The Case of Marion And The Pacemaker Maddalena Roseto New York City College of Technology HSA Legal Aspects of Healthcare Dr. Gregory October 9, 2016 Abstract Working in the field as health care professionals, we are faced with ethical dilemmas almost always. Although each individual posses different values, there are specific codes of conduct to abide by, despite personal beliefs. Without the use of a structural code, individuals in the health care field would make decisions based on their own personal beliefs in accordance to their culture and religion. In the case of Marion and the pacemaker, we witness the desires of the patient at hand, Marion, and her family, be interrogated by the floor nurses. Although the intent behind the actions of the floor nurses can be described as morally just, thinking they are helping preserve the life of Marion, based on medical ethics, their behavior is of some degree to be questioned. This paper will focus on the boundaries we witness crossed by floor nurses and how they go against the medical ethics approved, and what effects they have on patients and their care givers. In the case of Marion and the pace maker, like that of many cases of elderly patients, there are several factors that need to be understood by both the patient and their family before any decisions can be made, such as in her case, the surgical procedure of implanting the pace maker, the benefits,
Hello all, my name is David Jamison, MHA. I am representing Marion General Hospital as the committee chairman of the ethics committee. I am currently reviewing the case involving female patient Margie Whitson. The patient is a 95 year old patient whom wishes to have her pace maker “turned off”, due to her unwillingness to live. The death of her only remaining son was the last event that, that had forced her to contemplate the reason why she still lives. Mrs. Margie Whitson is no stranger to loss. When she was younger, she lost her youngest son to a severe motor vehicle accident that took his life at the early age of 30. She injured herself over 10 years ago, and received a hip fracture. Her most recently bout was
The patient shows the ability to make her own treatment decisions as she has knowledge of the issues, is capable of making such decisions and there is no sign of coercion in reaching her decision. (cbhd.org, 2008). Margie shows the understanding that the deactivation of the pacemaker may end her life. She has made it known that continued treatment with the pacemaker is no longer consistent with her healthcare goals. (Pozgfar, 2012).
Nursing is not an easy job and those who chose it as their profession are truly special people. Nurses are confronted with ethical decisions that need to be made on a daily basis. Often they know the right thing to do but because of circumstances like institutional structure and conflicts with others, obstacles are created and distress ensues (Jenner, 2001). It is during times like these that nurses must rely on the training that they have received as well as the code of ethics that has been set down for their profession in order to do the right thing.
Butts and Rich (1-26) point out that effective nursing requires both broad knowledge and a set of well developed abilities and skills. The required tasks, are many and varied and in order to do them properly, care must be taken to respect each patient's rights and sensitivities. This is why, according to the authors, nursing care must be guided by a code of ethics. The purpose of this paper is to provide an overview and discussion of the "Code of Ethics for Nurses with Interpretive Statements" developed by the American Association of Nurses (ANA 1-2).
Nursing means being aware of patient’s beliefs, wants, and backgrounds without holding judgement or enforcing one’s own beliefs onto another. Nurses are supposed to be open-minded and put patients before themselves. In this situation, following the code of ethics in my practice allows me to act appropriately within my scope of practice. Treat the patient without any bias and ensure that they are supported, cared for, educated in their options, and ultimately
As someone who is interested in pursuing a career in the medical field, it becomes apparent that medicine and ethics have a unique and pertinent relationship. Everyday doctors, nurses, and other health care workers have to make ethical decisions or help families make ethical decisions for their patients. For example, in the video that featured bioethicist Toby Schonfeld, she discussed some of the ethical dilemmas faced in hospitals today. The most notable ethical conflicts she noted were physician assisted suicide, and other dilemmas such as transferring a patient to palliative care, or whether someone should get a pacemaker or not. Perhaps, in my future I will face similar ethical problems and will have to figure out a way to draw a conclusion that is the best for both the patient and their family.
