Uustal (1993) Proposed a Decision-Making Model Concrete

¶ … Uustal (1993) proposed a decision-making model concrete steps arrive a morally acceptable solution faced ethical dilemma. What type ethical dilemma encountered clinical setting? How decision-making model identified Uustal applied situation? Be specific describing steps.

Much of what constitutes nursing is being able to make decisions and carry out tasks according to those decisions. What nursing is often confronted with and feels unable to respond to in an effective manner at times is addressing and resolving specific ethical issues. One such issue we are concerned with here is caregiving for elderly individuals, specifically those at the end of life. Moreover, end-of-life decision making that affects physicians is of concerns to nurses as well since they are directly involved with caring for the individual. We believe quality of care is most imperious in such challenging moments because nurses have to confront a decisive and frail moment in a patient's life and must respond to that patient's needs more so than ever. In moments like these, Uustal's concerns on whether or not nursing tasks have been employed efficiently and to the benefit of the individual (White, 2001, p. 25) must become the main focus of nurses. In this respect, we believe that Uustal's decision -- making model as a step-by-step procedure may relate to caregiving situations and, in the following, we shall attempt to demonstrate how that may be the case by addressing particular steps accordingly.

In identifying the problem, besides taking into consideration the people involved and what is at stake, we also feel a full description of the problem as seen by Lundy and Janes (2001) is in order. This full description involves "what occurs in terms of person, place, and time." (p. 110) In matters of person, we've already established that our concern here is for the dying elderly. The place and the time are of importance because one elderly may be committed into the hospital, while another may reside in a retirement home, or may live with family. Another question in issue is whether or not a patient seeks to extend life or is merely doing so because of what he feels his family wants. In this respect, an ethical recommendation can be difficult to address, because we owe responsibility to the patient first, however, we may feel obliged to address family needs as well. Assessing the problem overall by considering the family's presence, the existing relationship, may diminish the tragic effect. Shumann and Alfandre (2008) concluded that it is when such decisions need to be taken immediately that a systematic approach ensures success (p. 36). Once we've established that the conflict is between the individual's needs and the family's whishes, me must consider our own position in regards to end-of life decision making and whether or not we feel confident enough to confront the situation and the patient's final decision.

Alternatives to end-of life decision must consider what kind of life would the individual be able to lead if he eventually excludes death. If "the moral rightness of an action is determined solely by its consequence," (Black, 2011, p. 95), would end-of life be considered a faulty consequence when the patient's physical and emotional suffering is at stake? This is one of the questions to be addressed in the matter.