How Dnr Causes an Ethical Dilemma Essay

The ethical issues that we have had a hard time fulfilling are central to autonomy, beneficence and truth telling. The ANA recognizes autonomy as an agreement to respect another’s right to self-determine a course of action, support of independent decision making. In 1990 the Patient Self Determination Act was passed by the United States Congress this act stated that competent people could make their wishes known regarding what they wanted in their end of life experience when they were possibly not competent. Also included in this Act is the durable power of attorney, which designates a competent person to assist in making end of life decisions when the induvial was no longer competent. (Beauchamp, 2009) Beneficence: compassion, taking positive action to help others, desire to do good; core principle of patient advocacy. (Beauchamp, 2009)

Individuals who are young and healthy possibly never think about advance directives including a DNR order. Perhaps, it is when a parent or a loved one becomes terminally ill that forces one to look at end of life directives. As a hospital staff nurse, I have found that most people are familiar with the term Do Not Resuscitate (DNR); however, the term advance directives must be further explained to patients and family members. Although terminology can be a barrier, most patients making an end of life decisions have strong opinions concerning the end of life care. Expressing those feelings in legal documentation can be a challenge. The ANA Code of Ethics Provision 1.4 (Nursing Ethics, 2016) addresses the responsibility of the nurse to be knowledgeable

The research was conducted to explore the issue, and ethical principles presented. Personal ethical viewpoint was given along with professional examples. The work was actively discussed with classmates and received compliments. In the Case: Lack of Consent and Patient Death physician’s failed to obtain the consent from the patient. The failure resulted in inappropriate procedure, which led to the patient’s death (Pozgar, p. 1243, 2012). The work included my opinion regarding court’s decision, analysis of ethical and legal dilemmas, analysis of failed hospital’s ethical duty to the patient, and personal intake for “What would I do” situation. I chose to present this piece of work as my exemplar as this module incorporated all aspects of the course, and included ethical and legal concepts from contemporary issues in nursing we studied for the duration of the

Medical assistance in dying can be given only to patients who can give a consent. Thus, the consent must be signed by a capable patient, and not by a substitute decision maker or through an advance directive. If the patient is not capable of signing the request, it must be signed by another person under the patient’s direction.

The right of an incompetent patient is one of the greatest issues. If the incompetent patients lose the power to speak, or make decisions, patient’s family usually makes the alternatives in the patient’s health care. It becomes hard when the family’s decision relates to a patient’s life. The issues include withdrawn of hydration, nutrition, and oxygen are parts of the difficulty of reaching a determination. The Nancy Cruzan is the substantial case in this matter. This event is called “right to become flat,” several state courts addressed that issue, but they are still in contention. And so, the Supreme Court has to break the law in this important region because it pertains to many aspects such as religious, moral, and medical decision making. The Cruzan case led to a

Paramedics have a legal and moral duty to their patients to act ethically and with integrity (Christen, Ineichen, & Tanner, 2014; Townsend & Luck, 2013). Paramedics are repeatedly engaged in confronting situations in which they are forced to make some very difficult decisions. Decisions being made by paramedics are so crucial that require vital skills and abilities to understand and deliberate fundamental ethical principles. By acting in accordance to these principles Paramedics are permitted to attain positive outcomes, for the well-being of patients. These critical ethical principles consist of; Autonomy, Beneficence, Non-maleficence and Justice.

In this paper I will defend ethics and palliative care as they pertain to end of life treatment of terminally ill patients. Aggressive medical administration of the terminally ill patient has created critical issues in the morals of end of life consideration. In summary, I will defend this hypothesis by arguing that the following principles, autonomy, beneficence, and justice must all be taken into consideration when treating a terminally ill patient.

The execution and use of an advance directive or living will address the dilemma on the issues of end of life care planning. These documents reveal the wishes of the patient about the medical care, provides specific instructions and designates the power-of-attorney to their healthcare decisions (Center for Bioethics University of Minnesota,

The “Right to Die” (Euthanasia) should be further looked into as an option for terminally ill patients and not considered unethical. There has been an issue concerning the topic of “Human Euthanasia” as an acceptable action in society. The research compiled in conjunction with an educated opinion will be the basis for the argument for voluntary Euthanasia in this paper. Patients suffering from an incurable illness, exhausting all medical treatments, should be given the freedom of choice to continue their path of suffering or end it at their own will. “The Right to die” is not suicide, as you are fully aware that death will be certain, as Euthanasia spares the individual of additional pain.

