Most Defensible Leadership Position
Based on current research, healthcare law, and recommended ethics best practices in dysphagia management
Option 1 - Support Shared Decision-Making
After weighing the pros and cons of each option, Sofia and Daniel decide that the most ethically defensible leadership approach uses the Rights Lens of applied ethics, which highlights shared decision-making grounded in informed consent. This approach recognizes that patients have the legal right to make informed healthcare decisions as protected by the Patient Self-Determination Act of 1990 (Teoli & Ghassemzadeh, 2023), even if those decisions result in harm to the patient.
“The duty of disclosure—and patients’ corresponding right to accept or refuse the choice(s) offered—applies to all patients whether or not medical practitioners agree that the decision is wise or unwise, or rational or irrational.”
Although a facility administrator like Sofia may think they’re reducing liability by limiting a patient’s ability to choose a potentially unsafe diet texture (Horner et al., 2016), they’re actually violating the patient’s federally protected rights to medical autonomy (Teoli & Ghazzemzadeh, 2023), which places the facility at risk of legal liability.
This approach recognizes that patients have a federally protected right to make informed choices about their heathcare (Teoli & Ghazzemzadeh, 2023).
This option recognizes that:
Safety matters
Risk mitigation matters
But autonomy matters too
Ethical leadership requires balancing:
Beneficence
Nonmaleficence
Dignity
Informed consent
Quality of life
Patient rights
A patient like Margaret should not lose the right to make medical decisions simply because those decisions involve risk.
Ethical leaders must create systems that:
support transparent communication
encourage patient participation
reduce coercion
educate interdisciplinary teams
normalize ethical complexity
Leadership is not about eliminating uncertainty.
It is about responding to uncertainty ethically.