Ethics Discussion 3

Part A
I chose cultural diferences at the end of life. In this scenario, there was a
lady that had a stoke 3 years ago. At that time she had a feeding tube placed and
was not able to moe her right side. !he stroke had afected her communication,
she was no longer able to erbali"e she could only communicate by pointing. In
recent eents, she deeloped aspiration pneumonia and sufered cardiac arrest.
#he is on the entilator and is minimally responsie and able to s$uee"e with her
left hand. !hree family members were present and spoke to Dr. %im about their
mother&s prognosis and wanted to remoe the entilator. #he did not hae the
$uality of life she once knew and the family thought that the continued treatment
was causing their mother to sufer. !he patient had a ery actie life style up until 3
years ago. #he was actie in an art cultural group, she was actie in her church and
she often on awards for her yard. !he family knew that she would be angry with
them if they allowed her to continue to lie the way she was liing. !hey ask Dr. %im
for his adice. Dr. %im had a ery similar e'perience with his mother. Dr. %im&s
mother had a stroke, had a feeding tube was contracted but the family members
took care of his mother under his direction not because he was a physician but
because he was the eldest of the group. (e could not help himself but to disagree
and stated to the family, take the feeding tube, she stares and take the entilator
she dies. )hat do you want me to do* +linicians do not like to see the one&s they
care for die and with Dr. %im&s culture and his beliefs he did not want to do what the
family had ask. !his scenario shows a great deal of diferences in patients and
families culture. In this case study, it shows one family that is ery aware of the
situation and what they beliee would be the right thing for their loed one. Dr. %im
was looking at the guilt and the regret the family may feel if they remoed the
entilator or the feeding tube. #ome families would feel that way depending on their
beliefs. #ome would feel ery relieed speaking of end of life and others would be
ery stressed speaking of end of life discussions. !he commentary states that it is
ery important ant we understand our own culture, ethnicity, religion and customs
surrounding death and dying and that can help clinicians proide more
compassionate guidance and care for the dying patient. As clinicians we are often
bothered by not knowing what we would do in our patients, circumstances and the
guilt we feel at unsuccessfully healing a patient. -o one wants those they care for to
die, neither physicians nor families, yet the true acceptance of an ineitable death
is best engineered with a carefully worded.
I beliee that in this situation that we .healthcare/ needs to listen to patients
families. Especially in this scenario. !he family had spoke in great detail about
what was best for the mother and they were shot down with no e'planation other
than if we do that she will die. !hey were already aware of this and I beliee that
Dr. %im was using his personal beliefs or e'perience to make the family feel guilt or
fear because it is something that he would not do.
Part 0
Empowering patients
I do think that it is ery important for us to empower our patients by giing them
the opportunity to be an actie participant in their care. +linicians can empower
patients by giing them the opportunities to increase the $uality of life. #ocial
support is a big empowering tool. It gies the patient the opportunity to meet
others that hae the same .or close to the same diagnosis/ to gie support and to
see what else works for those people. I think that we can ofer alternatie
therapies, such as reiki or energy medicine .in addition to medical treatment/ if that
is something that they are open to. I also think that meditation or rela'ation
techni$ues are a must in any chronic disease diagnosis. I often do rela'ation
techni$ues and reiki with my patients that are open to it that hae stress related
disorders and they 1nd it most helpful. I beliee that nurses hae always
empowered patients and should always do so. 2any of the patients con1de in
nursing staf because that is who is with them most of the time and we .as nurses/
can take full opportunity of this and ofer things that the patient may hae neer
thought of. Also there is a lot of technology out there to where patients can
research and study on their own. I beliee that we need to ofer them dependable
site to where they can do their research because as we all know eerything on the
internet is not true. !here are so many way nurses can empower their patients it
can be from a smile when you enter the room or a friendly hello to a reference of a
social gathering or a number of things.
Part +
1. 3es, I beliee that she should be told. Een at age 4 there are things that can
be done to help her deal l with things and een empower her. I hae always
been honest with my children and I like to think that I would be able to speak
with them about this and educate them and empower them anyway that I
could. !his would be including alternate healing methods for stress ect.
2. I would do the same as aboe. A person is a person and if they can
comprehend the situation it is their right to know what is going on with their
body.
3. As an ethics committee team member, I would not oerride grandma right
away. I would talk to her and get her point of iew. !ry to understand where
she is coming from and the reasons why she does not want to tell the
children. I would work with her and empower her as well and gie her the
support she needs to address that child&s disease or maybe she is not
comfortable and I would ofer go in and speak to the child. 3ou hae to
understand the situation before you oerride someone.
4. I beliee that eeryone has the right to know what is going on with their body
and why they are so sick and enduring so much pain. I beliee the nine year
old is old enough to understand what is going on. #he may want to get
things in order before she crosses the eil. #he may hae $uestions that
maybe a pastor can answer or maybe een grandma. It is the e'act same
situation with the 56 year and 7 month old adolescent. !here are proper
ways of e'plaining the disease to each age group but both hae the right to
know.