Ethics In The Nursing Profession

Ethical Case Studies

(Select 0ne of the following cases on which to base your discussion)

Case One

You are working in a fertility clinic and a patient, who herself was adopted, has decided to pursue genetic testing through a commercial genetic counseling site. She shares she believes strongly those with genetic predisposition to certain physical weaknesses should not reproduce.

Weeks later she comes in and shares she has the gene for a genetic anomaly; she also wants a pregnancy test. It turns out positive and she is very matter of fact about making an appointment for an abortion without consulting her husband. A new, strongly prolife nurse on your staff, the daughter of the CEO, speaks with the patient’s husband. She does not reveal the pregnancy outright but encourages him to come to the next appointment with his wife to surprise her. The patient arrives at her follow-up appointment 72 hours later and her husband appears in the waiting room; the patient does not expect to see her husband in the waiting room. The patient is irate at the breach of confidentiality; the husband is elated and downplays his wife’s rage saying she will calm down in a few days.

What do you do next to address this ethical dilemma?

· Briefly describe the ethical problem in this scenario.

· Discuss ethical principles breached in this scenario.

· What ethical principles can be beneficial as you attempt to resolve this issue?

· What do you think your response should be in this situation? Why?

· What values are involved within this dilemma?

· Discuss how your personal values influenced how you resolved this dilemma.

· Discuss the ANA Code of Ethics Provisions that support your resolution to this dilemma.

· How do these provisions relate to this situation?

local nursing home

Case Two

You work at a local nursing home. One of your patients is 37 years of age. He has resided at the nursing home for the last five years. He had had a severe stroke when he was 32 years of age. He watches the activity around him; however, he has expressive aphasia. He is unable to swallow. He has had a gastrostomy tube (G-tube) for the last four years for G-tube feeding. He is in decerebrate posturing. The staff try to get him out of the room in a recliner every day for a change of scenery, but there is no apparent response. He simply stares.

The patient’s wife has a sales job and is out of town frequently, so she rarely visits. It has been over a year since the last time she came into the nursing home. The patient is a full code. Today, the patient’s wife came into the nursing home with her boyfriend, and asked to have the patient’s status changed to “Do Not Resuscitate.” Also, she asked for hospice to be called in so that they could order the G-tube feedings and medications discontinued. The physician wrote the order for a DNR and hospice consult, and hospice has been called and have visited with the patient and his wife. You receive the order to discontinue the g-tube feedings, fluids via g-tube, and all medications. You know that discontinuing the feeding and fluids will result in the death of this patient and feel uncomfortable following this order.

type of ethical problem

· Briefly describe the type of ethical problem described in this scenario.

· Discuss ethical principles related to this scenario.

· What ethical principles can be beneficial as you attempt to resolve this issue?

· What do you think your response should be in this situation? Why?

· What values are involved within this dilemma?

· Discuss how your personal values influenced how you resolved this dilemma.

· Discuss the ANA Code of Ethics Provisions that support your resolution to this dilemma.

· How do these provisions relate to this situation?

Case Three

You work at a small rural hospital in the Midwest and the latest buzz in the hospital is the admission on the second floor is a practicing Muslim male who is refusing care from the female nursing staff. He insists on getting out of bed for prayer five times daily, though the physician has him on complete bed rest. The emergency room male technicians and two male nurses on staff have done as much as they can do to assist the female nurses.

One of the male unit clerks, who is in nursing school, even stepped in and provided personal care once. You have an appointment with Risk Management and the Director of Nursing at 1:00 p.m. leaving you just enough time to grab lunch in the cafeteria. You sit down near a table full of staff nurses and overhear bits of conversation heavily sprinkled with slurs. Now, in addition to the situation of the patient, you realize your staff needs major education.

What do you do next to address this ethical dilemma?

· Briefly describe the ethical problem in this scenario.

· Discuss ethical principles breached in this scenario.

· What ethical principles can be beneficial as you attempt to resolve this issue?

· What do you think your response should be in this situation? Why?

· What values are involved within this dilemma?

· Discuss how your personal values influenced how you resolved this dilemma.

· Discuss the ANA Code of Ethics Provisions that support your resolution to this dilemma.

· How do these provisions relate to this situation?

Ethics In The Nursing Profession