Case Study Fetal Abnormalityjessica Is A 30 Year Old Immigrant From M ✓ Solved

Case Study: Fetal Abnormality Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome. Dr.

Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face.

She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud. Marco and Dr. Wilson continue their discussion, and Dr.

Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr.

Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears. Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred.

Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically†and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends†to take place and urges Jessica to think of her responsibility as a mother. © 2020. Grand Canyon University.

All Rights Reserved. Leadership Development Paper Student Name Dr. Kim Metcalf MG 5125 New England College Month, Year This paper is designed to allow you to examine your leadership skills based on what you have learned in this course and to develop a plan moving forward – hence the title of the paper being Leadership Development Plan . For this reason, this paper is to be a paper that you write about yourself based on what you have learned about yourself and your own research. That means do not copy someone else’s plan as your own, instead, write your own plan.

Introduction (I recommend writing this section after you have completed the paper) Provide a paragraph introduction that describes the components that will be presented in the paper. This shouldn’t be too detailed, just provide an overview of what you plan to cover. Analysis of Personal Leadership Skills Analyze your current leadership skills based on what you have learned from this course. Identify your primary style of leadership and identify 2 leadership theories/styles that would be beneficial to your current/future leadership role. Summary of Leadership Theories Summarize your understanding of both leadership theories/styles.

Explain how you would apply both to make you a more effective leader and illustrate 2 positive outcomes that you would expect to occur from each. Analysis of Results from Authentic Leadership & Emotional Intelligence Assessments Summarize results from each of the two assessments you have taken this term and identify 2 areas within each assessment you wish to further develop. Identify how you will develop each over the next year and explain how it will make you a more effective leader. Illustrate 2 positive outcomes that you would expect to occur from developing each of these areas further. Development of Personal Leadership Philosophy Develop a personal leadership philosophy and support your ideas with material from this course and outside research.

Provide an example where your leadership philosophy can be applied to lead an organizational change. Consider your leadership style, personality, career path and the industry you work in (or wish to work in) and determine which skills will be most effective. Think about your trajectory of leadership as it applies to your career aspirations, and from that develop a philosophy that aligns with your goals. Conclusion (I recommend writing this section after you have completed the paper) In this section you are to provide an overview of the whole paper and tie it back to what you said you would cover in the introduction. As a rule this section is usually written in past tense.

References Your minimum of (6) scholarly references belong on a new page Reminders: · The paper is to be double-spaced and a maximum of 6-8 pages (not including the title page and reference pages). · All references are to be used in the paper as in-text citations and do not list any references that are not cited in the paper · References as well as citations are to follow 7th edition APA format · Grammar and spell check papers before uploading them · A title page and reference page must be included · Any papers without a name will require a revision for a maximum grade of A- · Any papers missing headings will require revision for a maximum grade of B 280 LEADERSHIP THEORY AND PRACTICE Authentic Leadership Self-Assessment Questionnaire Instructions: This questionnaire contains items about different dimensions of authentic leadership.

There are no right or wrong responses, so please answer honestly. Use the following scale when responding to each statement by writ- ing the number from the scale below that you feel most accurately character- izes your response to the statement. Key: 1 = Strongly 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly disagree agree 1. I can list my three greatest weaknesses. . My actions reflect my core values. .

I seek others’ opinions before making up my own mind. . I openly share my feelings with others. . I can list my three greatest strengths. . I do not allow group pressure to control me. . I listen closely to the ideas of those who disagree with me.

8. I let others know who I truly am as a person. . I seek feedback as a way of understanding who I really am as a person. 10. Other people know where I stand on controversial issues.

11. I do not emphasize my own point of view at the expense of others. 12. I rarely present a “false†front to others. . I accept the feelings I have about myself. .

My morals guide what I do as a leader. . I listen very carefully to the ideas of others before making decisions. 16. I admit my mistakes to others. Scoring 1.

