The purpose of the article, “Ethical Dilemmas in the Intensive Care Unit,” is to discuss two important ethical issues that health care workers in the intensive care units face. The first dilemma is treating a nonverbal patient, the second being medical futility. I chose this article because I intend to go into the critical care field once I finish nursing school. I also felt the topic of medical futility was of great important with recent headlines in the news regarding Brittany Maynard. Critical Care health workers are facing a growing patient population; this increase in patients leads to an increase in ethical issues and dilemmas surrounding the critical care field. The article begins by discussing the death rate among critical care …show more content…
“Medical futility is a complex concept as there is no universally accepted definition.” (Chow, RN, ANP-BC, 2014) Futility was found among the group of colleagues on the ICU floor to mean a considerable use of resources without hope for recovery. The most common answers as to why medically futile care was provided were due to demands from family members and disagreements among team members regarding their plan of action. A major concern in these situations is that family members are left to make decisions without any health care knowledge. Communication is key here; critical care team members and family members have to try to overcome the difficult situation they have been placed in to figure out what is the best plan. The palliative care team should have been brought in sooner in L.J.’s case because on top of the lack of communication, “the case happened at the beginning of an academic year when new medical residents and fellows were just becoming oriented in the hospital system.” (Chow, RN, ANP-BC, …show more content…
Death is a frequent visitor of the intensive care unit; patients in this area are at the very peak of their illnesses, many of them being nonverbal. As well as figuring out how to communicate with your patients, one might also have to accept the fact that the case could be medically futile and nothing can be done other than make the patient as comfortable as you can for the remainder of their stay. Recent news headlines have brought this topic closer to home, often if you are not in the health care field or studying to enter the health care field you may hear about these topics on television or the radio but they do not take up place in your conscious thoughts. Hearing about Brittany Maynard made me stop and ask myself what would I do, if I were in her shoes, or if I was a nurse in the hospital that was treating her, and the answer is I do not know. Ethical dilemmas such as this are complicated and there is often not a black and white answer, we live in the gray areas, it is about finding what is right for that patient and being able to accept the fact that their beliefs may not be the same as your
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
Ethical issues are present in every aspect of healthcare. Ethical dilemmas in the Neonatal intensive care unit (NICU) are especially difficult because the patient cannot express him/herself. It is therefore the responsibility of the parents to make the decisions regarding treatment. It is the nurse’s job to advocate for the patient to ensure that they are receiving the best possible care. The cost of care, termination of treatment, and the nurses’ role in the termination of treatment are all factors that are included in the care of patients that are suffering in the NICU.
In A Tender Hand in the Presence of Death, Heather, the nurse, would put in IVs and feeding tubes in hopes of prolonging hospice care even when they were ineffective in order to give more time to the families who were having trouble letting go (MacFarquhar, 2016). In my personal situation, I can relate, as two of my grandparents have passed away from cancer and suffered for a long time before passing. Although it was incredibly sad and our families bargained for more time, there was some peace in knowing that the suffering had come to an end once they passed. For our own selfish reasons, we want as much time as possible with our loved ones who are suffering and close to death, but in reality, the decision for assisted suicide should only concern the individual whose life it
This paper will talk about the book No Good Deed and how there are many ethical dilemmas that healthcare providers deal with every day. Each day there are ethical issues that arise, especially when caring for terminally ill patients. The book No Good Deed talks about how two nurses struggle with a situation that is far too common in healthcare today. Despite the literature about end of life care, it still remains an issue for many providers and patients. Nurses are lead to deal with multiple ethical issues seen in the book No Good Deed. After reading the book No Good Deed one is able to see how literature about end of life care is viewed and how beneficence plays are large role in nursing care.
Mohr, M., & Kettler, D. (1997). Ethical aspects of resuscitation. British Journal of Anaesthesia, 253.
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.
The American Nurses Association (ANA) thinks that nurses should stay away from doing euthanasia, or assisting in doing euthanasia because it is against the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001; herein referred to as The Code). Overall, nurses are also advised to deliver a quality of care what include respect compassion and dignity to all their patients. For people in end-of-life, nursing care should also focus on the patient’s comfort, when possible the dying patient should be pain free. Nurses have also the obligation to support the patient but also the patient’s family members during these difficult moments. We must work to make sure that patients and family members are well informed about every option that is
In today's society, one of the most controversial health-care-related ethical issues is assisted suicide for terminally ill patients. Assisted suicide is not to be confused with ethically justified end-of-life decisions and actions. Nurses have a responsibility to deliver comprehensive and benevol...
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
As precious as life is to come in to this world, there is debate about whether life going out of this world should hold the same amount of pricelessness, happiness, and peace in cases of the terminally ill with no chance of long-term survival. This deliberation of whether physician assisted suicide should be permitted is a major medical ethical concern, however, as a future nurse, this argument does not have a place in modern medicine. In the following sections, the ethical principles of autonomy, beneficence, and nonmaleficence are discussed with regard to the patient’s best interest and the personal views and opinions of a prospective nurse.
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 dilemmas in nursing happen daily therefore nurses must treat all patients with respect and integrity for the patients’ best interest and health. Nurses must be the advocators for their clients, in this case being an advocate for the patient helped in the resolution because the nurse made sure to speak for the patient with mediation error and no affect on the patient’s health. The decisions nurses make can affect the patient’s health and quality of life, hence making the right choice is critical in nursing. The decision making can be based on the nurses’ values, experiences, ethical principles and theories.
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 ...
In my future role as a healthcare administrator, ethical decision making will be required to address a conflict or uncertainty regarding competing values , such as personal, professional, organizational, and societal values (Thompson, 2011). Administrators involved in this decision-making process must consider the ethical principles of justice, autonomy, beneficence, and nonmaleficence. Healthcare organizations having growing concerns over ethical issues such as:
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.