Ethics: Deactivating a Cardiac Pacemaker: Is it Ethical? This paper will address the ethical dilemma of deactivating a cardiac pacemaker. While this issue seems ethically simple, it is in practice, incredibly complex in its ethical ramification. This paper will attempt to chart out these ethical implications particularly as they pertain to nursing. While it is not necessary to look at the precise mechanics of a pacemaker, it must be understood, first, that a pacemaker is an electronic device that is implanted in a patient’s chest and which regulates the beating of the heart through electric stimulus of that organ. The ethical dilemma involved in deactivating such a device can therefore be a life or death issue, since it is possible that deactivating a pacemaker in a patient with a weak heart could result in the death of that patient. However, the outcome of deactivation is not that certain. Bevins identifies three possibilities in the event of deactivation: "no discernible clinical consequences," immediate death, and "new symptoms that may accelerate death" (2011, p. 108). However, despite the possibility that deactivate might have "no discernable clinical consequences," the other two possibilties both entail the …show more content…
126). Here, again, the circumstances must be analyzed on a case by case basis, for it is easy to imagine a scenario in which deactivation would bring harm to the patient, since possible death can be viewed as harm especially if it’s possible that health may be gained. Some would consider this to be harm inherently. This is where the issue becomes tricky to evaluate ethically, where deactivation is an active harm, or a passive harm, or whether it constitutes harm at all. The ethical and moral framework of the practitioner, beyond legal and professional policy guidelines, then gives shapes to the appropriate
As a result, life-sustaining procedures such as ventilators, feeding tubes, and treatments for infectious and terminal diseases are developing. While these life-sustaining methods have positively influenced modern medicine, they also inadvertently cause terminal patients extensive pain and suffering. Previous to the development of life-sustaining procedures, many people died in the care of their own home, however, today the majority of Americans take their last breath lying in a hospital bed. As the advancement of modern medicine continues, physicians and patients are going to encounter life-altering trials and tribulations. Arguably, the most controversial debate in modern medicine is the discussion of the ethical choice for physician-assisted suicide.
Nurses everywhere face problems and challenges in practice. Most of the challenges occur due to a struggle with the use of ethical principles in patient care. Ethical principles are “basic and obvious moral truths that guide deliberation and action,” (Burkhardt, Nathaniel, 2014). Ethical principles that are used in nursing practice include autonomy, beneficence, non-maleficence, veracity, confidentiality, justice, and fidelity. These challenges not only affect them, but the quality of care they provide as well. According to the article, some of the most frequently occurring and most stressful ethical issues were protecting patient rights, autonomy and informed consent to treatment, staffing problems, advanced care planning, and surrogate decision making (Ulrich et. al, 2013). The ethical issue of inadequate staffing conflicts with the principle of non-maleficence.
In Josephine’s defense I would not consider her choice of stopping chemotherapy or removing her pacemaker euthanasia. She is simply discontinuing a treatment that is causing her continued pain and suffering. Her pacemaker is only adding to the prolonged suffering that her body can no longer endure. In her defense one could argue that her pace maker is a foreighn device in her body that when removed is not the cause of death but rather her tired body and heart would be the cause of her death.
During week 4, we became familiar with the application of ethics in the nursing practice settings. We learned about ethical theories and principles, which are crucial when practicing in any clinical settings during ethical decision-making and while facing one or multiple ethical dilemmas. Also, we were introduced to the MORAL model used in ethical decision – making progress. The MORAL model is the easiest model to use in the everyday clinical practice, for instance at bedside nursing. This model can be applyed in any clinical settings and its acronyms assist
...ns. Patients should not be so medically ill that they are unable to make this decision. Patients should be fully conscious and understand the implications of their decision. Everything should be documented possibly even videotaped that way the doctor doesn’t lose their job, receive a lawsuit or worst jail!
...d how these determinations effect a physician’s approach to various types of critically ill patients? These types of questions come in to play when one attempts to critically analyze the differences between the types of terminally ill patients and the subtle ethical/legal nuances between withholding and withdrawing treatment. According to a review by Larry Gostin and Robert Weir about Nancy Cruzan, “…courts examine the physician’s respect for the desires of the patient and the level of care administered. A rule forbidding physicians from discontinuing a treatment that could have been withheld initially will discourage doctors from attempting certain types of care and force them prematurely to allow a patient to die. Physicians must be free to exercise their best professional judgment, especially when facing the sensitive question of whether to administer treatment.”
