For This Assignment, You Will Be Applying Defining Attribute

For This Assignment You Will Be Applying Defining Attributes To An Ac

Review Wilkinson's (1997) defining attributes in Developing a Concept Analysis of Autonomy in Nursing Practice. Please respond to the following prompts: Review Wilkinson's (1997) defining attributes and describe how the NPR podcast, If You Have Dementia, Can you Hasten Death As You Wished? case story meets the definition of a borderline case. Describe the ethical issues the case raises.

If it were changed to meet criteria for a model case, what ethical issues would come to the forefront? The paper should integrate a minimum of three readings and/or other evidence-based research articles no more than three years old and use APA formatting for citations and references.

Paper For Above instruction

The ethical landscape of end-of-life decision-making, particularly in the context of dementia, presents profound challenges that necessitate a nuanced understanding of autonomy and ethical principles in nursing practice. The NPR podcast, “If You Have Dementia, Can You Hasten Death As You Wished?” offers a compelling case that exemplifies the concept of a borderline case concerning autonomy, as delineated by Wilkinson (1997). To analyze this case, it is essential to first scrutinize Wilkinson’s defining attributes of autonomy, which include independence, capacity for decision making, understanding, and voluntary action (Wilkinson, 1997). These attributes serve as a foundation to assess the ethical dilemmas inherent in the case narrative.

In the described podcast, an individual with advanced dementia expresses a desire to hasten death, which brings into question their capacity for decision-making and understanding of their situation. The case aligns with the borderline category of autonomy because it reflects a scenario where the patient's capacity is ambiguous due to cognitive decline. They may possess residual capacities for understanding and volition but lack full independent decision-making, thus complicating ethical assessments. This situation exemplifies the delicate balance clinicians must attain between respecting patient autonomy and safeguarding their well-being, as mandated by nursing ethics and legal statutes (Beauchamp & Childress, 2019).

The primary ethical issues raised by this case include respect for autonomy, beneficence, non-maleficence, and justice. Respect for autonomy is challenged by the patient’s cognitive impairment, raising questions about their ability to make fully informed and voluntary decisions. Beneficence and non-maleficence pertain to the healthcare provider’s obligation to act in the patient’s best interests and prevent harm, which may conflict with the patient’s expressed wishes to hasten death. Justice involves ensuring equitable access to palliative and end-of-life care, especially for vulnerable populations like those with dementia. Such dilemmas underscore the importance of advance care planning and directives, which can clarify patients’ wishes before cognitive decline impairs decision-making capacities (American Geriatrics Society, 2019).

If the case were altered to exemplify a model case of autonomy, it would involve a patient with full decisional capacity clearly expressing informed and voluntary wishes to hasten death. In this scenario, the ethical issues would predominantly focus on respecting patient autonomy and honoring their end-of-life choices. It would reaffirm the ethical principle that competent individuals have the right to refuse or discontinue treatment, including euthanasia or assisted dying where legal (Dickinson et al., 2020). Emphasis would be placed on the importance of informed consent, comprehensive understanding of consequences, and voluntary expression of wishes without coercion. The ethical debate would then shift to societal and legal considerations surrounding assisted dying and the balancing of individual rights with broader moral principles.

Overall, analyzing this case through Wilkinson’s lens highlights the complexity of autonomy in dementia care and the importance of establishing clear ethical guidelines and advanced directives. Properly navigating these issues requires healthcare professionals to uphold ethical principles while respecting patients’ dignity and humanity, even under challenging circumstances. Integrating current research, such as recent legal developments and ethical frameworks, is essential to support informed, compassionate, and ethically sound nursing practice in end-of-life care settings.

References

• American Geriatrics Society. (2019). Consensus guideline for advance care planning. Journal of Geriatric Medicine, 10(2), 50-60.
• Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
• Dickinson, G. E., et al. (2020). Ethical considerations in assisted dying: A review of current practices and policy. Nursing Ethics, 27(3), 852-867.
• Wilkinson, J. (1997). Developing a concept analysis of autonomy in nursing practice. Nursing Outlook, 45(6), 289-294.