case-1-for-ethical-decision-making (1).docx - CASE 1 FOR...

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CASE 1 FOR ETHICAL DECISION MAKING:Miss. S is a 67-year-old retired teacher. She has never married and has no children or living siblings. Her closest relatives are several nieces and nephews, whom she has seen intermittently over the years. Since her retirement, Miss S. lived with Ana, a very distant female relative for companion who is also studying acaregiving course. She is independent and lives frugally, yet comfortably. One evening while alone in the house, Miss S stumbled and fell backward on her porch, hitting the back of her head. She felt weak all over and experienced tingling in her arms and hands, but was able to crawl to the phone and call 911. Paramedics in an ambulance took her to a nearby tertiary hospital. X rays of the cervical spine showed a high-cervical fracture.Miss S. was a delightful woman, slight in stature with frail skin and severe osteoporosis. She was placed in a halo body jacket and underwent uneventful cervical spine stabilization. Because of her advanced age and potential respiratoryissues, she was placed in the neurosurgical intensive care unit postoperatively. After the first 48 hours, Miss S developed difficulty eating; a swallowing evaluationdemonstrated partial paralysis of the pharynx and vocal cords. A small-bore feeding tube was placed to prevent aspiration pneumonia. Within a few days, she was transferred to the surgical ward and she began working with occupational andphysical therapists. The neurosurgeon began talking to Miss S. about discharge planning. She vehemently opposed to placement in an inpatient rehabilitation facility and insist to go home. After a few days, she acquired pneumonia so she was transferred back to the intensive care unit in acute respiratory distress. She improved enough to be transferred back to the surgical ward. Miss S. had little control over her surroundings and grew more depressed as other complications, such as skin breakdown around the pin sites on her forehead, developed. Miss S. had difficulty to move even with the assistance of physical therapy. Because of her slight frame,

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Term
Fall
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