Smarksbury-ProfessionalCodeofEthicsAnalysis-M4

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Professional Code of Ethics Analysis Samantha L. Marksbury Purdue Global CS212M4 Thinking Ethically and Critically Mary Fitzpatrick September 11, 2023

In the nursing profession, a Code of Ethics is instituted to ensure quality care for every patient. However, there are, on occasion, situations that violate these standards. Each medical organization sets these standards to determine what values and ground rules are expected to be followed by employees. The American Medical Association is a well-known organization that influences the medical community with its Code of Ethics. These rules and regulations are easily accessible through their website, and any topic can be searched to pull up specific guidelines. One prevalent topic in my ICU nursing profession is caring for patients at the end of life. These specific situations are full of emotions from family and staff. Dealing with end-of-life situations without guidelines can create more stress and ethical issues. The American Medical Association Code of Ethics outlines knowing when to withdraw or advance care, who can consent to end-of-life decisions, and how care should be managed. So, what are the guidelines regarding end-of-life care for a dying patient? Through the AMA Code of Ethics, opinion 5.3 reviews these guidelines. These guidelines indicate that medical professionals are expected to review advance directives and, if there is none, evaluate the patient's values and goals of care through the patient themselves or the patient’s surrogate. Preferences are to be documented and made known. Medical professionals are expected to support the patients or surrogates in decision-making. Medical professionals are to provide options for interventions that follow the patient's or surrogate's goals of care. Discuss timelines and intervention effectiveness. Determine when these interventions no longer benefit the patient and when care should be withdrawn. Explain that the surrogate should make decisions on the patient's behalf when the patient cannot make decisions for themselves. The surrogate should be encouraged to make decisions that best support the patient’s wishes and goals of care. An ethics

counsel should be contacted when decisions for patient care cannot be met or there is no surrogate to make decisions for the patient. Ensure that ethical clinical practice and palliative care are followed when there is a decision to withdraw life-sustaining treatment (American Medical Association. 2023). Even though there are resources like the American Medical Association Code of Ethics, ethical dilemmas still occur that cannot be foreseen. These opinions are guidelines to help support medical professionals in daily care decisions. One of these dilemmas that can arise in my profession is withdrawing care from a patient clinically diagnosed as “brain dead.” There are multiple tests to rule out brain death. By state law, at least in Indiana, once a person is declared a brain time of death, care can be withdrawn from medical professionals even if a surrogate wishes to keep the patient on life-sustaining machines and wishes for life-sustaining interventions. Withdrawing care or discussing palliative care measures can be triggering for some people. The common assumption is that when these topics are discussed, medical professionals are giving up, ignoring the patient's care needs, stereotyping the patient's previous life decisions, punishing the patient, or just saying that the hospital needs the bed “to make room” for someone else. The American Medical Association says it best: "Caring for patients at the end of life is a privilege that draws deeply on physicians’ commitment to alleviate suffering (American Medical Association. 2020).” At times, no amount of medicine can push us past our expiration date. Even though Nurses and the medical staff's primary goal is to heal the patient, sometimes our job is to be a loving hand. No matter what our duties entail, shift to shift, having a code of ethics allows the medical community to have a “lifeline” when gray areas arise in the medical practice.

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