The Ethical Dilemma Of A Patient 's Death Or Permanent Damage

Nearing the end of my shift in the Emergency Department, I was requested to accompany a patient while the nurse readied the discharge papers. Upon entering the bay, I met a very small and fragile patient who was anxious to go home. Conflicted between my primary duties and responsibilities to complete training for two inexperienced volunteers, I decided to put forth my interests in teaching by demonstrating compassionate care to my trainees. Although the patient repeatedly refused my assistance, I gave my best effort to calm her as I cloaked a warm blanket around her. As I listened to her confide in me of all of her hospital anxieties, I was shocked from the lack of quality care she had received which made her feel more sick after the first

One of the most critical factors which contribute to the number of preventable cases of healthcare harm is the culture of silence surrounding these cases. The fear of medical providers to report incidences is related to the possibility of punishment and liability due to a medical error (Discovery, 2010). The criminalization of some acts of medical error has resulted in job dismissal, criminal charges and jail time for some healthcare workers. This is despite the fact that the system they are working in helped to create the situation which led to the error in the first place. Human error, due to fatigue and system errors can result in deadly consequences, but by criminalizing the error it effectively shuts down the ability to correct the root problem. Healthcare workers, working at all levels within the medical system, can provide valuable input on how to improve the processes and prevent harm from occurring (Discovery, 2010).

“…She’s somethin’ of a cunt, ain’t she Doc?” Although Milos Foreman’s character, Randle McMurphy (Jack Nicholson), put his opinion of Nurse Ratched (Louise Fletcher) in the most vulgar of terms, he was not so far from the truth. In the movie One Flew Over the Cuckoo’s Nest (1975), Nurse Ratched’s treatment and care of the patients was unethical when compared to the standards one would expect of a health care administrator. She used control over her patients to ensure order, without regard to the feelings and concerns of the patients. This issue is presented by the director, Milos Foreman, through symbolism, characterization and scenes. This, in turn, determines how the director wants us, as viewers, to feel about the issue.

University Hospital is a well known hospital with a level 1 trauma treatment center for the tri-county area of a northwestern state, the hospital enjoys the fact they are known for their promising reputation among healthcare professionals and the public they serve. Jan Adams is an OR supervisor that has been working there for ten years, as a professional she makes surgeons follow protocol as required and enjoys working with trauma patients. One Friday night, which is the busiest day of the week for the trauma department; the unit was notified that a helicopter was on its way with a 42 year old man who had been in a car accident. Shortly after the patient arrived to the trauma center, the resident and other medical staff noted that he was in very bad physical conditions, needed immediate surgery or otherwise he was going to die. The issue was that the on call surgeon had to be present during the surgery and had not yet arrived, but regardless of the matter and protocol they proceeded with medically treating the patient immediately. The concern is that in doing so they violated medical procedures and put the patients safety at risk, this lead to a long list of ethical issues for example, patient well-being, impaired healthcare professional, adherence to professional codes of ethical conduct, adherence to the organization’s mission statement, ethical standards, and values statements, management’s role and responsibility, failure

Also, whether there was collaboration between facility members to ensure quality care. More issues would be whether examinations were thorough and tests were analyzed before discharging the patient. The moral issue at stake in this case is if the facility believes they did the right thing or not. For example, the physician could not recall what instructions he gave Kelly’s father, but he did nothing to clarify the situation, he just gave the father a business card as if that would suffice for his inability to remember the instructions he assigned (Pozgar,

As if it was premeditated and to have the nurses watch, as if they were an audience and I was a joke instead of them being medical professionals and helping me for the reason I was there, my hand. I never done anything to provoke Dr. Darren Huffman he never even had consideration just to come in and pretend to care about my hand. I never been in the situation like this and can’t fully comprehend why this doctor would do something like this. It caused an emotional scar for the violations Dr. Huffman committed because of a blemish on my medical file from something I had no control of or no knowledge of. I lost faith in the medical system and how they treat our medical files especially Mercy Hospital and their employees and how they don’t follow Federal and State laws or care about patients confidentiality. And it really makes me think, would Dr. Darren Huffman let a patient die because of certain things that are on his medical record?. Even after the incident I called the hospital spoke to a few nurse supervisors (Colleen+ Allie) and called various other people numerous times none of them would give me the doctor’s name I had to find out

At that time, I was just a student nurse and had yet to realize the consequences of this unethical practice. However, as a manager equipped with the knowledge of the ethical and legal dilemmas of a slow code, my actions today would be different. Involving the ethics committee in these cases would be encouraged. According to Pozgar (2007), “An ethics committee in the health care setting is a multidisciplinary committee that serves as a hospital resource to patients, families, and staff, offering an objective counsel when facing difficult health care issues and decisions.” As a

