You are a student nurse caring for Ms. Cranford. She is an 87 year old mentally competent woman who has lived alone since her husband died 10 years ago. She was admitted to the hospital with chest pain, feeling faint, a pulse of 48, and a blood pressure of 98/56. The physician and the nurses stabilize Ms. Cranford with medication and intravenous fluids but later inform the patient and her only son that she would need a heart pacemaker to regulate her heartbeat. After the physician explained the procedure and the risks involved. Ms. Cranford pondered the situation for a long while before discussing it with her son and the physician. Her medical history includes a long term adult onset diabetes, chronic renal failure, and atrial insufficiency. She feels very tired. She decided that she does not want a pacemaker. Once Ms. Cranford tells her son her wishes, he is quite upset, and he meets with the physician to discuss the options. The physician and Ms. Cranford's son revisited the issue with her in an attempt to persuade her to change her mind, but she continues to refuse the recommended treatment. She and her son have a loud argument about the issue. The physician tries to explain to Ms. Cranford that the pacemaker is for her benefit and in her best interest. It involves very minimal risks to her and would extend her life. She feels like they are "ganging up" on her and becomes angry. Once the RN becomes aware of the problem, you and the RN visit with Ms. Cranford and her son to assess and evaluate the ethical issues involved with her case.
1. What are the central ethical issues and questions in this case?
2. What principles are in conflict with this case?
3. What did the physician mean by "best interest" for the patient?
4. What is the role of the nurse caring for the patient in resolving this situation with the ethics team, her healthcare providers and her son?
1.The central issue here is whether to accept a patient's wish or not.In simple the principle of autonomy to be followed or not as the patient is refusing for a procedure.Though she is mentally sound, the judgement made by her is not sound ,which the healthcare professionals and her son is trying to explain to provide the best possible care.The question here is the dilemma in following the principles or nor.
2.The principle of Autonomy and Principle of Beneficence are in conflicts with this case.
3.The best interest refers to the availability of a service, which could serve a patient to have a positive outcome rather than negative effects .Placing pace maker can prolong her life.
4.The role of nurse are
You are a student nurse caring for Ms. Cranford. She is an 87 year old mentally...
You are a student nurse caring for Ms. Cranford. She is an 87 year old mentally competent woman who has lived alone since her husband died 10 years ago. She was admitted to the hospital with chest pain, feeling faint, a pulse of 48, and a blood pressure of 98/56. The physician and the nurses stabilize Ms. Cranford with medication and intravenous fluids but later inform the patient and her only son that she would need a heart pacemaker to...
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