PHI-FPX3200_ThompsonNia_Assessment5-1

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1 Tonya’s Case: Ethics and Professional Codes Nia B. Thompson PHI-FPX3200 Ginger Raya May 17, 2023

2 Tonya’s Case: Ethics and Professional Codes When it comes to end-of-life issues and care, all hospitals are affected and often face moral and ethical dilemmas depending on the situation. In this case study, we have Tonya Archer, a 15-year-old female who went in for what should have been a routine ACL surgery at Saint Anthony Medical Center. The surgery is a success, however, during transportation to her recovery room, she suffered a sudden cardiac arrest episode. The staff quickly began CPR, and she is intubated and placed on a ventilator. The resuscitation effort went on for seven minutes and as a result, Tonya suffered irreversible brain damage. It is determined that Tonya has complete brain death from the cardiac arrest and will never recover. Doctors and other members of the hospital administrative team have explained her condition to her parents. The staff feels strongly that the damage will get worse, and she should be removed from the mechanical ventilator. Her parents are adamant about leaving her on the machine as her body is still warm and she has a heartbeat, therefore she’s not dead. Ethical Considerations “During EOL care, ethical dilemmas may arise from situations such as communication breakdowns, patient autonomy being compromised, ineffective symptom management, non- beneficial care, and shared decision making” (Pirschel, 2016). If we want to view this from the place of patient autonomy, the patient herself would be the one to make the decision. In Tonya’s case, she’s only 15 years old and she is unable to make the decision for herself. Therefore it is the parents who would be called on to make that decision. Some physicians feel very strongly that this decision should not be made by family members. Family members are often lead by their emotions and don’t make the most appropriate decisions. This will often result in a hospitals ethics committee getting involved to help resolve any issues.

3 The hospital staff informed Tonya’s parents of her diagnosis, the outcome of what would happen to her by keeping her on life support, and what the best next steps would be. This showed the practice of Kantian ethics because it is the responsibility of healthcare personnel to be truthful and unbiased regarding the care that would need to be taken. The cardiac arrest forced the healthcare team to think quickly on what the chances of her survival would be. When they told the parents the truth, they did so with the knowledge that they were telling the parents they felt it best to remove life support thus effectively ending Tonya’s life. If the parents opt to keep Tonya on life support, then the hospital staff would need to respect that decision, but also keep the parents informed on the gradual effects of what would happen to her. Tonya is considered brain dead, the best course of action for Tonya and her parents would be to maintain minimal life-support and offering the parents the option to obtain a second opinion. Nursing Code of Ethics Nurses are typically seen as the middleman between the physicians and the patients and their families. They often walk a tightrope between their values and morals and what is ethically best for the patients. “To practice competently and with integrity, today’s nurses must have in place several key elements that guide the profession, such as an accreditation process for education, a rigorous system for licensure and certification, and a relevant code of ethics” (Epstein & Turner, 2015). The American Nurses Association is responsible for establishing the guidelines for the nursing code of ethics. The four main principles considered an invaluable part of the nursing code of ethics are: 1. Autonomy – recognition of each patient’s right to make their own decisions. 2. Beneficence – acting for the good of others by displays acts of kindness

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