Read The Case Study And Submit A 1-2 Page Essay
Read The Following Case Study And Submit a 1 To 2 Page Essay In A Mic
Read the following case study and submit a 1- to 2-page essay in a Microsoft Word document using APA 6th edition in response to the questions. Case Study : Ann is a seventy-seven-year-old grandmother. She has one daughter and three grandchildren. Two years ago, she was diagnosed with moderately advanced Alzheimer's disease, which causes her to have periods of confusion, frustration, anger, and obsessive thinking. When speaking, she is uncertain and her speech patterns are choppy. Before her mental deterioration, Ann was a woman of love, intelligence, and patience. Realizing they were getting older, she and her husband, Frank, discussed their wishes should anything happen to them. She told Frank that if there was no chance of survival, she would not want to be hooked to a breathing machine. They never got around to filling any papers. Frank is a sweet and sensitive man. His wife's state frightens him. Ann's love for him has been the focus of his life for sixty years. His urgent desire for the best care for Ann shows his devotion and love. Their daughter, Sarah, is a businesswoman. She is a hard worker and a good mother. She is forty-five, successful, and intelligent. Although she loves her parents dearly, she lives ten hours away. She regrets not seeing much of them, especially recently. Frank feels his role is to take care of Ann. He has spent the past year with her, watching after her, cooking for her, cleaning the home, and witnessing her deterioration. Finally, Ann is unable to walk alone safely and he finds he must have her admitted to a long-term care facility. He calls Sarah to come and help with the arrangements. After having Ann admitted to a local nursing home, both Frank and Sarah remember the pleading look in Ann's eyes as they walk away. After three weeks in the nursing home, Ann starts to cough and run a fever. She is seen by doctors and diagnosed as having pneumonia. She is transferred to a local hospital, where she is given intravenous antibiotics. Although the progress of her pneumonia is halted by the antibiotics, she stops talking and refuses to eat. The physician calls Frank to insert a feeding tube. Frank calls Sarah to ask what to do. They wonder, Is a feeding tube equivalent to a breathing machine? Would it be possible to allow Ann to lie there and die of starvation? Is that murder? What would she want? What is the right thing to do? (Burkhardt & Nathaniel, 2008). Respond to the following: Discuss the ethical decisions you would make. Discuss the legal decisions you would make. Explain, as a nurse, what advice would you give to Frank and Sarah. Support your responses with examples.
Paper For Above instruction
The case of Ann presents complex ethical and legal dilemmas surrounding end-of-life decisions, particularly for patients with advanced Alzheimer’s disease. As a healthcare provider, my primary responsibility would be to guide Frank and Sarah through these difficult choices by emphasizing respect for Ann's autonomy, quality of life, and previously expressed wishes, alongside legal considerations and ethical principles.
Ethical Decisions
From an ethical perspective, respecting Ann’s autonomy is paramount. Even though she can no longer communicate her wishes clearly, her prior expressed desire not to be on life-sustaining machines indicates her preference to avoid extraordinary measures that might prolong her suffering or quality of life she would find unacceptable (Beauchamp & Childress, 2013). It is important to consider whether feeding her via a tube is an extension of her autonomy or an invasive intervention that might undermine her dignity. Additionally, beneficence and non-maleficence guide us to act in Ann's best interests, ensuring that actions taken either alleviate her suffering or prevent harm (American Nurses Association, 2015). Withholding or withdrawing artificial nutrition can sometimes be viewed as letting nature take its course, and in cases where continued life does not align with her previous values or quality of life, this can be ethically justified.
Legal Decisions
Legally, advance directives or living wills are critical documents that specify a patient's preferences regarding life-sustaining treatments (Hollander & Trachtenberg, 2013). Since Ann and Frank discussed her wishes but did not formalize them legally, the decision depends on state laws governing surrogate decision-making and whether a durable power of attorney exists. Without legal documentation, Sarah and Frank may need to rely on substituted judgment—making decisions they believe Ann would have made if competent—or act in her best interest (P. Smith, 2012). In many jurisdictions, withholding artificial nutrition in a patient with terminal illness or advanced dementia, when it aligns with known wishes, is legally permissible, but this varies by state. Therefore, reviewing state laws and hospital policies is essential to ensure compliance.
Advice to Frank and Sarah
As a nurse, I would counsel Frank and Sarah to consider Ann’s previously expressed wishes, her current condition, and the ethical principles involved. I would advise them to prioritize her dignity and comfort, possibly focusing on palliative care measures to ease her suffering. Open communication and consultation with an ethics committee or palliative care team can provide additional guidance. I would encourage them to consider the importance of dignity in dying and to avoid invasive procedures that may not align with her values or improve her quality of life (Johnson & Smith, 2014). They should understand that refusing artificial nutrition in cases where the patient has advanced Alzheimer’s and severe pneumonia is recognized in many legal systems as acceptable, especially if it reflects the patient’s prior wishes. Ultimately, they should aim for a decision that honors Ann's dignity, minimizes suffering, and aligns with ethical and legal standards.
Conclusion
End-of-life decisions are inherently complex, involving balancing ethical principles, legal standards, and the patient's values. As healthcare providers and advocates for the patient’s wishes, nurses play a vital role in guiding families through these difficult choices, ensuring compassion, respect, and adherence to legal and ethical frameworks.
References
- American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). American Nurses Association.
- Beauchamp, T. L., & Childress, J. F. (2013). Principles of biomedical ethics (7th ed.). Oxford University Press.
- Hollander, G., & Trachtenberg, M. (2013). Legal aspects of end-of-life decision making. Journal of Health Law, 22(4), 445-460.
- Johnson, M., & Smith, L. (2014). Ethical issues in dementia care. Geriatric Nursing, 35(5), 367-373.
- P. Smith, R. (2012). Laws and regulations governing patient autonomy. Medical Law Review, 37(2), 223-245.