Healthcare Advocacy through Bioethical Decision-Making Model

Patient Advocacy
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Introduction A resident nurse can become an advocate by working on behalf of patients to maintain quality care and protect their rights. This essay analyzes healthcare advocacy through the bioethical decision model and the role nurses play in clinical Advocacy. Case study. Mary is a patient that has recently suffered transverse myelitis, a rare, paralyzing illness, consequently keeping her hospitalized for over a month. Her insurance company sent her a letter preapproving the battery tests recommended by the doctors. When the tests were conducted, doctors realized that she had beriberi which is a vitamin deficiency condition. However, her insurance company deemed the second test as unnecessary and refused to pay for the treatment. Mary can't afford to pay for the tests and treatment; therefore, she discourages the resident nurse from ordering more tests. Her family is on the brink of declaring bankruptcy, and she says she would never have the tests done had she known the insurance would fail to pay. The resident nurse has encountered many situations like this, which are referred to as retrospective denial. Insurance companies need to provide preapprovals, sometimes called prior authorization, for their clients for various procedures, drugs, and tests (Weber, 2020). This is different from way back when preapprovals were required for only expensive and new procedures. When insurances revoke the decision to pay, the patient is left with the burden of funding the treatment. A nurse can choose to speak to the hospital management, the insurance company, the community, or the regional government on behalf of the patient. Advocacy can pressure insurance companies to do away with loopholes that allow them to change their mind on patient's procedures when treatment has begun. Bioethical Decision-Making Model Bioethics is a department that deals with ethical values, people's freedoms, an obligation to others, and the consequences of actions. The complexity in bioethics occurs because one ethical question can give rise to other ethical questions. The bioethical decision-making model is a strategic plan that helps individuals navigate ethical dilemmas. The model comprises six strategic steps that include; identifying the problem, conducting research, identifying stakeholders, identifying values, coming up with solutions, and evaluating the decision. Identifying the problem is the first step of the model. Certain questions regarding legal, social, and medical perspectives need to be asked to get to the root of the problem. In the above case study, advocates need to analyze the legalities that encourage insurance companies to choose what treatment procedures they deem necessary. Therefore, the nurse can identify the insurance company's failure as the reason Mary is not keen to continue with her subsequent treatments. The second step is researching the issue. Legal issues are the first approach that can be pursued to establish if the insurance company has breached any contractual agreement between them and a patient. Ethical values also come into question when analyzing the decisions made by the insurance company. Nurse advocates can be deterred from standing up for pat...