Sum the responses on items 1, 5, 9, and 13 (self-awareness). 2. Sum the responses on items 2, 6, 10, and 14 (internalized moral perspective). 3. Sum the responses on items 3, 7, 11, and 15 (balanced processing).

4. Sum the responses on items 4, 8, 12, and 16 (relational transparency). Chapter 11 Authentic Leadership 281 Total Scores Self-Awareness: ______ Internalized Moral Perspective: _____ Balanced Processing: _____ Relational Transparency: _____ Scoring Interpretation This self-assessment questionnaire is designed to measure your authentic leadership by assessing four components of the process: self-awareness, inter- nalized moral perspective, balanced processing, and relational transparency. By comparing your scores on each of these components, you can determine which are your stronger and which are your weaker components in each cat- egory. You can interpret your authentic leadership scores using the following guideline: high = 16–20 and low = 15 and below.

Scores in the upper range indicate stronger authentic leadership, whereas scores in the lower range indi- cate weaker authentic leadership. Leading with Emotional Intelligence This self-assessment questionnaire is designed to get you thinking about the various competencies of emotional intelligence as they apply to you. Daniel Goleman first brought ‘emotional intelligence’ to a wide audience with his 1995. He found that while qualities traditionally associated with leadership such as intelligence, toughness, determination and vision are required for success, they are insufficient. Truly effective leaders are also distinguished by a high degree of emotional intelligence, which includes: Self-awareness The ability to recognize what you are feeling, to understand your habitual emotional responses to events and to recognize how your emotions affect your behavior and performance.

When you are self-aware, you see yourself as others see you, and you have a good sense of your own abilities and limitations. Managing emotions The ability to stay focused and think clearly even when experiencing powerful emotions. Being able to manage your own emotional state is essential for taking responsibility for your actions, and can save you from hasty decisions that you later regret. Motivating oneself The ability to use your deepest emotions to move and guide you towards your goals. This ability enables you to take the initiative and to persevere in the face of obstacles and setback.

Empathy The ability to sense, understand and respond to what other people are feeling. Self-awareness is essential to having empathy with others. If you are not aware of your own emotions, you will not be able to read the emotions of others. Social Skill The ability to manage, influence, and inspire emotions in others. Being able to handle emotions in relationships and being able to influence and inspire others are essential foundation skills for successful teamwork and leadership.

Prior to our face-to-face session this week, please complete the following assessment. Step #1 For the following questionnaire you will assess and score each of the statements. The assessment provides you a range from 1- 5. Score your assessment using a scale where: 1 indicates that the statement does NOT apply at all 3 indicates that the statement applies about half of the time 5 indicates that the statement ALWAYS applies to you Step #2 Transfer your scores to the calculation table and total your results. Keep in mind that this is not a psychometric test and the answers you give are likely to vary depending on your mood when you take it.

Step #3 Consider your results and identify one or two actions you can take immediately to strengthen your emotional intelligence. # How much does each statement apply to you Mark your score Read each statement and decide how strongly the statement applies to YOU. Score yourself 1 to 5 based on the following: 1 = Does NOT apply 3 = applies half the time 5 = ALWAYS applies the number that reflects how strongly the statement applies 1 I realize immediately when I lose my temper I can reframe bad situations quickly I am always able to motivate myself to do difficult tasks I am always able to see things from the other person’s viewpoint I am an excellent listener I know when I am happy I do not wear my heart on my sleeve I am usually able to prioritize important activities at work and complete them I am excellent at empathizing with someone else’s problems I never interrupt other peoples’ conversations I usually recognize when I am stressed Others can rarely tell what kind of mood I am in I always meet deadlines I can tell if someone is not happy with me I am good at adapting and mixing with a variety of people When I am being emotional I am aware of this I rarely fly off the handle at other people I never waste time I can tell if a team of people are not getting along with each other People are the most interesting thing in life for me When I feel anxious I usually can account for the reason(s) Difficult people do not annoy me I do not speak or act in an evasive way I can usually understand why people are being difficult towards me I love to meet new people and get to know what makes them tick # How much does each statement apply to you Mark your score Read each statement and decide how strongly the statement applies to YOU.

