NURS FPX 3200 Assessment 5 Tonya’s Case: Ethics and Professional Codes

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Tonya’s Case: Ethics and Professional Codes

NURS FPX 3200 Assessment 5 Attempt 1 Tonya’s Case: Ethics and Professional Codes

Tony Archer, a fifteen-year-old female patient is having surgery to treat an injury she got while playing softball. A girl of her age and health might readily recover from the accident, although her operation went smoothly. But she was being transported to her hospital room following the operation, and due to some unanticipated medical difficulties, she had a heart arrest. Despite surviving the heart attack, her neurological system had a full-blown case of brain death. When Tonya’s parents learned of the circumstance, they were in shock and it took them some time to adjust to the fact that they now had a child who was in a vegetative condition. Cases like Tony Archer align healthcare professionals to question moral issues and their consequences on the patient and their families while deciding end-of-life issues. Should life support systems be continued or withhold it?

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Sound Ethical Thinking in Applying Ethical Principles and Moral Theories

Tonya’s position requires a decision that would change her life as well as the lives of her family and the doctors treating her. As Tonya’s body underwent final physiological changes, the longer she was maintained on life support, the more likely that her body would deteriorate. Her doctors predict that the damage that caused to her brain is irreparable. Both her parents and the doctors had to make a very difficult choice about whether to keep her alive or let her pass away peacefully. Utilitarian philosophy suggests that in her physical situation if ending her life is for the greater good, one should disregard the emotional and psychological inclinationsof peers, physicians, and medical personnel but decisions like these only increase suffering of the family (Kim & Park, 2019). The concept of autonomy states that patients should come first in making decisions but Archer’s case state otherwise and Archer’s family members must make the choice for her. But this is the case of mixed emotion, the emotion of despair and hopelessness, yet it would still be impossible to persuade anybody to decide without carefully considering the circumstances or acquiring the consent of the authorized attendants. Sometimes medical professionals believe that family members’ choices are not the best ones for the patients. In cases like Archer’s institutional ethics committees may be consulted when critical care teams and family members are at odds. In providing end-of-life care like Archer’s, doctors encounter several ethical difficulties. Even the most valued principles of beneficence and nonmaleficence emphasize relieving the symptoms of the patient that causes harm (Varkey, 2021). During Archer’s stay at hospital, medical ethicists advised that there is no hope of keeping life support and that the damage done will get worse. Although the decision for keeping life support for Archer also come with implication, it will increase her suffering and that of her family. Ethical issues that arise during palliative care can be avoided with communication and collaborative decision-making among healthcare professionals, patients, and surrogates. 

Professional Codes of Ethics

When Archer was taken into the hospital the medical staff did everything, they could to restore her health and keep her from dying. The staff might receive a reprimand and be held accountable if the patient’s operation on ACL had caused her cardiac arrest or resulted in her death from a heart attack, but all professional norms of ethics were upheld. The only option the medical team had after an unexpected medical setback was to keep her alive in a condition of brain death and be honest with her family about the circumstances. 

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However, in the case of Archer, if the medical team decides to withdraw life support, then they must restrict themselves to the following code of ethics:

  1. Give the patient’s surrogate all pertinent medical information, so that it helps in the decision-making process.
  2. Assure the patient’s surrogate that all other medically necessary care will be given, including effective symptom control if the surrogate requests it and vigorous palliative care.
  3. Explain to the family, that they can decide the withdrawing life support on behalf of the patient.

Decisions to withdraw in critical situations carry a lot of emotional weight for nurses, doctors, and families (Metaxa, 2020). But healthcare providers can professionally tackle such cases through a professional code of ethics and can also free themselves from moral questions. In accordance with the ethics guidelines for surrogate decision-making, the patient’s surrogate may deny an intervention when the patient lacks the necessary capacity (Metaxa, 2020). After accepting the consent from the family of Archer they can initiate the withdrawal process. It is ethically acceptable for doctors to discontinue an intervention when it is no longer helpful in achieving the patient’s care objectives or desired quality of life (Morrison et al., 2021). If by any means Archer’s family intervenes in the withdrawing life support process nurses and health staff can take appropriate guidance from the ethics committee. 

