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Case study on nursing ethics
Clinical reasoning and decision making
Case study on nursing ethics
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Case Study Analysis:
The patient,MMMM, needs a blood transfusion and possibly surgery to save her life as well as the life of her unborn child related to an injury she sustained from a motor vehicle accident. The patient does not want to receive blood products or surgery. The patient's reluctance is related to her faith, which is based upon biblical scripture pertaining to blood. The primary ethical issue in this case is the patient's right to autonomy. There is another dilemma in this case and that is the unborn child is at an increased risk of death should the patient decide against the transfusion or surgery. When an adult refuses a blood transfusion related to religious beliefs despite receiving the information of benefit versus risks, it is considered an informed decision. However, a parent that refuses a blood transfusion for their child based upon this same belief may face legal charges of abuse or neglect and a judicial decision will be made (Burkhardt & Nathaniel, 2007, p. 456). This raises a precarious ethical dilemma for the health care team related to the principle of the autonomous rights of Juana as well as the principle of beneficence toward her unborn child.
Beneficence is defined as doing or promoting good, preventing harm, and removing evil or harm (Burkhardt & Nathaniel, 2007, p. 62). At what point does the nurse's duty to prevent harm surpass the patient's right to autonomy. This case would likely go before the court taking the decision from the patient as well as the health care providers ruling in favor of the best interest of the unborn child. The use of the ethical theory Deontology and a rationalist school of thought might ease the decision making process for the nurse.
The patient refusing treatment ...
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...loodless surgeries are cost effective as blood is more expensive than iron or Procrit, it decreases the risk involved in transfusions such as administering the wrong blood type related to a mistake made in the lab. Bloodless surgeries are on the rise and several hospitals have adopted this cost effective alternative for patients ("Bloodless surgery," 2013). The remainder of this case study analysis will utilize the four-method strategy to investigate the dynamics of this case in more detail.
Works Cited
Burkhardt, M. A., & Nathaniel, A. K. (2007). Ethics & issues in contemporary nursing (3rd ed.). Clifton Park, NY: Cengage Learning.
Safety, cost savings, simplicity back broader use of bloodless surgery [Special section]. (2013, May). OR Manager Inc, 29(5), 1-6. Retrieved from http://www.ormanager.com/wp-content/uploads/2013/05/ORM_0513_01_Bloodless.pdf
There are many ethical paradigms through which humans find guidance and justification for their own actions. In the case of contractarianism, citizens of a state are entitled to human rights, considered to be unalienable, and legal rights, which are both protected by the state. As Spinello says, “The problem with most rights-based theories is that they do not provide adequate criteria for resolving practical disputes when rights are in conflict” (14). One case that supports Spinello is the case of Marlise Munoz, a brain-dead pregnant thirty-three year old, who was wrongly kept on life support for nearly two months at John Peter Smith Hospital in Fort Worth, Texas. Misinterpretation of the Texas Advance Directives Act by John Peter Smith Hospital led to the violation of the contractarian paradigm. Although the hospital was following the directive in order to maintain legal immunity for its hospital staff, the rights of the family were violated along with the medical fundamental principle to “first, do no harm.”
- If all of the options were explored, and patient is given antibiotics and is treated without any pain or suffering than the treatment identifies with the ethnical principles of autonomy, non-maleficence, and veracity. In turn, Mrs. Dawson will be happy with the outcome of the procedure.
The classical term for the word ethics is, moral philosophies that rule an individual’s or group behavior or action. The American Nurses Association used ethics to write the Code of Ethics for Nurses with these values and visions in mind: “(1) As a statement of the ethical obligations and duties of every person who chooses to enter the profession of nursing. (2) To act as the nonnegotiable standard of ethics. (3) To serve as an expression of the understanding on nursing’s commitment to society.” (Nurses Code of Ethics, 2015). With our ever-changing society and healthcare, also comes changes to the American Nurses Association’s
Ethics has been a popular topic in nursing for a long time. Nurses are expected to demonstrate ethical decision-making as well as professionalism. I believe that in order to accomplish this, they need to use the ANA Code of Ethics as framework for their decision-making. It is also imperative for nurses to have a strong understanding of ethics, because they will be faced with many difficult ethical decisions that do not always have a straightforward solution.
