HCM 483 Week 5 Write Ups Shaellen Thompson.docx

HCM 483 Week 5 Write Ups Shaellen Thompson.docx - Shaellen...

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Shaellen Thompson HCM 483 June 10, 2017 Case 74: Ethical Issues over DNR Orders In this case a Mr. Warden is admitted into a hospital. He is 93 and is being sent to hospital from a nursing home. He can’t speak or even recognize anyone. Mr. Warden has many health conditions and is in congestive heart failure. The nursing home has indicated that he has had only one visitor in the past six months and they were not related to him. You are the physician in charge of Mr. Warden. You have a meeting with his daughter, son and two grandchildren to discuss a course of action for Mr. Warden’s care. You tell them about the congestive heart failure and his condition and recommend no further treatment. The daughter gets upset and cries, yells and says she wants you to do everything you can to save her father. The son understands the situation and just wants his father to be comfortable in the last days of his life. The daughter gets mad at her brother. She is asked why he does not visit her father when she lives so close. She ignores the question, asks you to give her father the best care, and will not give you a do not resuscitate (DNR) for her father. The brother knows that his father is not himself anymore do to his health condition and agrees to DNR. The physician finds out the brother is the father’s power of attorney and has the right to make the decision on whether to resuscitate Mr. Warden or not. The ethical dilemmas in this case are autonomy, nonmaleficence, beneficence, and justice. “You (the physician) must respect patients and clients’ autonomy – their right to decide whether or not to undergo any health care intervention – even where a refusal may result in harm
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or death to themselves…” under section 3.2 of the NMC Code of Professional Conduct ("NMC code of professional conduct: standard, The"). In this case Mr. Warden can no longer respond or speak to be able to tell the physician what he wants done with his care. A physician also promises to do the best he can for a patient which is beneficence. This is one of the foundations of a doctors Hippocratic oath. So, if he does do a DNR then he will have done harm to a patient which is considered to be against nonmalefience which is to do no harm. Finally, in this case is the question of justice for the patient. Is the doctor treating the patient fairly and the same as the other patients that have Mr. Warden’s conditions? Hopefully the physician has or he will have violated justice for his patient.
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  • Spring '19
  • Tim Ludwig
  • Health care provider, DNR, Mr. Warden

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