Legal and Ethical Issues in Healthcare
N520-1
Ihuoma Aguoru
Dr. Martin
Aspen University
Mrs. R case Study.
Advanced directive: Is a living will that acknowledges one’s communicated wishes regarding their medical care at the end of life. Medical power of attorney (or healthcare proxy) allows you to assign someone you trust to be a surrogate, in making medical decisions for your personal interest.
87 year old female, Mrs. R, was hospitalized due to Aspiration pneumonia, unable to breathe properly and attached to a ventilator system. She also has other medical history such as advanced Alzheimer’s disease, CAD, and stroke. She is very much debilitated and unable to recognize her family members for some time. Family members are worried about the continuous ventilator attached to Mrs. R, because they believed that Mrs. R under normal circumstances would not allow such care. But her physician , Dr G. is requesting for the nurses to speak with the family about transferring patient to a bigger hospital for a progressive treatment that involves energetic cares such as physical therapy and rehabilitation for Mrs. R .because he does not believe in termination of care for any reason.
How nurses in this scenario might respond to this physician request.
Autonomy basically means “self rule,” and it is a patient’s most basic right. As such, it is the healthcare provider’s duty to respect the autonomy of their patients. Nevertheless, sometimes this type of case can be difficult because it can conflict with paternalistic attitude of many health care professionals such as DR .R. who does not believe in discontinuation of any type of life support system coupled with the fact that there was no advanced directive or medical power of attorney for Mrs.R, even though the family were trying to represent Mrs. R, with the decision making at this time. These nurses need to remind DR. G about patient autonomy and the fact that she is 87 year old and that family member stated that Mrs. R would not like this type of care if she was alert.
How this scenario would cause moral distress among the nursing staff
Morals: Are generally seen as appropriate for more routine decisions, but inadequate for resolving the more complex issues arising in clinical practice settings (Phillips, 2006). Thus, ethics describes conduct or principles while morals actually propose restrictions on what may be considered appropriate actions (Barrocas, Tarbrough, Becnel, & nelson, 2003). As evidenced on Mrs. R. case. Moral distress: Is the instinctive reaction caused by experiencing a situation that is entirely opposing to a profession or personal ethics, principles and standards. It can be an aggravating felling by the sense that injury or accident has or will occur and the person lacks the authority, the power or the ability to right the wrong, as evidenced by these nurses feeling helpless as a result of Dr .G. action and request towards Mrs. R’s treatment.
Positive actions that the nurses might begin to take to prevent moral distress
These nurse should first o f all identify that all nurses will likely experience moral distress in their place of work one way or other. And that when such situation happens, it is important to talk with counselors or colleagues to certain feelings and obtain perspectives. Healthy coping comes from finding techniques to apply in the situation for a constructive professional development, problem resolving and for assisting others that are experiencing the same issues. Better to channel the negative energy in to a positive one for a better change for everyone.
Exercise 4.1(Guido, p44) Solving the Moral dilemma on Mrs. Smith case
Health care providers have the misconception that ethical dilemmas only occur in life and death situations (Monteverde, 2009). The decision making method in such situation is time absorbing, requiring different meetings of hospital ethics committees. According to Kim, Park, Ahn, Oh and Han (2003), ethical dilemma is any situation that causes a nurse to feel conflicted about what action to take. Ethical dilemmas occur every day in nursing routine and for the most part needs a speedy and imaginative decision making on the part of the nurses.
Ethical D
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