Many ethical dilemmas involving patient care are issues pertaining to end-of-life care and advanced directives. An advanced directive is a legal document that states an individual’s end-of-life preferences when situations arise where they are unable to make medical decisions on their own due to a lack of capacity, terminal illness, or permanent disability (Karnik & Kanekar, 2016). Patients with advanced directives can appoint a family member or healthcare provider to act as a surrogate allowing them to make medical decisions that need to be made throughout a prognosis (Karnik & Kanekar, 2016). Ethical dilemmas that occur with advanced directives are when patients and surrogates disagree on treatment options regarding end-of-life care. Evidence
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According to the American Nurses Association (ANA) Code of Ethics for Nurses Provision 1.3 (2015), “nurses are leaders who actively participate in assuring the responsible and appropriate use of interventions in order to optimize the health and appropriate use of interventions in order to optimize the health and well-being of those in their care” (p. 1). This includes eliminating unwanted interventions and minimizing suffering of the patient (ANA, 2015). The Federal Patient Self-Determination Act was put into place to help protect the patient’s right towards autonomy and their right towards making decisions for end-of-life treatment (Karnik & Kanekar, 2016). One of the foundational principles of bioethics is respect for autonomy, which holds one accountable to rightfully acknowledge a patient’s decisions and only take actions that pertain to a patient’s certain beliefs (Beauchamp & Childress, …show more content…
This opposing view can relate to the Utilitarian theory, which expresses “an act is right if it has the best consequences” (Rieder, 2017, p. 2). When looking at the clinical scenario, the patient’s surrogate felt she was doing greatest amount of good by making decisions that helped keep the patient alive. Evidence suggests that 54% of patients preferred the surrogates’ decisions over their own and 59% of patients’ most common reason for choosing surrogates’ judgment was due to trust in their ability to make a knowledgeable decision (Hughes, 2017). Another situation where surrogates may make decisions for a patient is when patient wishes and values are unknown or the patient has never had the capacity for decision-making (AMA, 2017). Decisions made by the surrogate may be based on their judgment of best interest and quality of life that is experienced by the
According to the American Nurses Association (ANA) Code of Ethics for Nurses Provision 1.3 (2015), “nurses are leaders who actively participate in assuring the responsible and appropriate use of interventions in order to optimize the health and appropriate use of interventions in order to optimize the health and well-being of those in their care” (p. 1). This includes eliminating unwanted interventions and minimizing suffering of the patient (ANA, 2015). The Federal Patient Self-Determination Act was put into place to help protect the patient’s right towards autonomy and their right towards making decisions for end-of-life treatment (Karnik & Kanekar, 2016). One of the foundational principles of bioethics is respect for autonomy, which holds one accountable to rightfully acknowledge a patient’s decisions and only take actions that pertain to a patient’s certain beliefs (Beauchamp & Childress, …show more content…
This opposing view can relate to the Utilitarian theory, which expresses “an act is right if it has the best consequences” (Rieder, 2017, p. 2). When looking at the clinical scenario, the patient’s surrogate felt she was doing greatest amount of good by making decisions that helped keep the patient alive. Evidence suggests that 54% of patients preferred the surrogates’ decisions over their own and 59% of patients’ most common reason for choosing surrogates’ judgment was due to trust in their ability to make a knowledgeable decision (Hughes, 2017). Another situation where surrogates may make decisions for a patient is when patient wishes and values are unknown or the patient has never had the capacity for decision-making (AMA, 2017). Decisions made by the surrogate may be based on their judgment of best interest and quality of life that is experienced by the