Question

A. Joe is a 62-year-old building contractor who has been in an ICU for the past 10 weeks. Per chart notes, he is not improving sufficiently to warrant hope for recovery. The best that can be hoped for now, says his critical care physician, is discharge to a long-term acute care hospital The prognosis does not include any likelihood of return to baseline, or to home. The situation is dire, and Joe seems to "get it". On the Saturday of Joe's tenth week in ICU, he mouths a message to his nurse, and then to the physician who is summoned, and then to an ethics consultant also. "Stop everything. Give me something. I want to die."

Questions:

1. In the rule of Autonomy, what should you do as an allied health care provider and why?
2. However, his condition is such that she cannot die on his own. He is begging and pleading with you to help him commit suicide. This would, of, course be illegal. What would you do?
3. As a future allied health care provider, moral standards deal with matters which can either seriously harm or seriously benefit human beings. How are you going to apply it in your daily living, cite an example

B. An accident takes place on an intercity highway. Ambulance staff pick up the injured driver and medical intervention is initiated. The driver suffers from a severe stomach ache, which is also affecting his back. Evaluating the patient, the ambulance doctor suspects that he might be experiencing internal bleeding. For this reason, venous access, in the doctor's opinion, should be achieved and the patient should be quickly started on an intravenous serum. The patient, however, who has so far kept his silence, objects to the administration of the serum. The day this is taking place is within the month of Ramadan and the patient is fasting. The patient states that he is fasting and that his fast will be broken and his religious practice disrupted in the event that the serum is administered. The ambulance doctor informs him that his condition is life-threatening and that the serum must be administered immediately. The patient now takes a more vehement stand. 'If I am to die, I want to die while I am fasting. Today is Friday and I have always wanted to die on such a holy day,' he says. The ambulance physician has little time to decide.

Questions:

1.     How should the patient be treated?

2.    Which type of behaviour will create the least erosion of his values?

3.    If you were in that situation, how will you act towards the patient with your utmost interest in your chosen profession?

Answer 1

A. Autonomy is an ethics, which describes accurate decisions taking bybnursecaccotding to situation. In this case Joe asks something to die. But the nurse should not do that. Because , already critical care physician advice to shift him to other health care setting. There is no chance for prognosis or recovery, in this situation nurse can try stop the painfull procedures. Till the end, nurse should try to save his life. She can give hospice care to patient.

If he is begging also, nurse should support him for commiting suicide. That is illegal, and against to ethics. So nurse can take legal advice with help of physician.

As a nurse in future, the moral principles should apply in duties. But whether that will give harm or benefit to patient, that is depending on the wellness for patient. Eg. If the patient need to be ventilate, then that will give some pain for patient, but that can give improvement of health.

So each action should maximum focus on ethics, that is beneficence. Each actions are for that only.

B.

1.So the patient have internal bleeding, then blood transfusion should start. But here if patient is not willing, then doctor can't do anything.

2.patient is giving importance for religious beliefs. So here if doctor neglects that, starts to give intravenous serum, then it will degrade his values.

3.as a nurse, should try to change the mind of patient. Because life value is more. Try to convince patient, that he can take the fasting in next year also, if he is living.