When Patient Care Conflicts with Moral, Ethical, and Legal Boundaries
Ethical Analysis Paper
NURS 4080
Trends and Issues
Austin Peay State University
Gregory A. Wood
March 18, 2005
When Patient Care Conflicts with Moral, Ethical, and Legal Boundaries
There are many situations that cause ethical dilemmas in the scope of nursing practice. One such situation that is encountered repeatedly is that in which a patient has no living will or advance directive to designate when extraordinary life saving measures will be stopped and the patient will be allowed to die. This becomes a dilemma in many cases because there is so much uncertainty in outcomes for individuals. This uncertainty stems from the fact that some people recover from profound states of illness while others do not. It is in these cases in which many subjective criteria tend to be added to the equation when trying to decide on the plan of care for the patient (Oberle & Hughes, 2001)
Situation
A 78-year old man who has not had any significant health problems in his life except for a myocardial infarction (MI), which was the reason for his admittance to the hospital emergency room. After the acute issues of the MI had been resolved a battery of tests, including: cardiac catheterization, electrocardiogram, echocardiogram, and serum enzyme tests were performed to determine the extent of the damage and the best course for treatment. It was determined that there were two blockages and that the patient would be a good candidate for coronary artery by-pass graft (CABG) surgery. During surgery, the patient sustained another MI and developed ventricular fibrillation which was corrected by electro-cardioverter defibrillation and the use of anti-arrhythmic medications. After surgery the patient was taken to the post-anesthesia care unit where it was found that after the effects of the anesthesia should have dissipated, the patient was unable to sustain
References: American Nurses Association (2001). ANA Code for Nurses. Retrieved March 15, 2005 from http://www.nursingworld.org/ethics/ecode.htm. Oberle, K. & Hughes, D. (2001). Doctors ' and nurses ' perceptions of ethical problems in end-of- life decisions. Journal of Advanced Nursing, 33,6. Retrieved March 15, 2005 from Tennessee Health and Wellness Resource Center Database. Taylor, C., Lillis, C. & LeMone, P. (2001). Fundamentals of Nursing: The Art and Science of Nursing Care (4th ed.) Philadelphia: Lippincott. Yoder-Wise, P. (2003). Leading and Managing in Nursing (3rd ed.) St. Louis: Mosby.