Ethical-Dilemma in Nursing
Case study: an ethical dilemma involving a dying patient.
Abstract
Nursing often deals with ethical dilemmas in the clinical arena. A case study demonstrates an ethical dilemma faced by healthcare providers who care for and treat Jehovah 's Witnesses who are placed in a critical situation due to medical life-threatening situations. A 20-year-old, pregnant, Black Hispanic female presented to the Emergency Department (ED) in critical condition following a single-vehicle car accident. She exhibited signs and symptoms of internal bleeding and was advised to have a blood transfusion and emergency surgery in an attempt to save her and the fetus. She refused to accept blood or blood products and rejected the surgery as well. Her refusal was based on a fear of blood transfusion due to her belief in Bible scripture. The ethical dilemma presented is whether to respect the patient 's autonomy and compromise standards of care or ignore the patient 's wishes in an attempt to save her life. This paper presents the clinical case, identifies the ethical dilemma, and discusses virtue ethical theory and principles that apply to this situation.
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"Juana" (fictitious name) a 20-year-old, Black Hispanic female, 32 weeks pregnant, was brought to the emergency department (ED) in an ambulance by the paramedics. She arrived in the ED immobilized on a flat board with a hard cervical collar in place. Juana was the driver of a sedan involved in a single-vehicle collision. She stated she was driving at approximately 60 miles per hour on the highway and suddenly lost control of the vehicle and crashed into a light pole. She also stated her head hit the windshield and shattered the glass. She denied loss of consciousness. Upon her arrival in the ED, Juana was alert and oriented to person, place, and time and had a Glasgow Coma Scale of 15/15. Her initial complaints were lightheadedness, weakness, left shoulder pain, and severe abdominal cramping that started immediately
Abstract
Nursing often deals with ethical dilemmas in the clinical arena. A case study demonstrates an ethical dilemma faced by healthcare providers who care for and treat Jehovah 's Witnesses who are placed in a critical situation due to medical life-threatening situations. A 20-year-old, pregnant, Black Hispanic female presented to the Emergency Department (ED) in critical condition following a single-vehicle car accident. She exhibited signs and symptoms of internal bleeding and was advised to have a blood transfusion and emergency surgery in an attempt to save her and the fetus. She refused to accept blood or blood products and rejected the surgery as well. Her refusal was based on a fear of blood transfusion due to her belief in Bible scripture. The ethical dilemma presented is whether to respect the patient 's autonomy and compromise standards of care or ignore the patient 's wishes in an attempt to save her life. This paper presents the clinical case, identifies the ethical dilemma, and discusses virtue ethical theory and principles that apply to this situation.
**********
"Juana" (fictitious name) a 20-year-old, Black Hispanic female, 32 weeks pregnant, was brought to the emergency department (ED) in an ambulance by the paramedics. She arrived in the ED immobilized on a flat board with a hard cervical collar in place. Juana was the driver of a sedan involved in a single-vehicle collision. She stated she was driving at approximately 60 miles per hour on the highway and suddenly lost control of the vehicle and crashed into a light pole. She also stated her head hit the windshield and shattered the glass. She denied loss of consciousness. Upon her arrival in the ED, Juana was alert and oriented to person, place, and time and had a Glasgow Coma Scale of 15/15. Her initial complaints were lightheadedness, weakness, left shoulder pain, and severe abdominal cramping that started immediately
References: American Nurses Association. (2001). Code of Ethics for Nurses with Interpretive Statements. Washington, D.C.: American Nurses Association. Beauchamp, T., & Walters, L Society for the Advancement of Blood Management. (2008). Blood Management Program Database. Retrieved June 19, 2008, from http://www.sabm.org/hospitals/ Chua, R., & Tham, K Gardiner, P. (2003). A virtue ethics approach to moral dilemmas in medicine. Journal of Medical Ethics, 29, 297-302. Illinois v New York State Department of Health. (2008). Patient 's Bill of Rights. Retrieved June 19, 2008, from http://www.health.state.ny.us/nysdoh/hospital/english2. htm#patients Larew, C., Lessans, S., Spunt, D., & Covington, B Leonard, B., & Plotnikoff, G. A. (2000). Awareness: The heart of cultural competence. American Association in Critical Care, 11(1), 51-59. Levy, J Macklin, R. (2003). Applying the four principles. Journal of Medical Ethics, 29, 275-280. Miller, J Volbrecht, R. (2002). Nursing ethics: Communities in dialogue. Upper Saddle, NJ: Prentice Hall. United States Department of Health and Human Services Watchtower Bible and Tract Society. (2004). Rightly value your gift of life. Watchtower, 15, 14-16. Women 's Hospitals Australasia