In this essay the author will rationalize the relevance of professional, ethical and legal regulations in the practice of nursing. The author will discuss and analyze the chosen scenario and critically review the action taken in the expense of the patient and the care workers. In addition, the author will also evaluates the strength and limitations of the scenario in a broader issue with reasonable judgement supported by theories and principles of ethical and legal standards.
Barnett, Wilson J.(1986). Ethical Dilemmas in Nursing. Journal of Medical Ethics. Retrieved on 12th July 2010 from
Under the code of ethics for nurses this moral issue is also conflicting because you’re first and foremost obligation is to the patient. Now you also have your institution ethical code conduct that you also has to abide by. Provision 5. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth (ANA, 2001, p.18). In this case the nurse owes it to herself in making the right moral decision to preserve integrity and safety of patient and
This can be seen in the case study as ethical and legal arise in resuscitation settings, as every situation will have its differences it is essential that the paramedic has knowledge in the areas of health ethics and laws relating to providing health care. The laws can be interpreted differently and direction by state guidelines may be required. Paramedics face ethical decisions that they will be required to interpret themselves and act in a way that they believe is right. Obstacles arise such as families’ wishes for the patients’ outcome, communicating with the key stakeholders is imperative in making informed and good health practice decision. It could be argued that the paramedics in the case study acted in the best interest of the patient as there was no formal directive and they did not have enough information regarding the patients’ wishes in relation to the current situation. More consultation with the key stakeholders may have provided a better approach in reducing the stress and understanding of why the resuscitation was happening. Overall, ethically it could be argued that commencing resuscitation and terminating once appropriate information was available is the right thing to do for the
The purpose of this paper is to discuss nursing ethics. The paper will discuss: the history of ethics, definition, doctor/nurse being education about ethics in college, code of ethics, futile care and the confusion with DNR orders. Ethics needs to be recognized on all levels of healthcare such as doctors, nurses, patients and families. CINAHAL and PubMed search engines were utilized for . Many articles were presented with the initial search, expansion on keywords assisted in generating more specific articles.
Kasman, D. L. (2004). When is medical treatment futile? Journal of General Internal Medicine, 1053-1056.
life-sustaining treatment that a patient wants but that they deem "futile." or "inappropriate" or "inappropriate." Alarmingly, hospitals in California and throughout the country have begun. to implement these "futile-care" policies that state, in effect: "We reserve the right to refuse service. " Medical and bioethics journals for several years kept up a drumbeat. advocating the implementation of medical futility policies that hospitals for obvious reasons -- don't publicize.
Several ethical principles that are incorporated in the nursing care of patients on a daily basis are nonmalificence, autonomy, beneficence, justice, fidelity and paternalism. Nurses should strive to comply to as many of the principles as possible. In this case there are principles which support and conflict with the wishes of the patient. The first principle that supports the wish of the patient is autonomy. Autonomy means that competent patients have the right to make decisions for themselves and the delivery of the healthcare that they receive. Another factor that would support the patient’s wish to not be resuscitated is nonmalificence. Non maleficence means that nurses should not cause harm or injury to their patients. In this case the likelihood of injury after resuscitation was greater than if the patient were allowed to expire. A principle that could have negatively affected the outcome of the provision of ethical care was paternalism. Paternalism is when a healthcare provider feels that they know what is best for a patient, regardless of the patient’s desire for their own care. I demonstrated the principle of paternalism because I thought that I knew what was best for the patient without first consulting with the patient or family. This situation might have had some very negative consequences had the patient not have been competent. Practicing a paternalistic mindset might have caused a practitioner in the same instance to force their ideas about not resuscitating the loved one onto the family. This could have caused a sense of remorse and loss of control of care amongst the
Another huge ethical topic is the patient’s right to choose autonomy in the refusal of life-saving medicine or treatment. This issue affects a nurse’s standards of care and code of ethics. “The nurse owes the patient a duty of care and must act in accordance with this duty at all times, by respecting and supporting the patient’s right to accept or decline treatment” (Volinsky). In order for a patient to be able make these types of decisions they must first be deemed competent. While the choice of patient’s to refuse life-saving treatment may go against nursing ethical codes and beliefs to attempt and coerce them to get treatment is trespass and would conclude in legal action. “….then refusal of these interventions may be regarded as inappropriate, but in the case of a patient with capacity, the patient must have the ultimate authority to decide” (Volinsky). While my values of the worth of life and importance of action may be different than others, as a nurse I have to learn to set that aside and follow all codes of ethics whether I have a dilemma with them or not. Sometimes with ethics there is no right or wrong, but as a nurse we have to figure out where to draw the line in some cases.