Nursing Ethics: Across the Curriculum and into Practice – Medical Ethics Example

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"Nursing Ethics: Across the Curriculum and into Practice" is a wonderful example of a paper on medical ethics. The nurse must assist the patient and do everything she can to help ease her breathing.   These are measures that are meant to make her feel more comfortable, not to resuscitate her from a cardiac arrest.   The difficulty in breathing she was going through may or may not have been related to an impending cardiac arrest; and all efforts must therefore be taken in order to ease her breathing (Odom-Forren, 2012).   The nurse should therefore ignore the daughter’ s orders and follow the patient’ s request for assistance. Has the patient revoked her living will and DNR order? The patient has effectively revoked her living will and DNR order.   DNR orders may be revoked by patients at any time for as long as they are of a competent mind and are able to express their intention verbally or in written form (Odom-Forren, 2012).   In this case, the fact that she was able to express her desire to live is a major indicator of her revocation of the DNR order.   She desires to live and she should therefore be given the chance to live. Should the nurse follow the daughter’ s orders? The nurse must not follow the daughter’ s orders because the patient is still conscious and is mentally competent.   She has the autonomy to determine her care, and her daughter does not have the right to negate such a right to care and to make decisions on her care (Barnett, 2006).   If the daughter is the health care agent, can she determine what should be done? If the daughter is the health care agent, she can indeed determine what should be done.   Under these conditions, the patient has to be mentally incompetent and unable to verbally or nonverbally express her desires before a healthcare agent can be validly assigned (Barnett, 2006).   As a healthcare agent, she would have been authorized to make the decision in relation to the patient’ s care, including the upholding of the DNR order.   What are the potential areas of liability for the nurse?

For the facility? If the DNR order would have been upheld, and if the nurse violated such order, she may be held liable for assault because any actions she may undertake on the patient would be contrary to the patient’ s wishes (Butts and Rich, 2005).   The facility may also be held liable for malpractice in failing to honor the wishes of the patient.   Who can sue the nurse?

Why? The nurse can be sued by the patient’ s family for failure to honor the DNR order (Butts and Rich, 2005).   What type of law applies to this situation? The Patient Right to Self-Determination may apply in this case as it covers the right of the patient to his care and to refuse care.   This law protects the right of patients to refuse care and punishes health providers to violate this right.   How can an individual revoke a living will and DNR according to your state laws? An individual can revoke a will and DNR based on my state laws by first filling out a state prescribed form for DNR, to be signed by the physician.   My state does not recognize living wills alone to support DNR orders; an actual order signed by the patient and by the physician must be prepared to support such order.   Is this an ethical dilemma? This is an ethical dilemma, one which affects the patient’ s right to self-determination and her right to beneficence (Odom-Forren, 2012).

References

Barnett, A. (2006). Diabetes: Best practice & research compendium. California: Elsevier Health

Sciences.

Butts, J. & Rich, K. (2005). Nursing ethics: Across the curriculum and into practice.

Pennsylvania: Jones & Bartlett Learning.

Odom-Forren, J. (2012). Drain's perianesthesia nursing: A critical care approach. California:

Elsevier Health Sciences.

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