Montessori Critical Care Nursing In Resource Limited Environments Discussion Ethics Issue:Your elderly aunt has asked you to take on her health care power

Montessori Critical Care Nursing In Resource Limited Environments Discussion Ethics Issue:Your elderly aunt has asked you to take on her health care power of attorney. She makes the request while she is healthy and able to make her own decisions. You Ch 12
Ethics Issue:
Your elderly aunt has asked you to take on her health care power of attorney. She makes the
request while she is healthy and able to make her own decisions. You agree and sign the
appropriate legal papers. She tells you at this time that she never wants “heroic measures” to be
undertaken to save her life, if her quality of life would suffer.
1. Five years later, you aunt is 86 and suffering from diabetes, coronary problems, and
dementia. While in a long-term care facility, your aunt suffers a severe heart attack and is
transported to the local hospital’s emergency room. She is conscious when she reaches the ER,
and when the attending physician asks her if she wants “all measures taken to preserve her life,”
she says yes. When you arrive at the hospital, your aunt is comatose and has been placed in the
intensive care unit. Her physician says she cannot recover, but he could transport her to a larger
hospital where physicians could “try” a pacemaker. How will you respond?
2. What ethical issues will influence your decision?
Case Study:
You are a member of a hospital resource allocation committee that must decide which three out
of seven critical patients will receive immediate life-saving surgery. The hospital has resources
to save just three of the seven, but without surgery, all seven patients will die. The situation is
further complicated by the fact that a blizzard is raging outside, and none of the patients can be
transferred to another hospital. All seven are too critically ill to be moved by snowmobile. Here
is the list of the seven patients:
An infant child of non-English speaking immigrants
A 15-year-old son of the Village President (nonsmoker)
The 50-year-old Village President (nonsmoker)
A 73-year-old town judge who announced her retirement last week in the newspaper
(nonsmoker)
A 39-year-old man on disability (nonsmoker)
A 45-year-old single mom of 3 kids ages 3, 5 and 9 (smoker)
A 25-year-old waitress in a local cafe who is also 4 months pregnant (assume that if she gets the
surgery, the baby will also survive) (smoker)
1. Which three patients above should get the surgery and why?
Ethics Issue:
Every health are facility should have a disaster plan and should practice implementation of the
plan periodically.
1. In your opinion, would it be ethical, in case of a disaster (think terrorist attack, floods,
wildfires, war), for triage personnel to recommend treating only those injured individuals who
could recover?
2. If materials were sorely lacking and some health care team members had been unable to
report in during a disaster, in your opinion should ethics be suspended and volunteers used to
perform patient care duties?
3. Which patient care duties could reasonably be suspended during an extreme emergency, if
materials, personnel, and perhaps even the usual medical facility were not available?
Case Study:
In 2014, American patients with recurring head and neck cancers were traveling to China to
receive gene therapy via a drug designed to activate the p53 gene, which is supposed to turn off
cells that multiply abnormally, but often malfunctions, letting cancerous tumors grow. Since the
drug was not FDA-approved in the US, patients traveled to China to receive it, at a cost of
$20,000 for the two-month treatment. No studies had yet been conducted to determine the
efficacy of the treatment, but many patients believed their tumors were receding. A genetic
research company in the US was threatening to sue the Chinese company manufacturing the
drug, alleging patent infringement.
1. In your opinion, should American patients be prohibited from traveling to foreign countries to
receive unproven and possibly dangerous medical treatment? Explain your answer.

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