Question

At a small rural hospital with a four-bed intensive care unit, two women had cardiac arrest within a few minutes of each other. One was a 52-year-old college professor with teenaged children at home, and the other was a 78-year-old widow from a nursing home with advanced Alzheimer’s disease. Because the hospital and unit were so small, only one code cart with a defibrillator was available with one RN and one LPN on duty at the time. The RN had to decide which client to resuscitate.
 
Questions
 
1. On what ethical principles could she base a decision?
2. What should her decision be?
3. How could she defend her decision if questioned by the ethics committee?

Answer 1

Answer 1. There are four tenets of medical ethics by which the RN should take her decision

• Autonomy – respect for the patient's right to self-determination.
• Beneficence – means 'do good' to patient
• Non-Maleficence – means not to harm the patient
• Justice – to treat all people equally and equitably.

From above we can deduce that the RN should no longer be guided by justice as she has no option to treat both equally.

And no question of doing harm is relevant here

As patients here are in no condition to self determine,

RN can stick to only Beneficence

Answe 2.     her decision should be to revive the younger one with teenaged CHILDREN

Answer 3.     Anyway the beneficence is two sided here

doing good to the society as she is still much young ( can maintain teacher job) and doing good to her own as well as society as she is in charge of teenaged children. This period is crucial for their (teenager) mental growth and upliftment,