This ethical scenario presents an 86 year old female with numerous health issues and chronic illnesses. Mrs. Boswell’s advancing Alzheimer’s disease makes it extremely difficult to initiate dialysis, leading her physician to conclude a poor quality of life. The ethical dilemma portrayed in this case is between nonmaleficence and autonomy. Health care workers should focus on promoting the patient’s overall wellbeing and weigh the benefits and risks of the course of action, while also considering what the family declares they want done. Since the patient is deemed unable to make decisions, the goal is to collaborate with family, assess patient quality of life, address prognosis, and establish realistic care goals.
The ethical principle of nonmaleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with nonmaleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, suffering of the patient and family would be evident. Autonomy is the right to making own decisions and freedom to choose a plan of action. When making decisions regarding treatment of another person, it is important to respect the expressed wishes of the individual. John says that his mother would want to live as long as she could, but questions arise related to her quality of life and perception of prolonged suffering by prolonging the dying process. In BOOK states that quality of life changes throughout one’s life ...
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...rs. Boswell’s dilemma has provided a circumstance to investigate nonmaleficence and autonomy. Knowing and applying ethical principles, provides people involved in patient care guidelines that are deemed right or reasonable. It is essential to maintain the highest standard of care while taking into account all elements of the situation. Ultimately, nonmaleficence was obtained while also achieving to maintain and support autonomy.
Works Cited
Pah-Lavan, Z. (2006). Alzheimer's disease: the road to oblivion. Journal of Community Nursing, 20(5), 4. Retrieved from EBSCOhost.
Griffith, R., & Tengnah, C. (2011). Determining a patient's best interests. British Journal of Community Nursing, 16(5), 250-253. Retrieved from EBSCOhost.
Charalambous, A. (2010). Good communication in end of life care. Journal of Community Nursing, 24(6), 12-14. Retrieved from EBSCOhost.
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.
Ethical principles is focused on the morals and values of the individual who has dementia (Cribb and Duncan, 2002) Decision made by family to have a person who has dementia to live in a residential home from their personal home can be seen as inconsiderate to the individual values. It is for the best for the decision to be made before the individual was ill, the family members will feel less guilty. In the event that circumstances of the family members are not capable of caring it is understandable (Curthbert and Quallington, 2008). On the other hand this could be the best decision as cares in residential homes have skills development to provide professional care (Nice, 2010). Naidoo and Willis (2009) stated that the consequential theory is there to measure the end result of action in this case considering the health and wellbeing of people with dementia. The pr...
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
In Sam’s Choice (Collins, 2010), Sam’s visiting nurse, Karen Collins, RN, faces an ethical dilemma where she has to choose either patient advocacy and autonomy or beneficence. As a retired veteran, Sam was very independent and determined to be able to stay in his own home and live his life on his own terms. After an injury, which resulted in hospitalization, however, a healthcare home nurse, Collins, was sent to his home to evaluate his health as well as his living situation. Upon this assessment, Collins determined that the best thing Sam could do for his health was to move to a long term-care facility or assisted living facility. This option, in Collins’ opinion, would have provided the most beneficence to Sam, which is an important ethical principle every nurse must consider when working with patients. Sometimes, however, patients do not share the same values as the nurse and choose to make their own decisions on what is best for their health. This was definitely the case with Sam; Collins writes, “to me, it was evident that a long-term-care facility was the best option for Sam—but obviously this wasn’t evident to him. So instead of trying to change his mind, I turned my attention
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.
Charlotte’s parents thought otherwise, the Ethics Advisory Committee had to get involved. The debate surrounded if the doctors were in the right to control the life of someone who were incapable of deciding themselves, or is it the parents right. The Ethics Advisory Committee, stated that the parents were superior to those of the hospital and the hospital should conduct with less painful test. Charlotte’s parents wanted the doctors to continue testing until it was determined that her life diffidently had no chance of remaining. Because, of Charlotte’s parents’ desires unfortunately caused Charlotte to die a painful death without her parents. If the patient is unable to speak for their selves, the family should be able to have some say in the medical treatment, however; if the doctors have tried everything they could do, the hospital should have final decisions whether or not the patient dies or treatment
Ethical framework bridges in the gaps of life-threatening signs and health care, inhibits a person...
In critical and complicating medical cases, family members often find it tedious to decide as to what mode or procedure of treatment is idyllic for the recovery of their patient. In such cases, well-qualified and medically educated can play a pivotal role in deciding the kind of treatment that should be given to the patient to enhance its recovery. In a contrary situation a nurse may know that administering a particular drug may improve the patient’s condition, but may be refrained from conducting the required action due to doctor’s absence or non-permission. There are numerous cases through which ethical dilemmas in the profession of nursing can be discussed. Nurses in order to remain within the defined boundaries ...
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
Autonomy is identified as another professional value and one that the nurse must possess. Autonomy is the right to self-determination. Nurse’s respect the patient’s right to make a decision regarding their healthcare. Practical application includes, educating patients and their families on their choices, honoring their right to make their own decision and stay in control of their health, developing care plans in collaboration with the patient (Taylor, C. Lillis, C. LeMone, P. Lynn, P,
Utilitarianism is the ethical and moral philosophy that has a tendency to grant people the full benefit. In this case; it is not only advantage for the facility, but also the patient who is affected. The act seeks to maximize utility of an action rather than on its fundamental of the basis Utilitarianism is built on the theory that promotes happiness and satisfaction through the eyes of majority. This concept is stated as, "the greatest good of the greatest number" (pg.36). The purpose of this paper is to discuss the code of ethics and how it affects the patients if not followed and personal reaction on the Bayless and the nurse situation.
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.
The American Nurses Association Code of Ethics for Nurses has five elements that pertain to the Principle of Autonomy. Each individual element applies to “respect individual persons” (Baillie, McGeehan, Garrett T, M., Garrett R. M., 2013, p.33). In Chapter 2 of the Health Care ethics: Principles and problems text, it discusses thouroghly the consent of an individual to make their own decisions regarding their health and future requests of care. As a nurse or within all heath care professions, we must treat each individual patient with care, respect, and to remain mindful to the patient regarding any aspect of their lives. In the ANA Code of Ethics for Nurses, it explains ways of maintaining the empathy required in the health field. It further discusses that the respect for human dignity must be a priority, relationships to patients must remain neutral, the severity of the situation, the right to self-rule, and the professionalism that must be upheld by the nurse and their associates.
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.