Score yourself 1 to 5 based on the following: 1 = Does NOT apply 3 = applies half the time 5 = ALWAYS applies the number that reflects how strongly the statement applies 26 I always know when I am being unreasonable I can consciously alter my frame of mind or mood I believe you should do the difficult things first Other individuals are not difficult, just different I need a variety of work colleagues to make my job interesting Awareness of my own emotions is very important to me at all times I do not let stressful situations or people affect me once I have left work Delayed gratification is a virtue that I hold to I can understand if I am being unreasonable I like to ask questions to find out what is important to people I can tell if someone has upset or annoyed me I rarely worry about work or life in general I believe in being driven and focused to make things happen I can understand why my actions sometimes offend others I see working with difficult people as simply a challenge to win them over I can let anger go quickly so that it no longer affects me I can suppress my emotions when I need to I can always motivate myself even when I feel low I can sometimes see things from others’ point of view I am good at reconciling difference with other people I know what makes me happy Others often do not know how I am feeling about things Motivations has been the key to my success Reasons for disagreements are always clear to me I generally build solid relationships with those I work with Step #4 Total and interpret your results Record your 1, 2, 3, 4, 5 scores for the questionnaire statements in the grid below.

The grid organizes the statements into emotional competency lists. Self-awareness Managing emotions Motivating oneself Empathy Social skill Step #5 Calculate a total for each of the five (5) emotional competencies. Total = (SA) Total = (ME) Total = (MO) Total = (EM) Total = (SS) Step #6 Interpret your totals for each area of competency using the guide and record your results for each. 35-50 This area is a strength for you. 18-34 Direct focus to where you feel you need attention 10-17 Make this area a developmental priority Strength Needs attention Developmental Priority Self-awareness Managing emotions Motivating oneself Empathy Social Skill Step #7 Reflect on your results and identify one or two actions you can take today to strengthen your emotional intelligence Adapted from Leading Across London Emotional Intelligence questionnaire (2018)

Paper for above instructions

Introduction

The case study involving Jessica and Marco highlights complex issues in prenatal care, cultural beliefs, medical ethics, and personal autonomy. At the crux of the situation is the diagnosis of a fetal abnormality and the differing perspectives of the family, healthcare provider, and extended family on how to handle this crisis. This paper will examine the ethical principles involved in Jessica’s scenario, the implications of informed consent, and the influences of cultural beliefs on decision-making in healthcare. In doing so, this analysis will incorporate relevant literature to delineate the responsibilities of healthcare providers in ensuring patient autonomy while being sensitive to the sociocultural dynamics involved.

Ethical Principles in Prenatal Care

Ethical principles are fundamental in the medical profession, particularly when addressing sensitive issues such as fetal abnormalities. The four guiding ethical principles are autonomy, beneficence, non-maleficence, and justice (Beauchamp & Childress, 2019).

Autonomy

Jessica's autonomy as a patient is paramount. According to Beauchamp and Childress (2019), autonomy refers to the right of patients to make informed choices regarding their medical care. However, Marco’s insistence on withholding information from Jessica poses a significant ethical dilemma. The ethical principle of autonomy suggests that patients should have access to all relevant information to make informed decisions about their health and that healthcare providers should respect patients' rights to make choices concerning their care (Gillon, 1994). Dr. Wilson's frustration about having to breach this autonomy to reveal the diagnosis acts as a conflicting force in the case.

Beneficence and Non-maleficence

These two principles are often seen as complementary. Beneficence refers to acting in the best interest of the patient, while non-maleficence pertains to the duty to avoid harm (Beauchamp & Childress, 2019). Dr. Wilson believes that presenting all options, including abortion, is essential for Jessica’s well-being and aligns with both beneficence and non-maleficence—the hope being to prevent undue suffering resulting from the implications of raising a child with severe disabilities (Daniels, 2008).
However, it is vital to consider Jessica’s emotional well-being. If the disclosure of her fetus’s condition leads to immediate distress—and could be viewed as harm—Dr. Wilson must weigh the potential psychological impact against the ethical obligation to inform her fully.

