The case study goes as such: Mr. Martinez was a seventy-five year old COPD (chronic obstructive pulmonary disease) patient. He was in the hospital because of an upper respiratory tract infection. He and his wife had already requested that CPR should not be performed if he required it and a DNR is placed in his charts. While in his room on third floor, being maintained with antibiotics, fluids, and oxygen and seemed to be doing better. However, Mr. Martinez’s oxygen was inadvertently turned up, causing him to go into respiratory failure. This scenario in my opinion causes for drastic measures and I personally feel like his wishes should be overthrown by what the caring physician sees ethically and morally right. The doctor should look at all the circumstances in front of themselves and make an ethical decision. Mr. Martinez was previously being treated and had been improving. Although some may argue that he already has a disease that could be terminal. Looking at the bigger picture of the situation that he was being treated for the upper respiratory infection and he was progressing. I believe he should be transferred to intensive care so that his oxygen level can be monitored and his respiratory failure be treated by a ventilator.…
In this scenario, Jamilah Shah, a 90-year-old Turkish immigrant who speaks basic English, was admitted to the hospital after collapsing in her bed in an ECF. Tests and labs show that Jamilah had a heart attack. She has no advanced directives on file and her youngest son, Bashir, is her emergency contact. The healthcare team is divided on how to proceed with treatment, as Bashir is requesting only comfort care, while her social service worker is advocating for medical intervention based on their duty of care and Jamilah's desire to live with this statement "please help me, I want to live." The ethical dilemmas in this scenario include autonomy, non-maleficence, and beneficence.…
There are many cultural considerations that a medical assistant needs to be aware of when addressing issues related to the female reproductive system. Some of these considerations are: believes and practices of religion, values, and even the attitudes of the people with different cultures. The most important thing that a medical assistant should avoid is offending the patient and make it seem as if they are judging them. Everyone has different beliefs and that is perfectly fine. Medical assistant just need to remember that no patient is the same, for example: some cultures forbid communication about reproductive issues with a particular gender. As an MA, it is their job to make sure the patient is cared for and to just give them the support…
Clinicians are expected to provide medical services to help others. However, there is a debate about whether clinicians should treat friends and family, members also known as non-patients. “Treatment of non-patients is widespread, with some studies reporting nearly 100 percent of physicians engaging in this practice” (Latessa & Ray, 2005, p.42). A case was presented where a physician assistant (PA Brian) was asked to treat his supervising physician (Dr.Yarnell) for different medical conditions while prescribing multiple controlled substances. Legal standards provide vague ethical guidance regarding this issue and leave a lot of blank spaces open for clinician interpretation. In Dr.Yarnell and PA Brian’s case there were numerous ethical dilemmas that can be examined under the four ethical principles of medicine: beneficence, nonmaleficence, respect for autonomy, and justice.…
This article present a case in which the patient and the family made a decision in favor of resuscitation that ran contrary to the physician’s medical judgement. The author argues that, where a patient request for treatment in conflict with physician’s responsibility to provide what he or she believes to be good medical care, a resort to autonomy alone is insufficient. The principal of autonomy, which allow patient to refuse any procedure or choose among different beneficial treatment, does not allow them to demand nonbeneficial and potentially harmful procedure. This is important because CPR should not be considered an alternative to be offered by physicians in such cases. Instead, the physician should have listened to the patient’s hopes and fears, reassured him that the physician should would continue to be there and provide appropriate therapy, and, if necessary, refer the patient to psychiatric personnel or clergy.…
In the United States, privacy and confidentiality are the basic rights of the society enshrined not only in professional practice codes of ethics but also in the constitution. Hence, nurses and for that matter, all health care professional have a legal, moral and ethical responsibility to protect patient's privacy.…
There is a difference between being nice and involved in a patient’s life and healthcare and being with that patient and making irrational choices for the patient because of that relationship clouding up judgement. A lot of doctors say that a relationship with a patient is unethical and unprofessional. According to a survey done by Medscape in 2012 asking 24,000 doctors, “is it ever acceptable to become involved in a romantic or sexual relationship with a patient?” 1% say that “yes” “even if it’s with a current patient”, 22% say “yes, 6 months after they stopped being a patient” and 68% say “no”. There is the last 9% that say that it depends on the situation (Physicians Top Ethical Dilemmas), which is the grey area that everyone questions.…
In the emergency department (ED) the most frequently encountered circumstance with respect to self-determination, is the patient who arrives via emergency medical services (EMS) in extremis who is a no code and objects to extraordinary measures, however, the family desires intervention. Emergency nurses retain a legal and ethical obligation to affirm the patient’s autonomy regarding the decision for no resuscitation and allowance of a natural death (Emergency Nurses Association, 2014).…
In accordance with the EMT Code of Ethics adopted by the National Association of Emergency Medical Technicians, EMTs pledge “to conserve life, alleviate suffering, promote health, do no harm, and encourage the quality and equal availability of emergency medical care”. Through the medical education for an EMT license, a student learns how to appropriately treat and care for a medical or traumatic emergency in order to be able to successfully follow this system. Students are also taught the concepts on how to follow the moral and ethical components of the pledge. However, actually being prepared to handle these kinds of dilemmas in real-life scenarios is a challenge EMT face no matter if they have been an EMS provider for months or years. These…
