Dnr Ethical Dilemmas

In today’s medical setting nurse practitioner are often challenged by ethical dilemmas that appear to have equally valid answers, Often these dilemmas are resolved by an effective therapeutic relationship with the patient and family. Nurse practitioners care for very diverse patient populations that have many chronic health problems. The discussion and solutions must recognize the viewpoints of all parties involved; this ensures the full participation by the patient (Jezewski, 1994). Physicians do not have the right to treat a patient against their wishes, salus aegroti suprema Lex, well-being of the patient is the most important law (Mohr & Kettler, 1997). The Ethical dilemma of autonomy of the patient’s right to refused advanced medical
Jones admitted multiple times for advanced liver failure, she had been denied for re-transplantation and is now being managed medically. On her final admission she had expressed her wishes that she no longer wanted to continue her fight. Mr. Jones on the other side was saying he wanted everything done for his wife. The attending from critical care had convinced the husband that to continue care at this stage would be fruitless and counterproductive to his wife’s health and wishes. Mrs. Jones care was transferred from critical care to family medicine. The resident assigned to her case, then convinced the husband to rescind the DNR order and scheduled Mrs. Jones for a Peg-tube replacement. The registered nurse (RN) in this case intervened on the behalf of the patient and with the help of her manager got the order for DNR to stand, and the cancellation of the Peg-Tube.
Ethics really do not have any punishment or associated penalties. Overall both are expected social actions, but laws enforce the actions while ethics set forth social guideline (Cohn, Bucolo, Rebellon, & Van Gundy, 2010)

Ethical-Legal Reasoning Model for Dilemma Solution
The first step would be, try to remain neutral, actively listen the husband and find out what the barriers are. Sympathize with his fears offer to bring in counseling and identify if there is a need for religious comforting.
The second step is to try and predict the future educate the husband on the course of his wife disease. Help him understand that his wife is most like going to die within the next few days. Step three, identify your feelings, and explain to the husband that you think his wife is now at a point of suffering. The next compassionate step would be to help make her comfortable so she can finally rest. Explain that you are obligated by law to follow her wishes, but also want to include him in the process. Steps four ask yourself if you could live with the decision that went against your patient’s