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Legal And Ethical Nursing (N520) Legal And Ethical Issues In Healthcare N

John Marsh
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Aspen University

Legal and Ethical Nursing (n520)

Legal and Ethical Issues in Healthcare N

Mrs. R case Study.
Advanced directive: Is a living will that acknowledges one’s communicated wishes regarding
their medical care at the end of life. Medical power of attorney (or healthcare proxy) allows you to
assign someone you trust to be a surrogate, in making medical decisions for your personal interest.
87 year old female, Mrs. R, was hospitalized due to Aspiration pneumonia, unable to breathe
properly and attached to a ventilator system. She also has other medical history such as advanced
Alzheimer’s disease, CAD, and stroke. She is very much debilitated and unable to recognize her family
members for some time. Family members are worried about the continuous ventilator attached to Mrs. R,
because they believed that Mrs. R under normal circumstances would not allow such care. But her
physician , Dr G. is requesting for the nurses to speak with the family about transferring patient to a
bigger hospital for a progressive treatment that involves energetic cares such as physical therapy and
rehabilitation for Mrs. R .because he does not believe in termination of care for any reason.
How nurses in this scenario might respond to this physician request.
Autonomy basically means “self rule,” and it is a patient’s most basic right. As such, it is the
healthcare provider’s duty to respect the autonomy of their patients. Nevertheless, sometimes this type of
case can be difficult because it can conflict with paternalistic attitude of many health care professionals
such as DR .R. who does not believe in discontinuation of any type of life support system coupled with
the fact that there was no advanced directive or medical power of attorney for Mrs.R, even though the
family were trying to represent Mrs. R, with the decision making at this time. These nurses need to
remind DR. G about patient autonomy and the fact that she is 87 year old and that family member
stated that Mrs. R would not like this type of care if she was alert.
How this scenario would cause moral distress among the nursing staff
Morals: Are generally seen as appropriate for more routine decisions, but inadequate for
resolving the more complex issues arising in clinical practice settings (Phillips, 2006). Thus, ethics
describes conduct or principles while morals actually propose restrictions on what may be considered
appropriate actions (Barrocas, Tarbrough, Becnel, & nelson, 2003). As evidenced on Mrs. R. case. Moral
distress: Is the instinctive reaction caused by experiencing a situation that is entirely opposing to a
profession or personal ethics, principles and standards. It can be an aggravating felling by the sense that
injury or accident has or will occur and the person lacks the authority, the power or the ability to right the
wrong, as evidenced by these nurses feeling helpless as a result of Dr .G. action and request towards Mrs.
R’s treatment.



Legal And Ethical Nursing (N520) Legal And Ethical Issues In Healthcare N

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