NURS FPX 3200 Assessment 5 Attempt 1 Tonya’s Case: Ethics and Professional Codes

Organizational Documents like Mission and Value Statements

From the case study, it is evident that Archer was treated by a professional surgeon and did his job without any complications. Then she was moved to the hospital room where she went into cardiac arrest. She was placed on a ventilator and the hospital ethicist advised the family that the ventilator and other interventions are hopeless. Healthcare organizations can decide what exactly they want to accomplish with the help of mission, vision, and values statements (Paxton et al., 2020). They can also figure out how to give patients the kind of care they need. Tonya was admitted to a hospital that promotes a more compassionate, patient-centered approach to care, therefore deviating even little from that model could undermine the institute’s main goals. Based on the hospital’s core valuesone can constantly putpatients’ needs first, preserve a high standard of honesty and respect, and adjust to new innovations in medical practice to give them the best care possible (Paxton et al., 2020).

Role of Accrediting Bodies and Its Impact on Tonya’s Case

The role of the accrediting body is to ensure that healthcare organization must meet standards set by recognized bodies.  The US-based organization named the Joint Commission is responsible for accrediting healthcare services across the globe. It aims to create solidarity among institutes regarding decisions like Archer’s. The Joint Commission has been involved in this to ensure Tonya’s better health results without any discrimination. On the other hand, the decision of her survival depends on the decisions of her parents. These are the instances when authority of The Joint Commission cannot interfere into the matter. Even in this situation, TJC’s main concern is making sure Tonya has the finest medical care possible without any bias or discrimination. Other than that, her parents are the only ones who can decide whether she should live or die while waiting for the course of events to play out.

Conclusion

Tony Archer, a fifteen-year-old female patient although involved in a small accident, experienced a significant cardiac arrest without medical personnel’s fault and suffered a fatal consequence of brain death. Her condition depicted an inevitable loss of life and irreparable harm and madeher treatment challenging for the medical team and nursing. The ethical and moral rule of conduct in such a situation dictates that medical professionals shouldmake aware her family of the seriousness of her condition and take no urgent action. Only by keeping Tonya alive and waiting for her family to accept her position could they finally carry out their decision to remove her from the ventilator. This is the reason that makes nursing and healthcare challenging and difficult occupations.

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NURS FPX 3200 Assessment 5 Attempt 1 Tonya’s Case: Ethics and Professional Codes

References

Kim, W.-J., & Park, J.-H. (2019). The effects of debate-based ethics education on the moral sensitivity and judgment of nursing students: a quasi-experimental study. Nurse Education Today, 83, 104200. https://doi.org/10.1016/j.nedt.2019.08.018

Mentzelopoulos, S. D., Couper, K., Voorde, P. V. de, Druwé, P., Blom, M., Perkins, G. D., Lulic, I., Djakow, J., Raffay, V., Lilja, G., &Bossaert, L. (2021). European resuscitation council guidelines 2021: Ethics of resuscitation and end of life decisions. Resuscitation, 161, 408–432. https://doi.org/10.1016/j.resuscitation.2021.02.017 

Metaxa, V. (2020). End-of-life issues in intensive care units. Seminars in Respiratory and Critical Care Medicine. https://doi.org/10.1055/s-0040-1710370

Morrison, R. S., Meier, D. E., & Arnold, R. M. (2021). What’s wrong with advance care planning? Jama, 326(16), 1575. https://doi.org/10.1001/jama.2021.16430

Paxton, P., Velasco, K., & Ressler, R. W. (2020). Does use of emotion increase donations and volunteers for nonprofits? American Sociological Review, 85(6), 000312242096010. https://doi.org/10.1177/0003122420960104Varkey, B. (2021). Principles of clinical ethics and their application to practice. Edical Principles and Practice, 30(1), 17–28. Karger. https://doi.org/10.1159/000509119