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With regard to the medication administration itself, in a life saving circumstance, which this clearly is not the weight of the potential for depression of respiration and cardiac status is clearly indicated, yet it would seem unethical under these circumstances, if the review of the documentation proves its validity and clearly indicates the patients wishes, to deny at least the smallest dosage (2mg) of ordered Morphine to reduce the pain and potentially allow the patient to regain calm, which will clearly improve his status with regard to short-term treatment.
If the fear of doing harm, drives every medical decision, based on the extreme notion that all patients can be saved under all circumstances then bioethical decisions are futile. The observations and communications of others in the immediate vicinity to care, including the family, other nurses, support staff and most importantly the orders of the doctor to administer palliative care for this presumably dying patient should be taken into consideration.
If this kind of care is outside the comfort zone of the individuals within the emergency room, then a reevaluation of training and procedures should be done. Additionally, if the patient is in dire need of intervention, other staff should question the action or inaction of the individual making the decision to deny palliative care even if it means creating strife and/or...
As an incoming staff member the first response that the individual should have is to see the patient, and make a decision based upon the doctor's orders and the wishes of the patient and his family. If the individual is still alert and asking for Morphine the lowest dose should be administered with frequent subsequent pain scale checks to determine if more of the drug is needed to maintain the comfort of the patient. If the need for the medication seems to exceed the ordered dosage then the new nurse, should communicate with the physician and evaluate the need to change the treatment protocol. Above all the needs and desires of the patient should not be ignored, and a clear sense of the need for palliative care is essential in this case scenario.
References
Andre, J. (2002). Bioethics as Practice. Chapel Hill, NC: University of North Carolina Press.
Forsythe, C.D. (2005). Protecting Unconscious, Medically-Dependent Persons after Wendland & Schiavo. Constitutional Commentary, 22(3), 475.
Mantz, a. (2002). Do Not Resuscitate Decision-Making: Ohio's Do Not Resuscitate Law Should Be Amended to Include a Mature Minor's Right to Initiate a DNR Order. Journal of Law and Health, 17(2), 359.
Saunders, D.E. (2003). Removing the Mask. The Hastings Center Report, 33(2), 12.
An adult do not need to make all decisions in advance, but educating oneself is a vital first step. (Death with Dignity: Planning Ahead for End-of-Life Care) few guidelines for signing a DNR order are given here. A Do Not Resuscitate Order - DNR is a physician's order to not to employ cardiopulmonary resuscitation - CPR in case of cardiac or pulmonary arrest. Competent adult patients may relinquish CPR
The relatives in this case state that they know the woman's wishes, and they have her regular health care provider to back their statement. Thus, it seems in the case that the on-call physician would not be in error, should he remove the support of the ventilator. What other measures could have been placed to assure the patient's wishes were honored? Instead of merely giving proxy to the woman's relatives, a
And they're still arguing with me. 'Oh, we have to get the ethics committee together,' and all this crap. I had a living will and they wanted to talk about ethics, okay?" (Tercel, 2001). The right to die and physician-assisted suicides are even more volatile because many people are against them for spiritual and ethical reasons, and many physicians and other healthcare professionals feel they go against the entire
hospital is that it does not any longer believe in the promises that it made when the founders set up the hospital. The second problem is due to the large differences that exist among the members of the Board and as a result the CEO is not finding it possible to control these differences. The third problem can be viewed as an extension of the same lack of control
politics of memory, and the politicization of memory, with particular reference to Chile and the human rights violations inflicted upon the population by the Pinochet regime. What memories are present in Chilean society? In 1973, Chile witnessed a political coup, with President Salvador Allende's left government being overthrown by the military dictatorship of General Pinochet. Following this coup, Pinochet made it his mission in life to eradicate 'leftist' thinking, to
Ethics Abe and Mary had an extremely difficult decision to make. The couple did indeed have a child to save the life of Annisa. It could be possible that in the future Marissa-Eve's relationship could be harmed by this truth. Eve may feel as though her sister's life is more important than her own. In many ways Eve was treated as a means to an end because her life was