There are many people who do not make their wishes known to family members on what they want to happen should they be in this situation. These patients are often subjected to treatments and procedures that do not relieve pain and suffering and may even prolong and increase it unnecessarily when they are in the terminal phase of incurable illness or injury (Oselka & de Oliveria 2007). This is why it is crucial to have those hard discussions with family members and make sure advance directives are filled out and everyone understands what is wanted for end of life care.
Feeney, S., & Freeman, N. K. (2016). Ethical issues: Responsibilities and dilemmas. YC: Young Children, 71(1), 86. Oselka, G., & de Oliveira, R. A. (2007). Ethical aspects of brain death and end-of-life. Dementia & neuropsychologia, 1(3), 226-229. • Part 4
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This week I chose the article by Feeney and Freeman regarding the difference between ethical responsibilities and ethical dilemmas. This article makes a clear distinction that an ethical responsibility is a mandate of what we must do or not do much like a legal responsibility requiring or forbidding a particular action. A summary of their code for childhood educators which also applies in medicine is that we will not cause harm or participate in practices that are emotionally damaging, physically harmful, disrespectful, degrading, dangerous, exploitative, or intimidating (Feeney 2016). This brings to mind situations where nurses are required to call CPS /APS to report possible or blatant abuse or neglect. These situations require us to act based on the knowledge our patients are at the least being harmed and at worst could die as a result of how they are being treated by others. The authors then discuss ethical dilemmas where there could be two solutions to a problem, each which could be morally justified and seen as having some benefit and some costs. This is something I encounter on almost a daily basis as a nurse. I am put in the middle by a family who wants to filter bad news to a patient who is alert and oriented in order to minimize the emotional distress they will feel hearing their health and life are in jeopardy. Family will ask me not to "say the word hospice" because of the bad connotation hospice has received as "the place where you go to die". I understand they hope to reduce anxiety and pain for their loved one but I have to explain that the patient will be smart enough to figure out what is happening which could lead to distrust and resentment toward them and our team. I will try to discuss why I am there without saying hospice but I am clear that I am there because a doctor has said that there are no further treatments available to make them
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