The following case involves a seventy one year old male patient who told his family if the time ever came when he could not sustain life on his own he didn’t want measures taken to do so. This patient found out in the late summer of 2008 he had stage four pancreatic cancer. The doctor gave him about four weeks to live. At this point he took things into his own hands and made his daughter durable power of attorney for his healthcare needs. Over the next few weeks he became very week and could no longer walk. He stopped eating and drinking due to the mixture of him not feeling well and the medication he was taking. Eventually Hospice was called in to help assist with him and provide some comfort measures. Due to the increased incontinence he was having, hospice felt it was necessary to put a catheter in place. The family became concerned about him not eating and drinking and wanted an IV line started in the patient. Some of the family chose to place the line. The daughter who was the power of Attorney of healthcare over him decided a few days later to discontinue the IV line. This caused a big argument among the family members. The hospice nurse was ordered to discontinue the line. She felt horrible going into the home and discontinuing the IV line but she had to follow the doctor’s orders. Approximately one week later the patient passed away.
The ethical decision the nurse was put in was not what she would have done with her
own family member, but this was her job and she needed to follow the orders from the physician. Multiple things need to be taken into consideration before a good a good ethical decision can be made. A good ethical decision making process is what we will be looking at throughout this paper.
When faced with the need to make an ethical judgment, we may choose the first idea
that comes to mind or take advice from another individual. However, a professional
who wishes to maximize the chances of making the best decision possible in any given
circumstance, may enhance the possibility of providing good care to the dying person and/or
loved ones, and protect them self from repercussions if someone is unhappy with the
events that took place or the outcome that followed some sort of decision making model.
Further, the importance of consultation and documentation (as well as documentation of the
consultation) throughout the decision (Hamric, Spross,: and Hanson, 12).
Step One: Gather Relevant Information
This patient was diagnosed with stage four pancreatic cancer and given a month to live. Options of treatment were discussed with the patient and his family. This patient decided he would have a stent put in to help ease the pain but that was as far as he wanted to go.
The patient decided to make his daughter the durable power of attorney for his healthcare. He stated his wishes that he wanted no measures taken to sustain his life. He believed he had lead a good long life and wanted to live his final days at home with his family not running back and forth to the hospital. The patient decided he thought the quality of his life would be better without treatment. He states “if god says it’s time to go why try and fight him
A durable power of attorney for healthcare is when you place someone else in charge of your decisions for your healthcare needs. By placing his daughter in control of healthcare decisions even though he wanted no measures taken to sustain his life she had the final say in what the decision was.
Step 2: Type of Ethical Problem
There are many types of ethical problems. Ethical problems become dilemmas when there are at least two good choices. The choice then becomes between good and good or good and bad. (Hamric, Spross,: and Hanson, 8). The nurse was placed in an ethical dilemma with this patient’s family. A ethical dilemma can occur among any type of problem that has...