Read the description of the six caps and the “Case Study for Six Caps” on p. 175 of Professional Nursing. Answer the following questions individually. Then, discuss your answers in your Learning Team forum online. After you have discussed each question and achieved a consensus, compile a group response, which will be submitted as a Learning Team assignment.
What pieces of information are needed to assist the family in making a decision regarding Marianne’s care?
For the family to make a decision regarding Marianne’s care, they need “knowledge about the probability and nature of consequences attending various courses of action,” and expertise and special knowledge from the nurse (Blais & Hayes, 2011, p. 62). Components in the decision-making process are facts about the situation, ethical theories and principles, nursing code of ethics, client’s rights, patient and family personal values. Aspects that may compromise one’s ability to make an informed decision about their loved one’s care such as “cultural values, societal expectations, degree of commitment, lack of time or experience, ignorance or fear of the law, and conflicting loyalties” are needed in the decision process as well (Blais & Hayes, 2011, p. 61). It is important for the medical providers to make the family completely aware of their options, benefits, and possible difficulties Marianne may face before and after surgery. It is also important for the family to know what can be expected if they decide not to do surgery. The family if they will they continue ventilation, or discontinue it and provide comfort measures only. Marianne’s family needs to decide whether to order a DNR or keep her as a full code. It is important for the physician to clearly explain in detail the option of making Marianne a DNR. The family needs to know the laws that govern their decision and their rights. It would be helpful for them to have an idea of the cost involved with the options, and the kinds of support that will be available to them regarding each decision (Blais & Hayes, 2011). However, “In the absence of an advanced directive or documentation of goals of care, the surrogate, in collaboration with the medical team determines a plan of care, including decisions about end of life care” (McGowan, 2011, p. 64). The conversation of Marianne’s wishes must be discussed, what would Marianne want? What were the conversations the family had with Marianne about health prior to falling ill?
How might family members’ values and morals affect their decision-making process when faced with potential end-of-life decisions for a loved one?
According to Strack and Gennerich (2011), when there are “interpersonal value conflicts, ethical principles are employed to justify own actions (p. 419). Their study Personal and Situational Values Predict Ethical Reasoning, suggest that people with different sets of values could have difficulty agreeing on an ethical situation (Strack & Gennerich, 2011). Strack and Gennerich incorporated work from Rokeach’s Nature of Human Values (1973), in which he found through studies that “Values function as cognitive standards for individual actions” (2011, p. 421). Because not every person considers the same values to be important, this can cause conflict when several people are in the decision-making process about a possible end-of-life decision for a loved one (Strack & Gennerich, 2011). Several people use ethical reasoning to rationalize and validate their actions and choice of values. For example, when a person says, “the outcome is best for everyone,” they are using utilitarianism ethical reasoning. In this situation Marianne’s husband would be basing his decision to “try everything” on the utilitarian theory; the “rightness or wrongness of an action depends on the consequences of the action” (Taylor, Lillis, LeMone, &Lynn, 2008, p. 102). By refusing surgery Marianne’s...