Question

When to Tell A 48-year-old woman was scheduled for a below-the-knee amputation due to complications from diabetes. She was admitted to the preoperative area, signed a number of surgical permits, and was given her preoperative sedative medication. Because clients undergoing this type of surgery usually lose a significant amount of blood, several units of blood had been typed and cross-matched and placed on standby for her. After she was moved to the operating room and anesthetized, the nurse anesthetist rapidly administered the first unit of blood in preparation for the anticipated blood loss during surgery. The circulating nurse was checking the paperwork before the beginning of the operation and noticed that there was no consent signed for the administra- tion of blood products. In examining the chart further, she noted that "Jehovah's Witness" was written under the "Religion" section. The Jehovah's Witness religion does not allow blood transfusions or transplantation of any tissue or organs. The circulating nurse told the nurse anesthetist about the client's religion, and his re- sponse was, "Holy cow-I can't believe this is happening!" The family did not know about the blood transfusion, and obviously the client, who was under anesthesia, did not know she had received a unit of blood. The nurse anesthetist announced that it was not his fault because he was never told about the client's religion and was not going to tell the family or client about the mistake. The circulating nurse felt that because she did not administer the blood, she should not be the one to inform the family. The unit manager was called in, and the consensus was that she should be the one to reveal the infor- mation because she was ultimately responsible for what occurred in the surgical unit. Her feeling was that because no physical harm was done to the client, the whole incident should just be kept quiet. Questions for Thought 1. Using the ethical decision-making model listed, work through the decision- making process for this ethical dilemma. 2. What are the key ethical principles involved in this dilemma? 3. What are the possible solutions to the dilemma and their consequences? 4. How would you resolve the dilemma? How would you defend your decision?

Answer 1

1, Respecting patient autonomy is responsible for nurses as an ethical decision making important. Jehovahs witness ethical issues arise when the patient refuses blood transfusion and when the nurse did not get informed consent for blood transfusion.
2, the ethical principle involved in this dilemma include autonomy to respect patients for their treatment option, beneficiaries that health care providers should benefit patient in each situation.justice for concerning when decision-making option, non-maleficence not to do harm for the patient at any situation.
3, Autonomy through informed consent is basic bioethics. as a nurse, they should follow the code of ethics, discipline decision making. address the consequences earlier and prevent an ethics perspective and not lead to further conflict.
4, Patients should be treated with respect by staff, they should be sensitive to patient beliefs, values and culture. by adopting ethical dilemmas we can solve the issues. The nurse should reveal the information to the patient with the concern of blood loss and potential risk.