The main ethical issues that presented in the case scenario is maintaining privacy and confidentiality. “Privacy is limited access to a person, the person’s body, conversations, bodily functions or objects immediately associated with the person” (CNO, 2009, p. 7). Nurses recognize the importance
Ethics are a set of moral principles that serve as a guiding philosophy for behavior. Consequently it is not a surprise that ethical dilemmas occur daily in the health care setting. Any nurse who refuses to provide care for a patient faces an ethical dilemma (Kuhn, 2012, pp. 412-418). The reasons given for refusal range anywhere from a conflict of personal values to fear of personal risk of injury. Nurses do have the right, at times, to refuse patient care assignments. The decision to accept or reject an assignment must be based upon a judgment by the nurse of the nurse 's ability to provide competent patient care. This paper aims to show both sides of the argument when it comes to nurses refusing a patient assignment. One side believes that nurses has the right to refuse patient assignment, as they must be true to themselves if they want to perform their best on the job. On the other hand, the other side believes that it is the nurse’s responsibility to care for all patients and, therefore nurses cannot simply refuse a patient.
In case study 2, there is a patient lingering near death. Their spouse has previously passed, and the family of the patient has come to a decision to request the pacemaker of the patient to be turned off so that the patient will no longer suffer. The charge nurse delays the request to the physician, while the floor nurse takes the request to the physician who gives the order. In this case study, the ethical theory of Deontology is illustrated.
From a particular self-administered survey taken by over 1000 nurses in four different states and in four different census regions in the United States, over half appeared to “feel uncomfortable in addressing the ethical issues they encountered in patient care”. (Ulrich et al. 1). Also, from analysis of over 422 questionnaires, the top five most frequently occurring and trying ethical patient care issues were “protecting patients’ rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making”. (Ulrich et al. 1). Although,
Oftentimes, I am asked the question of why I am a nurse, and truth be told, sometimes I don’t know the answer why I want to be a nurse. All I really know is that I have wanted to help those in need since I was a little girl. Time has really flown, I‘ve been a professional nurse for almost 26 years. When we discuss the topic of making ethical decisions today, I look to the very beginning of my nursing career. I was very happy to see my pediatric patients had been discharged home from their illness (e.g. fever, pneumonia, diarrhea, and infection disease etc) after we took good care of them. One day, the parents of a patient who was 2 year old boy with acute kidney
The film “Wit” portrays many ethical dilemmas in which arise continuously in the nursing profession. The author discusses the ethical issues when it comes to medical research, in regards to patients' safety, or even perhaps, their final wish. The author continues to highlight how a patient like Vivian can be seen as merely a research. But, what is really surprisingly fascinating is how a nurse, not a doctor, advocates to ensure that Vivian is receiving the most beneficial care. What was really surprising was how Nurse Susie reacted for her patient's sake when another ethical line was crossed. Towards the end of the movie, the young doctor “codes blue” and orders for the patient to be resuscitated (Nichols, 2001, 1:30:31) immediately after she
This case study has highlighted the fact that there are many considerations to take into account – there is no one answer. However, it also means that as health practioners, it is vital that we are aware of the principles around moral values and how these impact on, not only the patient, but ourselves. The ethical dilemmas that are presented on a daily basis affect not only the patient, but all those involved in the care – family, doctors, nurses, care home managers, social workers and, because of the many changes in research and modern medicine, the society in general.
Codes of ethics contain a coherent set of normative principles underlying a nurse’s purpose and associated values (Vanlaere and Gastmans, 2007). Two perspectives of ethics are the ethics of justice and the ethics of care (Botes, 2000). The ethics of justice constitutes an ethical perspective in terms of which ethical decisions are made on the basis of universal principles and rules, and in an impartial and verifiable manner with a view to ensuring the fair and equitable treatment of all people (Botes, 2000). The ethics of care, on the other hand, constitutes an ethical approach in terms of which involvement, harmonious relations and the needs of others play an important part in ethical decision making in each ethical situation (Botes, 2000).
It is recommended only when the patient is at high risk. When there occurs sudden cardiac arrest then this implantable device sends low or high impulses to reset the heart so as to beat in normal rhythm. Many surgical procedures like maze procedure in which doctors make an incision in the cardiac tissues and thus they does not conduct electricity and which results in lowering down of the heart rate, another surgical procedure involved is cardiac bypass surgery, this is performed when there are many other coronary artery problems other than arrhythmia. Minor tachycardia can also be controlled by medication. (Scott C. Litin,