Imagine a frail elderly woman laying in the nursing home in pain. This woman is 80 years old and has been diagnosed with terminal lung cancer and her heart cannot withstand treatment via radiation or chemotherapy. She has less than six months to live. Day in and day out you pass her room and hear her crying out from the immense pain. The pain medications are no longer working. She’s tired of fighting, tired of hurting, and tired of waiting to die. After consideration and discussions with her family she has decided to ask the doctor to help and end her life. The doctor feels remorse for the elderly lady and wants to help but cannot decide if it is the ethical thing to do because he knows that what he’s being asked to do is considered physician-assisted suicide.…
The profession of nursing must have high values and ethics, but how does a nurse make that tough ethical decision. Ethical decision making is defined as “The process of choosing between actions based on a system of beliefs and values” (Black, 2014, p. 347). The nurse has to go through a process to come to the most ethical and just decision based on their facility and their ethics.…
Life in the emergency room is can be fast paced, with decisions made by healthcare professionals who need to consider the basic ethical principles of non-maleficence, beneficence, autonomy and justice. These principles are resources designed and intended to provide a comprehensive understanding, guidance and rules of conduct to ensure an ethical and legal decision is made, regardless of the medical staffs subjective view of what is right and wrong (Tong, 2007, p. 7)…
Ethics of Emergencies “The Ethics of Emergencies” explains Ayn Rand’s radical and unique view of altruism. She believes that there are 4 consequences of altruism, all of which are negative. These, simply put, are lack of self-esteem, lack of respect for others, a pessimistic view of life, and an indifference to ethics. She says that altruism hinders acts of true benevolence, and instead people act out of an obligation to others that has been internalized over time. Rand then argues that one should only volunteer to help strangers in emergency situations, and even then, only when the risk to one’s own life is less than the risk to the stranger’s. Rand advocates action in such emergencies because of the high value of human life. But Rand does not believe that assistance should not be given in non- life threatening situations. She views hunger, illness, and poverty as part of the experience of human life and not a threat to human life. Rand also analyzes the motives of those who risk their own lives to save a loved one’s. She denies an altruistic motive and instead cites selfishness as the cause. Rand says the Altruist’s favorite argument is that of the downing man. She disagrees with the notion of saving the man and recommends the contrasting view: "If the person to be saved is a stranger, it is morally proper to save him only if the risk to one's own life is minimal; when the danger is great, it would be immoral to attempt it; only a lack of self esteem could permit one to value one's life no higher than that of any random stranger." I was shocked when I first read her rationale. If you endanger your life to save a stranger, you are immoral! But not just immoral, also psychologically damaged, in that you lack self-esteem! Now imagine the downing man incident occurring in a world where almost everyone has adopted Rand’s moral code. A lone young man is swept out to sea on a dangerous beach. The crowd stands by, doing nothing, as they have too much self-esteem to…
An ethical dilemma exists when the right thing to do is not clear or when members of the health care team cannot agree on the right thing to do (Potter, Perry, Stockert, & Hall, 2011). S.Z. is a 65-year-old Hispanic man who was admitted to the hospital for the third time in 6 months, for hyperglycemia. He is now scheduled to be discharged but his daughter pleads with the nurse that she does not want her father discharged because he is non-complaint with his medications and diet at home. She says she has small children at home and can’t be responsible for him, too. She is worried sick that he is doing this on purpose because he has been so depressed since her mother, who did everything for him, passed away. She says that her father has been seeing a curanderos, who treats him with traditional methods and that he refuses to take his medicine and only follows what the curanderos tells him to do. She does not agree with this and confides that she hopes to find a way to prevent her father from seeing this person and wants to know if the nurse can have her father’s discharge canceled and to ask the doctor to admit him to a nursing home where they can ensure he eats right and takes his medicine and not the herbs he has been using. Then she pleads, “Please just tell the doctor he won’t take his medicine.” Many years ago he was diagnosed with Diabetes Mellitus Type II and has been on insulin for two years. His blood sugar on admission was 589. He is retired and was widowed one year ago. He’s active in his church, gardens, and likes to work on small projects around the house. His medical history includes Diabetes Mellitus Type II, insulin dependent, Hyperlipidemia, and Osteoarthritis.…
The ethical issues that arise for ones that are for life-sustaining treatment are potential recovery, sanctity of life, personal request, and professional physician integrity. Although there are often minimal benefits seen with the use of extreme measures to prolong life, the potential recovery is valid reason for patients to continue with life-sustaining treatment. The sanctity of life, which is the belief that people are made in the image of God and their lives are sacred and should be protected and respected at all time, is dependent upon the patient. Patients’ values and beliefs may differ, but if the patient has a “low quality” of life and still believes that their life is sacred, then the ethically correct decision is to continue with life-sustaining treatment. As mentioned previously, due to laws that have been created, patients have the right to choose the care and treatment that is provided to them near the end of life. Therefore, it is seen as unethical if anything or anyone takes that decision away from the patient, which again calls into question professional physician integrity. A physician is reliable for providing exceptional care to the patient and attending to the…