Ethical Ways of Knowing and Caring
Case 1:
John is a 72-year-old man who was recently diagnosed with pancreatic cancer. After undergoing surgery and further diagnostic testing, it was identified that the cancer had spread to John’s abdomen, liver, and brain. John’s physician informed him that he is palliative with approximately 3-6 months to live. The physician also informed John that should he choose to begin Chemotherapy, this may increase his life expectancy to 6 months to 9 months.
John has accepted his diagnosis and feels that he has lived a full and fulfilling life. He would not like to continue with treatment, however, his wife Mary is adamant that he continues with additional chemotherapy to increase his life expectancy. She can’t imagine a life without him and wants to give him every opportunity to be around for important life moments. She doesn’t believe that John’s decision considers the family and thinks he is “throwing his life away and giving up”. Although John does not want to continue with additional treatment, his wife’s happiness is important to him.
Therefore, he has changed his decision and is going to continue with treatment in an effort to make his wife happy. As John’s nurse, you are concerned that his ability to make decisions is being compromised. You believe that he should have the right to choose his treatment options without coercion from his family.
Explore only one ethical issue within this scenario using the paper outline.
Case 2:
You are a nurse working in a long-term care facility during the pandemic. Within the LTC facility there has been a reduction in the availability of PPE to support you and your colleagues. For example, at times there are not enough masks and gowns available to use a new one in-between patients. The employer informs you that you will need to reuse PPE in order to deal with the limited resources and that not all encounters will require the use of PPE.
They suggest they will provide a list of circumstances where nursing staff should not wear PPE into patient’s rooms to best use the limited resources. You are worried about how these limited resources will impact the spread of COVID-19 within the LTC facility. You are also concerned that you may bring COVID-19 home to your family.
Explore only one ethical issue within this scenario using the paper outline.
Case 3:
As a registered nurse working in the community, you are noticing that many individuals in the community are opposed to a mandatory mask protocol. Feedback to your community health center has identified that those against mandatory mask wearing in public areas believe it impedes their rights and freedoms as a citizen. While you understand these concerns, you are worried about those in the community that are immunocompromised, vulnerable, and more at risk of death as a result of a community acquired infection with COVID-19. You feel an obligation to support policy development that imposes the least restrictive measures, while still protecting the public and health of the population.
Your community health unit has been asked to provide advice to your local MPP in regard to the ethical implications of such a policy. Specifically, they ask you to consider the ethical implications with imposing a mandatory mask policy within the community and to make recommendations to support legislation which upholds ethical principles and protects the public.
Explore only one ethical issue within this scenario using the paper outline.
Case 4:
Ann, a mother of two daughters, was recently diagnosed with Huntington’s disease, an inherited genetic disorder. The healthcare team has explained to Ann that as her disease progresses, she will eventually require assistance with all activities of daily living and care. They also inform her that because this is an inherited genetic disorder, that each of her daughters has a 50% chance of having inherited the mutated gene, which would result in them also having the genetic disorder. The healthcare team recommends to Ann that she tell her daughters of her diagnosis, so that they can decided whether to undergo genetic testing to identify whether they are a carrier of the gene.
Ann appears to understand her diagnosis, but she identifies to the healthcare team that she does not wish to inform her family or tell her daughters about their risk of inheriting the disease. She states that she does not want to “interfere in what God has planned for them” and that telling them would only cause undue stress and anxiety.
As Ann’s nurse you wonder about whether her daughters have a right to know they may have inherited a genetic condition that they themselves could also pass on to their own children. You wonder whether Ann is making a decision that really considers the full implications for her children and not just herself.
Explore only one ethical issue within this scenario using the paper outline.
Case 5:
Caleb is a 17-year-old male dying of lymphoma. He has expressed his wish to die at home. All aggressive treatment attempted so far has failed, and for the past few weeks, Caleb has been receiving palliative care at home. One night, Caleb experiences shortness of breath. His family panics and calls 911. By the time the ambulance team arrives, he has settled, but the paramedics insist he be taken to the closest emergency department for further assessment. Caleb is admitted to a medical unit while the physician on call attempts to locate his primary physician.
While the nurse in charge and admitting nurse are settling Caleb into his room, he stops breathing. The nurses are aware of his palliative care history and intent to die peacefully at home. His family is outside in the waiting room. Since the nurses have not heard from the primary physician, they do not have a signed DNR order. They are faced with two choices—they can call a code and start CPR and other life-sustaining treatment, or they can invite Caleb’s family into the room and give them privacy.
Explore only one ethical issue within this scenario using the paper outline.
Aim:
This aim of this paper is to explore, critically analyze and develop evidence informed strategies that would respond to an ethical issue facing the profession.
Students will choose one of the case scenarios provided on the course blackboard site.
Using the outline below write a five-page paper that summarizes the chosen case and identifies ethical actions that would support resolution of the ethical issue.
Students will examine their professional responsibilities in relation to providing ethical care and envision evidence informed nursing strategies to address and prevent the development of ethical issues within the scenario.
In addition, students link their nursing strategies to addressing the impact of biases, stereotypes and systems of oppression that perpetuate inequities.
If a student wishes to choose a scenario other than the ones outlined on the blackboard site, they must discuss this scenario with their course professor prior to submitting the paper.
Paper Details: This paper must use APA 7th edition formatting. The maximum length does not include the references or title page. Please see the grading scheme for grades distribution. Should your paper be longer than five APA formatted pages, the additional pages will not be graded as part of this assignment.
You are required to use three peer reviewed journal articles from the ethics literature. You cannot use articles that were part of the syllabus. Additional (and necessary) sources such as the CNO standards and references to support your analysis do not count towards the required three peer reviewed journal articles.
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