APPLY ETHICAL THEORY OR PRINCIPLES WITH THE CASES PRESENTED.
INTUBATING THE DEAD PATIENT: TREATMENT PRACTICE WITHOUT CONSENT
1. Mr. Ellsworth who was 87 years old, was brought into the emergency room by the local rescue squad in a complete cardiac arrest. All emergency procedures were performed, including the establishment of an airway, placement of peripheral intravenous lines, urinary catheterization and more. After resuscitation attempts had been performed for 45 minutes, the patient was pronounced dead by the attending physician and family members were notified. When the family arrived at the emergency room, Mary Pope, the evening staff nurse, found the attending physician teaching intubation techniques to five medical students. They were using Mr Ellsworth’s corpse for the practice. She quietly notified the attending physician that the family had arrived and wanted. To talk to the physician. They also wanted to see their loved one’s body. The attending physician, however said he would be busy teaching the medical students for another 15-20 minutes. When she asked whether Mr Ellsworth had given permission for his body to be used for teaching purposes, the attending physician ignored Mrs. Hope and asked her to tell the family that he would be busy with another patient for a few more minutes.
WHEN DOING GOOD MAY HARM THE PATIENT
2. Nurses in a critical care unit had been under a great deal of stress from very ill patients, a high census and frequent staff illnesses during a two-week period. On one particular evening, two nurses recognized that they were developing the symptoms of an upper respiratory infection that had been affecting other members of the staff. Since they had three post op patients needing one on one care and were receiving another admission from the emergency room, the nurses solicited medication from the house staff in order to suppress their symptoms and keep going. While they were able to remain working on the unit and not contribute to an already critical staffing situation, they recognized that they might be causing more harm by communicating their illnesses to already vulnerable patients and by mistakes while under the influence of medications (antihistamine).
The two nurses contemplated the alternatives. They were convinced that the traditional risk to the patients were quite small, and they believed that they patients were in real need of the one-on-one care could only be provided if they remained on duty. They concluded that, on balance, the good they could do exceeded the risk of harm, but they wondered: is there special obligation for health professionals to avoid harm?
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