Ethical issues that we encounter everyday must be solved in accordance with proper ethical principles. In the field of nursing, there are many ethical issues that may leave any person involved undaunted to decide in accordance with wha is right and proper. Health care providers are more inclined to do what is right instead of disregarding justice over technicalities. The greatest ethical dilemma I face is coding patients who will have no quality of life after they are revived.
I’m talking about people who are terminally ill or with multiple chronic medical problems who have deteriorated to the point of not being able to do anything for themselves, and may not even have much brain function left. In my nursing career as a registered nurse, I have seen patients literally rot away on the ventilator, being kept alive on 100% O2 and not breathing above the vent at all. The heart keeps beating because we are giving O2 and breathing for the patient.
Don’t get me wrong, I believe in life support, and I will do anything in the ACLS (advanced cardiac life support) protocol to save a patient who is not DNR. However, there are too many patients who should be DNR (Do not Resusitate) who aren’t. Sometimes patients come into the hospital with an advanced directive that gets ignored, or they present health care providers with special power of attorney to a family member who ignores the patient’s wishes. The doctors are worried about the family members suing them if they don’t do everything possible for the patient.
The clear and convincing source of the dilemma is the difficulty of deciding whether or not a patient must live despite the obvious hindrances. Sometimes it is just time for the patient to die, but we keep doing everything to keep the patient alive when there is no hope for a recovery. I have seen some miracles, but I see more prolonged deaths with the patient suffering. If you talk to the family members six months later, after the patient has died, they always say that they wish they had 3 not allowed their father to suffer and linger so long.
It may be that they feel bad that their mother did not get to die at home, which is what she wanted. Our technology is too far ahead of our bioethics. We can save you, but we can’t guarantee you’ll actually get to live. We can drain your life savings and leave your family with a huge bill, but we can not give you any quality of life for that last couple of weeks we keep you alive. In this case, the best way to do is to decide in accordance with matters that are both beneficial to the patient’s family and the health care providers themselves (Aiken, 2001, p.105).
If there is a need for me to decide based on the ethical dilemma presented in this paper, I will follow the promptings to persuade the family of the patient to let the patient die in order to save money and to avoid further sufferings of the patient for nothing. If there is no hope for recovery, it is unfair on the part of the patient to suffer longer and for his family to pay huge hospital bills for useless and baseless reasons. There must be courage to let go of the patient both on the part of the health care providers and the family of the patient.
However, not all persons can be persuaded to let their family member die despite the fact that there is no hope for recovery. In this juncture, the ethical principle of justice is applicable. Justice is the obligation to be fair to all people. On my part, the requests of the patient’s family as well as the wishes of the patient are more important than my rationale in allowing the patient to die. I will also allow the patient’s family to carry the burden on their own free will and at their own expense with respect to the life of the patient.
Based on the standard of best principle, the decision of the health care providers and the family that is best for the patient is controlling. Besides, it is proper to consider the patient’s expressed wishes which might be his or her last requests. In this way, the ethical principles of justice and standard of best can be used to resolve ethical issues affecting health care providers in dealing with the patient’s family. 3
Aiken, D. T. Legal, Ethical, and Political Issues in Nursing. USA: F. A. Davis Company, 2001.