- Read the case study presented at the end of Chapter 8 (Guido, p. 150)
- Is
the patient correct in asserting that he has a right to know the names
and status of individuals who will be performing this procedure? - Does the manner in which the student introduced herself and the two other team members have relevance in this case?
- Was the informed consent deficient to the degree that there was a lack of informed consent by the patient?
- How would you decide this case?
- Is
- A
patient is admitted to your surgical center for a breast biopsy under
local anesthesia. The surgeon has previously informed the patient of the
procedure, risks, alternatives, desired outcomes, and possible
complications. You give the surgery permit form to the patient for her
signature. She readily states that she knows about the procedure and has
no additional questions; she signs the form with no hesitation. Her
husband, who is visiting with her, says he is worried that something may
be said during the procedure to alarm his wife. What do you do at this
point? Do you alert the surgeon that informed consent has not been
obtained? Do you request that the surgeon revisit the patient and
reinstruct her about the surgery? Since the patient has already signed
the form, is there anything more you should do?
Now
consider the ethical issues that such a scenario raises. Which ethical
principles is the husband in this example most portraying? Which ethical
principles should guide the nurse in working with this patient and
family member?
- Jimmy Chang, a 20- year- old
college student, is admitted to your institution for additional
chemotherapy. Jimmy was diagnosed with leukemia 5 years earlier and has
had several courses of chemotherapy. He is currently in an acute active
phase of the disease, though he had enjoyed a 14- month remission phase
prior to this admission. His parents, who accompany him to the hospital,
are divided as to the benefits of additional chemotherapy. His mother
is adamant that she will sign the informed consent form for this course
of therapy, and his father is equally adamant that he will refuse to
sign the informed consent form because “Jimmy has suffered enough.”
You
are his primary nurse and must assist in somehow resolving this
impasse. What do you do about the informed consent form? Who signs and
why? Using the MORAL model, decide the best course of action for Jimmy
from an ethical perspective rather than a legal perspective. Did you
come to the same conclusion using both an ethical and a legal approach?
Expert Solution Preview
Introduction:
As a medical professor in charge of creating college assignments and answers for medical college students, it is important to teach students about ethical issues that arise in healthcare. In this assignment, we will be analyzing three case studies and discussing the ethical dilemmas presented in each. We will use the MORAL model to guide our decision-making process and come to a conclusion that considers both ethical and legal perspectives.
Answer:
Case Study #1:
1. The patient is correct in asserting that he has a right to know the names and status of individuals who will be performing the procedure. Patients have a right to know who will be providing care to them and their level of experience and expertise.
2. The manner in which the student introduced herself and the two other team members is relevant in this case. Patients have a right to know who will be involved in their care, and how each individual is qualified to perform their duties.
3. The informed consent was deficient to the degree that there was a lack of informed consent by the patient. The patient did not receive adequate information about who would be performing the procedure.
4. In deciding this case, it is important to ensure that the patient’s rights are protected. The hospital should provide the patient with a revised informed consent document that includes the names and status of individuals who will be performing the procedure.
Case Study #2:
1. In this scenario, it is important to address the husband’s concerns and ensure that the patient is fully informed about the procedure. The nurse should communicate the husband’s concerns to the surgeon and request that the surgeon revisit the patient and reinstruct her about the surgery.
2. The ethical principles that should guide the nurse in working with this patient and family member include beneficence, non-maleficence, and autonomy. The nurse should ensure that the patient receives the best possible care while also respecting her autonomy and right to make decisions about her own health.
Case Study #3:
1. In this scenario, both the mother and father have valid concerns about their son’s treatment. It is important to consider both perspectives and ensure that the patient’s wishes are respected.
2. Using the MORAL model, the best course of action for Jimmy is to ensure that he is fully informed about the benefits and risks of additional chemotherapy. If Jimmy is able to make an informed decision, he should be the one to sign the informed consent form. However, if he is unable to make a decision, his mother may sign the form as his legal guardian.
3. The conclusion reached using an ethical and legal approach may be different in this case. While it is important to consider legal guidelines for obtaining informed consent, it is also important to consider the ethical implications of the decisions being made.
