carbonara, U., J. Kim, F., & Autorino, R. (2021). Risk factors and preventive strategies for unintentionally retained surgical sharps: A systematic review. Patient Safety in Surgery, 15(1). https://doi.org/10.1186/s13037-021-00297-3

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