Healthcare professionals have the responsibility to save and preserve lives. Simultaneously, the patient has rights as well. The patient has a legal right to a Do Not Resuscitate (DNR), in which is a legal order written in the hospital to withhold cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS) in respect to the wishes of the patient. In this case, Mac’s legal rights were violated. The facility management made a decision based on his personal feelings. The facility Medical Doctor was at fault in denying Mac a Do Not Resuscitate Order.

In an effort to reduce disparities, the Patient Self-Determination Act (PSDA) was passed in 1990. “The PSDA is a safeguard for patients’ rights, giving patients the legal right to determine how vigorously they wish to be treated in life-or–death situations, and calls for hospitals to abide by patients’ advance directives” (Black, 2014). Difficulties and confusion about do not resuscitate orders still exist, despite efforts to help patients, families, and surrogate decision-makers make informed choices (American Nurses Association, 2012). Where is the downfall? Is it that patients aren’t receiving adequate education regarding these orders? Is it that the world of healthcare is ever-changing and that patients expect that we can do more than we can to save their life?

“It is important for all staff to know what it is that the person has asked for” when dealing with patients under end-of-life care (Sander, 2014, p.96). Sander (2014) suggests that staff must first consider the wishes of the person who is dying over the family wishes. Once the patient’s wishes are considered first, then the staff can focus on the family who will be affected by the treatment and care of their loved one (Sander, 2014). After first looking to the patient’s wishes and then family wishes, the staff must consider staff and other residents’ experiences (Sander, 2014). Considering all those factors in that order promotes what Sander (2014) calls a good death. The administrator should have spoken to both Ann and John. Both are trusted persons of interest that Mrs. Smith established during her competent days. Both health proxy and durable power of attorney are important decisions makers. The health proxy makes healthcare decisions for incompetent patients (Pereira, 2013). Durable power of attorney assists communications between medical team and family members (Pereira, 2013). This assures there is respect for the patient’s values and expressed wishes (Pereira, 2013). The administrator did not value the patient’s wish. The administrator did not utilize Mrs. Smith’s trusted

Despite advanced public education and awareness of advanced directives there have been times when if care is placed in the hands of physicians without a durable power of attorney, those wishes could be terminated (CPOS, 2013). While most of the public would agree that not following specific end of life choices is an unethical act, some hospital staff feels as though life saving measures may not be appropriate in all situations, despite a written and signed document. The case that is analyzed in this paper involves a man with end stage renal failure who clearly voiced and wrote his wishes on paper in the presence of his primary physician and nephrologist. Without family or friends to act as his power of attorney, a POLST form was

End of life decision making and care are critical aspects of the delivery of patient centered healthcare. Advances in scientific knowledge and medical technology can now prolong the dying process indefinitely. Many Americans fear the possibility of dying a painful, protracted, or undignified death, in an institutional setting, absent personal control or meaning (Schwarz, 2004). With the modernizations of medical technology today, individuals are now given the option to choose how, when and where they die. This topic has prompted many ethical and legal debates regarding end of life care. As a result it has made it challenging for nurses and other healthcare professionals to provide appropriate care. Nurses need to incorporate the American Nurses Association (ANA) Code of Ethics and the professional standards of the Association of Hospice and Palliative Care Nurses when addressing end of life issues.

What if an individual could no longer make personal decisions about health care? In the event a patient is unable to personally advocate, having an advance directive ensures that end of life care will be carried out as desired and specified. As Galambos (1998) explains, advance directives are written documents acknowledged under State law that allow the expression of wishes regarding the extent of healthcare and intervention in the event of losing the capacity to express end of life wishes. The two most common advance directives are the Living Will and Durable Power of Attorney for Healthcare. In the event of a terminal condition and the patient 's inability to express his or her desires, living wills are intended to specify wishes for various end-of-life care procedures. Durable powers of attorney are used to designate a surrogate who will share the wishes of the represented patient and act in the patient 's best interest (Nelson & Nelson, 2014). Advance directives are important because they guide and direct health care professionals, patients and family members to protect end-of-life autonomy for clients (Galambos, 1998). This paper will explore advance directives within the context of federal and state laws, legal and ethical principles, and implications for the registered nurse.