Patient confidentiality is one thing that cannot be breached nor as a patient that you would want to be breached. In this day and age as healthcare professionals it is a very fine line of what breaching confidentiality is. We all want to know that when we are sick and in the hospital, the one thing that we can keep personal is our privacy which would include our health information. It is hard to imagine that in a state of vulnerability that some things must be disclosed to certain departments regardless of your desire to keep it private

We arrived at Clearview at 2231 Hrs. and took the patient to room 14. I went back outside and began to put our unit back together when Supervisor Carlock approached me and in a very agitated voice said: “WHY DID YOU PULL OFF?” Surprised, I said “What are you talking about?” He said loudly, “I TOLD YOU TO STOP AND YOU DIDN’T!” I replied, “Jeff was telling me not to stop because we had a pulse back.” He said “I DON’T CARE WHAT JEFF SAID, I’M YOUR SUPERVISOR AND I TOLD YOU TO STOP!” I said “Dennis, I think you’re talking to the wrong person, you need to be talking to Jeff, I was doing what he told me to do.” He replied “WHO’S YOUR SUPERVISOR, WHO’S YOUR SUPERVISOR, I AM, NOT JEFF, YOU DO WHAT I SAY!” I said ”yes, you are the supervisor, but at that moment I was doing what the Paramedic in charge of patient care was telling me to do, and what I felt was best for the Pt., since we had a 41 Y/O patient who had a pulse.” He said “I DON’T CARE, YOU DO WHAT I SAY!

I’m learning from observations and witnessing it first hand that there are many mishaps in life which seem to be unexplainable and unfair, and have devastating consequences. It takes a special person to work in the medical field, especially the Emergency Room. ER’s see the worst of the worst. You have the gentlest touch and most calming words, whether you are giving a diagnosis of something minor, to advising someone they may have cancer, to breaking it to a mother that her baby is not viable. When I get to that point I want to handle situations just like you do.

“The definition of a health professional is a person who works to protect and improve people’s health by the diagnosis and treatment of illness to bring about a complete recovery from mental, physical and social perspectives, either directly or indirectly (Kurban, 2010, pg. 760).” Nurses in the community today have acquired an increasing responsibility to intervene with medical decisions. In the past, there were clear differences between nurses and doctors. It was more common for a nurse to be supervised directly under the physician. They are not just performing Doctor’s orders anymore. The nurse role in patient care has been widely expanded. Allegations against someone can be one of the most stressful moments of their careers. Negligence

Everyday, healthcare professionals are faced with ethical dilemmas in their workplace. These ethical dilemmas need to be addressed in order to provide the best care for the patient. Healthcare professionals have to weigh their own personal beliefs, professional beliefs, ethical understandings, and several other factors to decide what the best care for their patient might be. 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 brains hemispheres which has left her unconscious. She only has some brain stem reflexes and requires a ventilator for support. She is unable to communicate how she wishes to proceed with her healthcare. Mrs. Smith’s children, Sara and Frank 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, as Sara would like to do, or stop all treatments and care, as Frank feels his mother would want. In the healthcare field, there are situations similar to this case that happen daily where moral and ethical judgment is necessary to guide the decision that would be best for the patient. The purpose of this paper is to explore and discuss, compare and contrast the personal and professional values, ethical principles, and legal issues regarding Mrs. Smith’s quality of life and further plan of care.

After reading this scenario about this patient, there are a few things that I wonder about and things that could have potentially contributed to this patient’s death. First, I do not understand why they did not place an Ewald tube down this patient and perform some sort of gastric lavage with activated charcoal (Gastric, 2017). They did all the work to stabilize the patient, but did not remove the remainder of the product, causing the acidosis. Basically, I feel that the patient came in with metabolic acidosis because of the aspirin, was stabilized, but then developed metabolic acidosis again. Which could have lead to a whole new list of complications to develop.

The creditability of our profession is undermined when we face the temptation to ignore our ethical responsibilities. The author of “Ethics & Critical Thinking” asserts the most common ethical fallacies rely on poor judgments, enormous stress, and conflict. Patient violations are committed everyday when our thoughts maintain “it’s not unethical even if our acts have caused harm as long as the person we harmed had it coming, provoked us, deserved it, was really asking for it, or practically forced us to do it—or, failing that, has not behaved perfectly, is in some way unlikable, or is acting unreasonably.” Integrity and values guide our behaviors and ethical commitment

Ethics, in medicine, is described as applying one’s morals and values to healthcare decisions (Fremgen 2012). It requires a critical-thinking approach that examines important considerations such as fairness for all patients, the impact of the decision on society and the future repercussions of the decision (Fremgen 2012). According to Fremgen (2012), bioethics concerns ethical issues discussed in the perspective of advanced medical technology. Goldman and Schafer (2012) state bioethical issues that arise in medical practice include antibiotics, dialysis, transplantation, intensive care units, issues of genetics, reproductive choices and termination of care. In clinical practice the most common issues revolve around informed consent, termination of life-sustaining treatments, euthanasia and physician-assisted suicide, and conflicts of interest (Goldman, Schafer 2012).