A Case Study Mrs. Shapence

After declaring Jahi McMath brain dead, the doctors at the Children’s Hospital ordered her to be taken off mechanical ventilation. Her mother, Latasha Winkfield, refused to accept that her daughter was dead and incapable of recovering (du Toit & Miller, 2016). Winkfield believed her daughter was still alive because McMath was breathing and her heart was still beating (du Toit & Miller, 2016). McMath’s family disagreed with the doctors’ report and filed a lawsuit to prevent life support from being discontinued (Paola, 2014).

Returned call to Ms Deborah Turner. She wanted to complain about a CW worker that did not allowed see her great-niece Astasia (2years old) and great-nephew, Odion (4 years old).

This scenario presents various ethical issues that could be argued several ways from HIPPA violations to whether or not this patient has/had the cognitive ability to understand the execution of an advanced directive and Power of Attorney. Advance Directives are put in place for this very reason. It eliminates the need for family members to make a choice in the heat of the moment and also respects the wishes of the person whom it affects directly. Although Mr. E’s hypoxia could affect his ability to think clearly one cannot assume that he has an altered level of consciousness nor the inability to execute an advance

The ethical principles for nurses to practice with beneficence and no maleficence. This legal battle between Terri Schiavo’s husband and her family was an ethical debate between continuing artificial life or remove her feeding tube by the request of her husband. Using the theories of utilitarianism and deontology can be applied or considered in making the most ethically correct resolution. The cases are very complex and raise many moral and ethical issues. The cases have brought awareness to society of “the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for health care, are a healthcare proxy clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions. Terri Schiavo should impress upon laypersons and professionals alike the uncertainty of the context in which issues of continuation and termination are argued ethically. Nobody knows what Mrs. Schiavo would have wanted. She left no advance directive and in its absence her husband says one thing and her parents

The parents agreed and to continue her treatment, the patient needed a compatible donor, but from the start, looking at the patient’s tissue typing, the doctor already knew that it would be difficult to find a donor. The patient had 2 siblings, the age of 2 and 4, but they were too young to be organ donors, and the rest of the family wasn’t “histocompatible”1. However, the father was and so the nephrologist meets with the father and also lets him know “the uncertain prognosis for his daughter even with a kidney transplant” . Hearing this, the father did not accept to donate his kidney, reasoning that his daughter had gone through enough, including other reasons that she could have a cadaver kidney and also that he didn’t have the courage to donate his kidney. Unfortunately with the father’s decision, he also insisted that the physician tell the family that he wasn’t histocompatible when in fact he was. He reasons that if the family knew he didn’t want to donate, this would “wreck his family”2 and make them believe that he allowed their daughter to die. Even though the doctor didn’t agree with this decision, at the end he did lie and stated that “the father could not donate a kidney for ‘medical reasons’”2. In the course of thoughts, the doctor was presented a dilemma, to lie or not to lie, and to know which decision was

“An ethical dilemma exists when a choice has to be made in which the consequences may have a potential positive or negative outcome.”("Topic 4: Contemporary Ethical Dilemmas (How do managers evaluate beginning-of-life dilemmas?). ", n.d.) The given scenario presents a patient named Jamilah Shah, who is of Turkish descent, 90 years old and collapsed at the side of her bed in the extended care facility in which she resides. The patient suffers from Chronic Pulmonary disease and diabetes mellitus. The patient was rushed to the ER were the EKG and lab tests revealed she suffered a heart attack and she was started on anticoagulants. The patient has no advance directives and a communication barrier exists, the ER department contacts the emergency contact, one of the patient 's sons Bashir. The patient 's family arrives at the hospital and her son states that he makes the decisions and the wants a do not resuscitate order for his mother and no medical intervention other than comfort care. The social worker handling Jamilahs case is concerned by her family 's lack of support and that the family 's wishes are at odds with the patient 's request for help and her expressed desire to live. Furthermore if the patient does not receive a cardiac catheterization or is considered for a coronary bypass, she will surely die.

