We have one resident in the long-term facility who has stage four cancer of spinal cord and he has been suffering from intense pain. Every time when I enter his room, he cries and implore to the god that he can minimize his suffering. He has prescription of hydromorphone 8 mg every 4 hourly PRN , oxycodone 5 mg every 6 hourly and 50 mcg of fentanyl path change every 3rd day. After giving all scheduled and PRN medicine his pain level remains same as before. When I see that patients I feel like to give highest dose of medicine as well as alternative pain management therapy so that he can have some comfort but ethically I have no right to do that. He is hospice but he has no comfort at all. Following are the nine steps of Uustal ethical decision making model. …show more content…
In my opinion cancer patients can alternative pain management and higher dose of pain medicine so that they can have some comfort during their stage of dying. Step 3: Take into consideration factors that relate to the situation and generate alternatives for resolving the dilemma. Alternatives would be prescription of different dose of PRN and regular pain medicines and alternative pain treatment such as implanted pain pumps, nerve block therapy, massage therapy, relaxation and guided imagery , chiropractic treatment and oncology rehabilitation so that level of pain can be minimized. Step 4: Examine and categorize the alternatives. Identify those that are consistent and inconsistent with your personal values. Availability of nerve block therapy, chiropractic treatment and high dose of pain medicine which will promote numbness, reduce sciatic nerve pain, minimize fatigue and decrease pain sensation. Similarly, implanted pain pumps which delivers a medicine directly to the spinal cord and symptoms can be controlled by smaller dose than needed dose with oral medication. Step 5: Predict all possible outcomes for those acceptable
Pain is neither objective nor seen or felt by anybody other than the person that is experiencing it. Pain is subjective, therefore there is no way to distinguish whether or not someone is hurting and the only and best measurement of pain is that what the patient says it is. In settings such as end of life care, patients present with many different disease processes and ultimately are there because they have an average of six months to live. Along with this stage in their lives, palliative care patients can encounter a myriad of symptoms, which can result in these patients experiencing tremendous physical and psychological suffering (Creedon & O’Regan, 2010, p. [ 257]). For patients requiring palliative care, pain is the most incapacitating of symptoms and in return unrelieved pain is the primary symptom that is feared most by these patients. So why has pain management not become the top priority when it comes to end of life care, considering this area is growing at an extraordinary rate as a result of an increasingly ageing population?
Through his discussion of quality of life and death, Singer offers ethical guidelines for the decision to refuse treatment to prolong life in the case of a terminal illness.
1. Identify the dilemma you are discussing and describe the choices the decision maker is facing.
Describe an ethical dilemma that could occur in your organization. Apply the ethical decision making model. Using the detailed analysis of alternative actions (Chapter 5, Table 5-1) create a table analyzing potential alternative solutions for your dilemma.
Abortion has been a political, social, and personal topic for many years now. The woman’s right to choose has become a law that is still debated, argued and fought over, even though it has been passed. This paper will examine a specific example where abortion is encouraged, identify the Christian world views beliefs and resolution as well as the consequences of such, and compare them with another option.
Pain is often controlled with NSAIDS such as Advil (Ibuprofen) and Naprosyn (naproxen). Your doctor may also prescribe opiates such as Codeine, Vicodin (hydrocodone-acetaminophen), or Oxycontin
This step depends on defining the right problem at the beginning of the process too create usable alternative to the objectives that will be used to make a decision. Identifying as many alternatives as possible will offer a wide range of possible solutions that can be used to make a decision. The alternatives selected should be the ones that will enable the decision made to achieve the objectives of the decision problem. Joan’s next step in the PrOACT decision making model is to understand the consequences and repercussion of every alternative identified. When she reaches this point of the PrOACT decision making model Joan can map the alternatives she selected for the objectives statement for her decision problem. At this point Joan can use decision matrix to identify the best alternative that can be used to accomplish the objectives of the problems she identified. The final step in Joan’s PrOACT decision making model is wrestling with trade-offs equalizing some alternative in order to apply the same weight when used in the decision making process. This is not a complex process but identifying similar items or process that can be weighted equally should be used when making trade-offs. This step involves identifying what will be given up by choosing one alternative comparatively to what will be given up by choosing another alternative for the decision that is being made.
Pain, which is defined in its widest sense as an emotion which is the opposite of pleasure (White, 2004, p.455), is one of the major symptoms of cancer, affecting a majority of sufferers at some point during their condition (De Conno & Caraceni, 1996, p.8). The World Health Organization (WHO, 2009, online) suggests that relief from pain may be achieved in more than 90 percent of patients; however, Fitzgibbon and Loeser (2010, p.190) stress that pain may often be undertreated, even in the UK. Foley and Abernathy (2008, p.2759) identify numerous barriers to effective pain management, among which are professional barriers such as inadequate knowledge of pain mechanisms, assessment and management strategies.
In order to address the above components, five decision making steps have to be put in place, these are; being attentive, being intelligent, being reasonable, being responsible, and being reflective. The first step, being attentive, involves evaluating the whole situation and coming up with the data and information about the problem at hand. In so doing the following questions are viewed; what facts to bear in mind, what direction to take so as to get the expected solution, and what is the main issue to work on. In the second step, being intelligent, the information is clearly studied to determine whether the collected data is revealing the correct details concerning the problem. Determine the stakeholde...
The right to die has raised many legal and ethical issues in the United States. We as a society rely on doctors in time of agony and discomfort because we believe in their healing capabilities. So when doctors deviate from the preservation of life and promote death, it creates an imbalance between what is ethical and what is best for the patient. The general rule of palliative care is to treat and care for patients, but when those patients are in a considerable amount of pain, should they not have the right to a choose their course of treatment? In this great nation, the greatest liberty that we have as humans is to live and die in our own right in accordance with our personal beliefs and free will.
Anti-inflammatory drugs such as non-steroidal anti-inflammatory medicines (NSAIDs) like ibuprofen, or oral steroids, to relieve inflammation. Epidural steroid injections - a steroid injection. Steroids, with their strong anti-inflammatory effects, are delivered at the origin of the inflamed sciatic nerve roots. Manual therapy, Osteopathy or Physiotherapy can be very effective, reduce the recovery time and helps to prevent further episodes of sciatica. Surgery may be required if the sciatic nerve pain is severe and has not been relieved with appropriate manual or medical treatments.
Write the six questions of the Wise Choice Process and answer each one as it relates to your situation.
Supports argue that patients who are terminally ill and in extreme pain should be able to ask for help from their physicians to seek relief; because it’s their duty to respect the patient’s autonomy. They rather seek a dignified death than live with pain and dependency. Even courts have found that just like how people have the right to refuse a medical treatment, there is a similar right to ask for
The next step is to choose the criteria that we are going to take into consideration. In my opinion, the most important criteria are the following (their order does not indicate their importance):
Terminal illnesses are most commonly associated with cancer, HIV and/or organ disorders. These diseases are known to debilitate the patient and cause extreme amounts of pain. This decision should be made entirely by the patient, as they are the ones dealing with the effects of these terminal illnesses. We can all understand that families and outsiders object to Euthanasia as an option, but the pain factor m...