Justice

The principle of justice refers to fairness in the distribution of healthcare resources and treatment (Beauchamp & Childress, 2019). This case could also touch upon social justice issues related to Jessica's immigrant status and economic situation, which may influence her access to healthcare and support systems. It underscores the importance of considering broader social determinants of health when discussing medical interventions and treatment options (Kawachi & Berkman, 2000).

The Role of Informed Consent

Informed consent is not merely a formality but a critical ethical and legal requirement in healthcare (Faden & Beauchamp, 1986). It necessitates that patients receive comprehensive information regarding their diagnosis, prognosis, and options for treatment. In this case, withholding information from Jessica constitutes a significant breach of informed consent.

Impacts of Informed Consent on Decision-Making

Dr. Wilson’s responsibility is not solely to present the medical facts but also to ensure that Jessica can make an independent choice about her pregnancy. By facilitating an open dialogue, he would not only be honoring Jessica’s autonomy but also empowering her to arrive at a decision that aligns with her values and beliefs (Parker, 2018).
Moreover, the discussions surrounding abortion may be inherently complex, given Jessica's cultural background. Women from different cultural backgrounds often experience differing pressures when faced with unwanted pregnancies, and their values and beliefs regarding motherhood may significantly impact their decision-making (Cheng et al., 2018). Dr. Wilson should actively engage Jessica, providing her with comprehensive information while allowing for exploratory discussions about her values and beliefs.

Cultural Considerations

Cultural competencies in healthcare are crucial, particularly in a plurality like the United States. Jessica’s support system, exemplified by Aunt Maria's passionate insistence on carrying the pregnancy to term, may reflect traditional beliefs rooted in their culture. Many cultures hold diverse views regarding disability and motherhood, often mobilizing community and familial support instead of focusing solely on clinical assessments (Cohen et al., 2021).

Impact on Healthcare Delivery

Healthcare providers must understand and respect these dynamics, which sometimes conflict with established medical practices and principles. It’s vital for Dr. Wilson to navigate this delicate balance as he interacts with Jessica and her family. Cultural competence entails understanding and navigating these values and providing care that not only respects patients’ rights but also aligns with their cultural beliefs and values (Brach & Fraserirector, 2000).

Conclusion

This case illustrates the moral and ethical complexities in healthcare, particularly around issues of informed consent and cultural sensitivity. Healthcare providers must navigate these challenges, ensuring they respect patient autonomy while also acting in the best interests of the patients under their care. The interplay of cultural beliefs, family dynamics, and individual rights presents a multifaceted scenario that requires sensitivity, understanding, and ethical reflection. Upholding these values will not only assist practitioners and patients but improve overall healthcare delivery in multicultural settings.

References

Brach, C., & Fraserirector, I. (2000). Can cultural competency reduce racial and ethnic health disparities? A Review and Conceptual Model. Medical Care Research and Review, 57(1), 181-217.
Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press.
Cheng, H. Y., Sidhu, R., & Cohn, J. (2018). Women’s decisions regarding abortion: a review of the literature. Journal of Women's Health, 27(5), 681-692.
Cohen, J., & Geller, H. (2021). Family Dynamics in Prenatal Counseling: Cultural and Personal Perspectives. Journal of Genetic Counseling, 30(1), 128-134.
Daniels, N. (2008). Just Health: Meeting Health Needs Fairly. Cambridge University Press.
Faden, R. R., & Beauchamp, T. L. (1986). A History and Theory of Informed Consent. Oxford University Press.
Gillon, R. (1994). Medical ethics: Four principles plus attention to scope. BMJ, 309(6948), 184-188.
Kawachi, I., & Berkman, L. F. (2000). Social cohesion, social capital, and health. Social Epidemiology, 174-190.
Parker, L. (2018). Models of patient autonomy in healthcare decision making. Medical Humanities, 44(1), 26-32.