20 Mar ETHICS PAPER SCENARIO
Scenario 1:
Mrs. G, a 58 y/o woman with terminal cancer arrives in the ED of a Texas hospital following an overdose of narcotics. When her husband and daughters arrive, they inform the ED physician that Mrs. G was diagnosed with ovarian cancer with metastasis six months ago and she is six weeks post the last course of chemotherapy. The family explains she has been in severe pain and was found unconscious and barely breathing in her bedroom. Upon arrival in the ED Mrs. G was intubated, placed on a ventilator and started on Dopamine for hypotension. The patient did not have a living will or durable power of attorney according to the family who demand aggressive care despite her attempt to commit suicide and a full code order is placed by the attending MD. After five days in the ICU without improvement in neurologic status, the healthcare team is convinced further interventions are inappropriate and could cause additional client harm. In a family meeting the daughters insists on continued support including additional surgery/chemotherapy/radiation and prolonged ventilator support despite the opposition from the husband who demands that the physician “finish the suicide”.
Consider the following as you write your paper:
Can providers complete the act of suicide?
Is removing her from the ventilator assisted suicide? Who decides?
What are the legal ramifications in Texas for providers?
Should a family be allowed to demand continued medical care when the healthcare team believes that the patient will not benefit from further therapy?
From grading rubric:
Summarizes the facts of the case; clearly states related problem and goal
Identifies competing moral claims (values, duties, rights) related to case and what must be decided
Defines and applies two ethical principles to the case; clearly identifies the conflict between the two principles
Discusses two alternatives with direct application of risks and benefits of each to patient
Formulates action plan of 1 resolution to dilemma with application to ethical principles previously identified; resolution rational, legal, ethical, evidenced based
Relates evaluation of resolution to: stated desired goal, closure of dilemma and benefits to those involved
Accurately applies distributive justice theory to dilemma and correlates theory to ethical principles previously identified
Accurately applies ethical theory that supports resolution; discussion concise and comprehensive
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