According to the Case Management Society of America, case management is "a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality, cost effective outcomes" (Case Management Society of America [CMSA], 2010). As a method, case management has moved to the forefront of social work practice. The social work profession, along with other fields of study, recognizes the difficulty of locating and accessing comprehensive services to meet needs. Therefore, case managers work with these
American Nurses Association. (2015, January 2015). Code of Ethics for Nurses With Interpretive Statements, 1-76. Retrieved from
Thompson, I. E., Melia, K. M., & Boyd, K. M. (2006). Nursing Ethics: Churchill Livingstone Elsevier.
This paper will focus on two BNUR leaner outcomes (University of Calgary, 2013) relevant to my learned understanding of nurses as ethical decision makers. I will outline the ways that I have seen ethics used and not used in practice, what I learned about ethics and its use in my theory courses and throughout my practicums, and I will reflect on how this understanding will translate into my professional practice moving forward.
Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing (4th ed.). Stephan Helbra.
Spokane Industries has contracted Franklin Electronics for an 18 month product development contract. Franklin Electronics is new to using project management methodologies and has not been exposed to earned value management methodologies. Even though Franklin and Spokane have worked together in the past, they have mainly used fixed-price contracts with little to no stipulations. For this project, Spokane Industries is requiring Franklin Electronics to use formalized project management methodologies, earned value cost schedules, and schedules for reports and meetings. Since Franklin Electronics had no experience with earned value management, the cost accounting group was trained in the methodology in order to bid for the project.
Davis J. Anne Diane Marsha and Aroskar A. Mila (2010). Ethical Dilemmas and Nursing Practice. Pearson
Rich, K. & Butts, J. B. (2014). Foundations of ethical nursing practice (Chapter 4, 3rd ed.). In K. Masters (Ed.). Role development in professional nursing practice. Burlington, MA: Jones & Bartlett Learning.
This theory takes into question whether or not a person is judged by their actions or their character. If a person is judged by their actions, then the theory states that they are judged ethically. If a person is judged by their character, then they are judged morally. This theory states that there is always a constant internal fight between a person’s ethics and morals. Transfusions are usually performed on patients going in for surgery or those suffering from injury such as loss of blood in a car accident or disease. Cancer is a prime candidate for the use of blood transfusions since it impacts the organs that affect your body’s blood count thereby greatly reducing red and white blood cell count. Whether it is a blood illness, burn, or liver failure various parts of blood can be used to counteract the damage done by such conditions using either red or white blood cells along with platelets. While blood transfusions play a vital role in combating both illness and injury with success these procedures do have some form of risk involved that any blood recipient must take into
The American Nurses Association created guidelines for the profession including, a set clear rules to be followed by individuals within the profession, Code of Ethics for Nurses. Written in 1893, by Lystra Gretter, and adopted by the ANA in 1926, The Code of Ethics for Nurses details the role metaethics, normative ethics, and applied ethics have within the field (ANA, 2015). Moral obligation for an individual differs within professions than it does within an individual’s personal life, so the code of ethics was written to establish rules within the profession. The moral obligation to provide quality care include the fundamental principles of respect for persons, integrity, autonomy, advocacy, accountability, beneficence, and non-maleficence. The document itself contains nine provisions with subtext, all of which cannot be addressed within this paper however, core principals related to the ethical responsibilities nurses have will be
Kidneys are very important to humans, because without a properly functioning kidney, humans will struggle to live well. At present, there are many actions that are done by desperate people to sell organs. Kidney sales cases occur when a person sells or transfers a kidney from one individual to another for the purpose of replacing the recipient’s damaged organ. There are thousands of people who would spring at the chance to buy a kidney legally. Also, there are many healthy people who are desperate for money. A safe, legislated procedure of removing a single kidney could satisfy many struggling families needs, and second-handedly, providing opportunities for the donor’s family to live healthily. So long as the procedure is legislated, the risk i...