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Medical Ethics: A Do-Not-Resuscitate Order
Introduction
In the given scenario, the nurse is faced with the choice of whether she should provide relief from choking because the patient has a DNR. A DNR order means that healthcare professionals cannot apply chest compressions, defibrillation, endotracheal intubation, assisted ventilation, or cardiotonic drugs to the patient (EMSA, 2018, p. 4). According to the American Heart Association (2017), rescue breathing and chest compressions are presented to a victim who is choking only when a case of unresponsiveness is experienced. A sudden cardiac arrest and choking are caused differently, so it is important to determine the cause of unresponsiveness in the given case. In this scenario, the olive that has choked and stuck on the patient could result in the patient coughing, panic expression, gasping, and not being able to speak. However, the patient could still be aware of what was happening.
If the patient could not cope with choking on their own and were not provided with help, the patient could collapse and lose responsiveness. Before that happens, the nurse can provide the patient with relief from choking by performing an abdominal thrust. According to EMSA (2018), relief of choking is appropriate in patients with DNR, but if it does not help and the patient becomes unresponsive, the use of ventilation is inappropriate. Therefore, it is morally ethical for the nurse to help the given patient before the patients heart stops beating.
Terminal Cancer
For a medical practitioner, informed consent dictates the quality of interventions provided. In this case, first, I would have to advise her to be bold and to open up to her parents. Secondly, I would inform the health care team about the girls wish so that they informed the parents. Perhaps, they could reach an informed decision that suits both the parents and the girl. The parents already understand the implications of their choice, which is driven by guilt. So, if they still wished to continue with the decision after knowing their childs wish, I would have no right to discharge her.
The teenage girl is legally unable to make a medical decision; therefore, her consent to medical decision-making is with her parents. Since the parents are fully aware of the oncologists final evaluations concerning their child, it is in their best interest to choose whether to grant the girl her wish or not. The health care providers do not have the right to make a medical decision on behalf of a patient unless there is informed decision-making and consent.
Surgical Procedure
Almost all surgical procedures in the healthcare setting require some infringement on an individuals psychological independence. In the case where a patient has changed his mind regarding signing a consent form for a surgical procedure, as a nurse, I would have to listen to the patient. I would not force him, but I would calm him and call the doctor back so that the patient opened up to him about the sudden change of mind. If the patient insisted on backing out, then he could not be forced.
The dignity of an individual being exposed to any procedure should be protected, and their autonomy recognized; their submission to the procedure should be voluntary. However, the patients decision should be informed to avoid adverse health consequences and possible litigation. Scibilia (2018) recommends that healthcare professionals should document informed refusal the same way as they do with informed consent. This way, healthcare professionals ensure that they provided the patient with all the information about the consequences of the treatment refusal. So, in the given case, I would inform the patient about the adverse effects of not undergoing an operation, and if it did not help, I would ask the patient to sign an informed refusal.
References
American Heart Association. (2017). Study guide 2017: BLS for healthcare providers. Web.
Emergency Medical Services Authority [EMSA]. (2018). Do not resuscitate (DNR) and other patient-designated directives. Web.
Scibilia, J. P. (2018). Document informed refusal just as you would informed consent. Web.
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