Articles and letters to editors continued to be published through the late s in many medical and nursing journals that supported either retaining traditional restrictions on family presence or adopting more lenient policies that allowed family presence in selected situations.
He was not wearing a seat belt and was thrown through the windshield, sustaining a traumatic, closed-head injury. Subsequent studies resulted in the publication of the first evidence-based guidelines, which recommended that hospital personnel remove restrictions on family presence.
Because new graduate nurses often choose to specialize in critical care, nurse educators who design and teach undergraduate critical care nursing courses are obligated to address ethical decision making as part of the curriculum.
Hanson and Stawser 2 published the experiences of the emergency department staff at Foote Hospital in Michigan, attributed as being the first hospital to allow family presence during CPR.
Next Section Case Study A year-old man lost control of his vehicle and struck a guardrail in a single-car collision. After the review of the literature and the search for current practice guidelines are completed, students will be ready to further define the opposing arguments inherent in the ethical conflict.
During the discussion of these issues, the instructor should function as both facilitator and moderator and should be responsible for ensuring that all points of view are equally represented and discussed as the ethical analysis unfolds.
Students conducting a review of the literature may be surprised to discover that most of the available information has been published within just the past 2 decades. Yet, many critical care nurses have reported that they received little preparation in their basic education programs to deal with these sensitive issues.
Once the issues defining the dilemma are exposed and described, students can search for relevant practice guidelines endorsed by medical, nursing, and other health-related organizations. He was brought to the trauma center via helicopter and was admitted to the surgical intensive care unit. The clinical analysis of the case study is designed to answer the question, Does an overriding obligation exist to honor the desires of the family or the desires of the healthcare providers?
Molter 1 published a landmark study that was the first to acknowledge the needs of families of critically ill patients. The debate about whether to offer family presence during CPR is an example of an ethical dilemma that arises within critical care nursing practice.
Family members viewed family presence not only as a fundamental right but also as a way of offering support to their loved ones in crisis. The advent of high-tech medical practices moved patients out of homes and into hospital beds.
Discussion of findings with their peers helps students identify key issues within the ethical dilemma.
However, they also expressed concern about feeling emotionally traumatized and obligated to witness CPR when they might prefer to decline. In this article, I present a case study of an ethical issue in critical care and describe a method of clinical ethical analysis that nurse educators can use when teaching students about making ethical decisions in clinical practice.
In small groups, students can begin their analysis of the issue by reviewing the current literature on family presence. However, other patients reported that they preferred to face death alone and did not want estranged relatives allowed to invade their privacy.
A moral conflict exists because 2 opposing obligations collide: Even though such a move offered greater proximity to lifesaving equipment, it removed patients from their families. The focus of the ethical questions that stem from this clash of desires is determining which obligation deserves to be fulfilled while the opposing obligation is ignored or compromised.
Some patients said that they felt safer and less afraid with family members present. At that moment, the student took the stunned wife into the hallway, and a nursing supervisor arrived to lead the woman into a private waiting room. Once students formulate an answer to this question, they can advance recommendations that reaffirm the traditional policies that restrict family presence or that promote the adoption of new policies that lift restrictions on family presence in the critical care setting.
When patients were too sick to be treated on general nursing units, they were moved to critical care units. No ethical dilemmas of this type existed before the development of CPR in the late s because family members were present at almost all deaths.Analysis of Ethical Issues in Case Study #1 Ethical Dilemma “Ethical dilemma may exist when there is a conflict between the rights and values of the people involved in the situation” (Perrin &McGhee, ).
The third ethical principle in the case study to discuss is paternalism. At times paternalism viewed as a negative act because it allows healthcare providers to make decisions for the patients (Andre & Velasquez, ).The facts in the case study provide for an excellent example of when paternalism should be exercised.
Ethics in Nursing: Case StudyAmong the five most frequently cited ethical concerns by nurses surveyed in a recent study in Australia is protectin /5(3).
The patient suicide attempt – An ethical dilemma case study. Author links open overlay panel Lin Jie. Show more. Analysis of the ethical dilemma In Mr Green's case, the nursing staff made the best ethical decision for the patient. She chose to share the information of Mr Green's suicide attempt with other health care professionals.
Nurse educators teaching critical care courses can increase students’ understanding of ethical dilemmas by having the students participate in a clinical analysis of a case study.
The debate about whether to offer family presence during CPR is an example of an ethical dilemma that arises within critical care nursing practice.
Critical Analysis of the Article Everyday Ethics: Ethical Issues and Stress in Nursing Practice - Author’s Credentials and Other Information Connie M.
Ulrich, PhD, RN is an associate Professor of Bioethics and Nursing center for Bioethics, Department of Medical Ethics, and Senior Fellow.Download