The principles of justice, nonmaleficence, and beneficence must be considered in this situation as the patient herself has neither voice nor living will expressing her desires. An ethical theory that applies to this situation is rule utilitarianism. This theory is a hybrid of deontological and utilitarian approaches (Purtilo & Doherty, 2012). Terri’s husband feels that he is legally honoring her wishes by allowing Terri to die as the natural consequence of her unfortunate medical condition. Using the utilitarian theory removing her feeding tube justifies the end goal of death. For her family, they feel a duty to Terri and having her feeding tube removed betrays their sense of duty and right. Conflict resolution, in this case, must consider promoting the person’s good or prevention of further harm to the patient. Ethical theories and principles can guide the best

A physician cannot force a patient to undergo a procedure or treatment against his or her will. Physicians must make informed refusal an integral part of their informed consent process. Physician should understand what patients' needs and balance between the psychological need and social and physical health. Sometimes, the stress environment of the doctor made him frustrated and they don't spend enough time with their patient to get the optimum information and don't show interest about patients’ psychosocial problems. When a patient feel that their doctors have a lack of knowledge of other treatment options may also contribute to why patients refuse our treatment plan. Good physician-patient relationship allows a trusting relationship to develop. Most patients will agree to doctors’ treatment strategies if they have a good communication and patients are kept fully informed by their

Traditionally, the physician was expected to use all of their talents and training in an effort to save the life of their patient, no matter the odds. More recently, the physician’s role has been redefined to preserve the autonomy of the patient. Now physicians must give life saving care only in so far and to the degree desirous of the competent patient.

The first scenario I will like to write about is from the video Advance Care and Planning, the case of Mary, Helen and Steven. According to the notes from PowerPoint slides on “Ethics and Aging,” death is viewed with a negative connotation, even considering it taboo, and some feel speaking about death might trigger a tragic life event (Wong, 5). This might be the reason why Steven, 32, might not have an Advance Care Plan nor a Power of Attorney for Personal Care as indicated by the video. As one of the members of the hospital ethics committee, I would talk to the Helen and Mary first about Steven, and figure out through them what Steven would consider to be a good quality of life. I would then try to convince both women that the quality of

This is illustrated in Mrs. Smith’s case. Mrs. Smith is an 85 year old who has suffered from a large stroke that extends to both of her brain hemispheres which has left her unconscious and unable to make medical decisions for herself. She only has some brain stem reflexes and requires a ventilator for life support. Mrs. Smith did not set up an advanced directive, which is defined by Miracle (2011) “mechanism by which individuals make known how they want medical treatment decisions made when they can no longer make them for themselves” (p.229). Without an advanced directive, medical decisions will fall to Mrs. Smith’s children, Sara and Frank. Each of which have different views regarding their mother’s plan of care. The decision that needs to be made is whether to prolong Mrs. Smith’s life with continued medical intervention, as Sara would like to do, or stop all treatments and care, as Frank

The case illustrates the situation where Mary is put in a hospital facility. She is in a state where she cannot make conscious decisions regarding hip replacement or at the very least cannot verbalize them. However, it is almost certain that the hip replacement should be done and her family members have to make the decision. Many factors should be considered when making the decision. First of all, the risks and rewards of the surgery. Mary is not a young woman, and the process could have significant implications for her health and well being (Banaszkiewicz, 2014). At the same time, it is essential to remember that her family might not have the financial funds to make the replacement and the process could have significant implications on their

To begin with, the client whose name is Mr. Sam Pilsudski has an obstructed airway secondary to cancer of the larynx. He is a 67-year-old widower, and a father of one son and two daughters, who is unconscious and terminally ill, if not for a much-needed operation to remove both his cancer and larynx to save his life. However, one of Mr. Pilsudski’s daughters has adamantly refused to consent to the surgical procedure despite the physician explaining that although the operation would unfortunately render his patient disabled without a voice consequentially, but ultimately surviving the procedure to live and recover. Moreover, the physician attempted with rational and clear communication to express the gravity of the rather poor prognosis of his illness to his daughter that in the event of foregoing the surgery, his patient would surely die (Ralph Dolgoff, Donna Harrington, and Frank M. Loewenberg (2012), Ethical Decisions for Social Work Practice. 9th Ed; p. 279).

In a case where a pregnant woman is involved in a crash or an accident which leaves her brain dead, it is rare that her wishes are known involving what she would want in this type of situation. If the mother 's wishes are unknown, the care plan would then be left to the family to decide. It should be the family’s choice on whether or not to keep the mother on life support or not until the baby can be delivered. If the hospital does not allow the family to make this choice, it may make the situation worse, especially if they both do not choose the same method of action. When the family is considering their options, they should take into consideration the baby 's chance of survival. If the mother becomes brain dead when the baby is 24

The autonomy of a competent patient is an issue not often debated in medical ethics. Refusal of unwanted treatment is a basic right, likened to the common law of battery, available to all people capable of a competent choice. These fundamental rules of medical ethics entered a completely new forum as medical technology developed highly effective life-sustaining care during the 20th century. Several watershed cases elucidated these emerging issues in the 1960’s and 70’s, none more effectively than that of Karen Ann Quinlan. Fundamentally, this case established that a once-competent patient without the possibility of recovery could have their autonomy exercised by a surrogate in regard to the