Nursing Home Ethics Case Studies

Nursing Home Ethics Case Studies-79
Keywords: Brain death, clinical ethics, ethics consultation, reasonable accommodation, religious conflict Link to Case on MUSE Reflection Questions: Jeffrey P.Spike Abstract: A fourteen year old is diagnosed with aplastic anemia. An ethics consult is called on the day of admission by an ethically sophisticated social worker and attending.

Keywords: Brain death, clinical ethics, ethics consultation, reasonable accommodation, religious conflict Link to Case on MUSE Reflection Questions: Jeffrey P.Spike Abstract: A fourteen year old is diagnosed with aplastic anemia. An ethics consult is called on the day of admission by an ethically sophisticated social worker and attending.

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As the healthcare professional in closest contact with both the patient and the physician, nurses face biomedical ethical problems in unique ways.

Accordingly, Case Studies in Nursing Ethics presents basic ethical principles and specific guidance for applying these principles in nursing practice, through analysis of over 150 actual case study conflicts that have occurred in nursing practice.

Relying on narrative to convey the experience of a family and clinical caregivers embroiled in this complex dilemma, the case analyzed here explores the practical challenges and moral ambiguities presented by the concept of reasonable accommodation.

Clarifying the term’s meaning and boundaries, and identifying guidelines for its clinical implementation, could help to reduce uncertainty for both health care professionals and families and, thereby, the incremental moral distress such uncertainty creates.

However, Nash argues fiction presents students with the opportunity to better under the patient and get to the root of the patient's concern.

To demonstrate his argument, Nash's paper extracts a 215-word ethical case from a 10-page short story "Fetishes," written by Richard Selzer, a physician and writer.The resident agrees to slip her dentures back in during her recovery so her husband doesn't see.Nash then critiqued the case study using principalist ethics—a common ethical framework in medicine., Woods Nash, a medical-humanities researcher at the University of Houston, argues that ethical case studies are too short and place a greater emphasis on action than characterization.As a result, Nash argues case studies lack nuance and have limited usefulness.In the story, a middle-aged woman named Audrey needs a hysterectomy.The night before her surgery, Audrey is told by a male anesthesiologist that prior to surgery she has to remove her dentures."In nearly every discussion of real ethical issues, you'll hear someone say [things such as], 'I wish I knew more about her husband,' or 'why's she so afraid of dementia,'" said Mc Nolty.Similarly, Piecha said "people actually using [case studies] in ethics committees in hospitals" instead of exclusively in a classroom "are aware of how austere and truncated they are." According to Pjecha, ethics committees generally view case studies "as an important first step, but then you unpack it further, and it spins into a story." But Nash maintained that short stories are "more effective means of teaching students and [health care] professionals to wrestle with the mess, to pay attention to narrative perspective and detail, and to become more comfortable with ambiguity." He added, "Why continue to use ethics cases if short stories are better at inviting realistic reflection and more enjoyable to read and discuss?Below is a list of the case study articles that have been published in NIB, each with keywords, a set of discussion questions, and further resources.To search page contents with keywords, select "Control-F" from a PC, or "Command-F" from a Mac. Smith, Anne Lederman Flamm Abstract: Despite widespread acceptance in the United States of neurological criteria to determine death, clinicians encounter families who object, often on religious grounds, to the categorization of their loved ones as “brain dead.” The concept of “reasonable accommodation” of objections to brain death, promulgated in both state statutes and the bioethics literature, suggests the possibility of compromise between the family’s deeply held beliefs and the legal, professional and moral values otherwise directing clinicians to withdraw medical interventions.

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