Premium Essay

Medical Reasearch

In: Social Issues

Submitted By catrippe79
Words 5146
Pages 21
Case 1: Is It Permissible to Shut Off this Pacemaker?

The following case is based on a real clinical dilemma that led to a request for an ethics consultation. Some details have been changed to preserve patient privacy. The goal of this column is to address ethical dilemmas faced by patients, families and healthcare professionals, offering careful analysis and recommendations that are consistent with biblical standards. The format and length are intended to simulate an actual consultation report that might appear in a clinical record and are not intended to be an exhaustive discussion of the issues raised.

Case:

Dorthea is a 69-year-old woman who was well and active until about five years ago when she developed diabetes. She was admitted to the hospital 18 months ago with recurrent fainting and was found to have an intermittent transient heart block1. She reluctantly consented to insertion of a permanent pacemaker.

Three months ago her kidney function was found to be diminished to about 10% of normal, probably caused by her diabetes. It was expected that she would soon require dialysis. However, her kidney function has since improved so that dialysis will not likely be needed for some time. She has since said she would refuse dialysis even if it were needed, and she has refused treatment of her profound anemia. She did consent to a colonoscopy last month to see if she had cancer (malignant change was found in one small area, presumably cured). She is now asking that her pacemaker be turned off so that she can die.

The ethics consultant met with the patient and two of her daughters. Dorthea says she wants to die now because (a) she misses her husband who died three years ago after 45 years of marriage; they were very close, did everything together, and she says she can’t live without him; (b) she can’t stand to live in their...

Similar Documents

Premium Essay

Ethical and Legal Issues in Nursing

...standard in place that must be followed. These are nonnegotiable, ethical standards, obligations and duties that every individual swears to when entering the nursing profession. These standards are all found within the American Nurses Association’s code of Nursing Ethics and Conduct. Whether dealing with patients and families during end of life decision making or dealing with nursing negligence within the court of law, the first provision in the code of ethics is the most imperative to remember. Nurses are always obligated to their patient’s best interest, therefore making them an unrelenting patient advocate. Many provisions are pointed out within the Nursing Code of Ethics. In the situation of dealing with Marianne’s family and medical treatments, there are many important things to consider. “The nurse respects the worth, dignity, and rights of all human beings irrespective of the nature of the health problem. The worth of the person is not affected by disease, disability, functional status, or proximity to death. This...

Words: 1233 - Pages: 5

Free Essay

Marijuana: Medicine or Menace?

...interesting details concerning it. I have always felt that marijuana should be legalized, or at the very least, people with serious medical conditions should have access to it. And marijuana doesn’t even have to be legalized in my opinion, but it should definitely be decriminalized. I don’t think anyone who wants to smoke a plant that they grow themselves should have to suffer consequences, considering they are responsible in their recreational smoking. I do feel that if it were legalized, that there should be an acceptable age limit to buy and/or consume marijuana, comparable to that of alcohol. There are beneficial as well as harmful effects concerning marijuana, but that goes for a lot of things people do in everyday life. And I feel that a lot of time has been spent shining the spotlight on the harmful effects of marijuana, while little research has been done or even allowed, on the benefits of marijuana. While preparing for the debate, I encountered many sources on each end of the spectrum; including some in the middle. Many of the sources I looked at seemed rather credible, but others were most definitely biased. One example of a blatantly biased comment was, "Most pot smokers drink alcohol heavily, and may become so confused that they take cocaine or heroin.” (medicalmarijuana.procon.org). Another interesting bit of information I found was, “Medical marijuana is now a serious $1.7 billion dollar market, according to a new report released this month by an independent......

Words: 949 - Pages: 4

Free Essay

Communications and the Impact on Health Care

...promote new products and new services the ways that this can be done would be through electronic medical records, or any form of a web-based communique. Some types of communications can also make the patient feel safer and also help the organization save time and money. Electronic medical records give the patient some benefits that are to the advantage of them as well as the provider. It allows the patient to keep their medical records up to date and accurate so that way there are no problems with such things as allergies, surgeries, or medications that are being taken. This is a way for the patient to keep accurate records of their medical history as well as keeping the provider updated at all times (Brooks, R., Grotz, C.). This an effective means of communication between the patient and provider by allowing the provider to give access to some of their records that will allow the patient to adjust certain things in their lifestyle or medications without going in to see the provider for something that would not require an office visit. This type of communication can allow the provider to keep a better watch on the consumer’s progress that will allow the provider to release some test and results to the consumer and the provider can also let the consumer know exactly what the their instructions are without being misinterpreted (Brooks, R., Grotz, C.). Electronic Medical Records is a form of communication that is developed to make health care records easier to......

Words: 846 - Pages: 4

Premium Essay

Assisted Suicide

...must ensure a health care ethic that respects the role of patients in decision making about treatment choices and other aspects of their care. Hospitals must be sensitive to cultural, racial, linguistic, religious, age, gender, and other differences as well as the needs of persons with disabilities (A patient’s bill of rights, 1992). To participate effectively in decision making, patients must be encouraged to take responsibility for requesting additional information or clarification about their health status or treatment when they do not fully understand information and instructions (A patient’s bill of rights, 1992). Three ethical considerations are autonomy, duty of care and risk-benefit. Ethical questions surround the concept of medical...

Words: 788 - Pages: 4

Free Essay

Prescription Drugs

...Prescription Drugs In this society, most Americans use some type of prescription drug. According to this week chapter reading: “More than 80 % of U.S. adults use some form of medication, with 50 % taking a drug prescribed by a doctor. The average American fills 11 prescriptions per year spending approximately $ 771 annually (Gentzen, p. 245, 2007).” This is a true statement because I am one of those Americans who depend on prescription drugs. I have a seizure disorder that doctors have not found what cause me to have seizure. Without medication, I can have a seizure. So now I have become what society has called “addicted” to prescription drugs, when I go too long without medication, I can have a seizure at any given time. So I am glad that my team has chosen this topic to discuss. We talk about The History of Prescription Drugs, Drugs Addicts, and The steps that we believe that could be used to make a change to the present system. Prescription drugs are medicine regulated by legislation to require a prescription before it can be obtained. The term prescription drug is used separate from over-the-counter drugs that can be purchased without a prescription. In the United States, the Federal Food, Drug and Cosmetic Act determines what requires a prescription. When obtaining a prescription, a person will also receive a pamphlet explaining the drug and helpful information about the effect of the drug and how it affects the body. It also describes side......

Words: 1431 - Pages: 6

Premium Essay

Hs435

...definitions of euthanasia: "A gentle and easy death...[T]he means of bringing about a gentle and easy death... However, in today’s society term euthanasia includes both voluntary and involuntary termination of life. Euthanasia has many meanings. Except for involuntary euthanasia, all these terms are closely related because the victim requests the action. The only difference is who is actually committing the act, Voluntary euthanasia is a help to mentally competent person to die through the assistance of others and can be divided in two categories. Passive Euthanasia means causing the death of a person by withdrawing some form of support and letting nature take its course. For example: removing life support, stopping medical procedures, stopping food and water and allowing the person to dehydrate or starve to death, and not delivering CPR. Active Euthanasia involves causing the death of a person through a direct action, in response to a request from that person. For many people, euthanasia is a preferable option compare to loss of independence and unbearable suffering. Background Euthanasia has always been a highly controversial topic. In...

Words: 2821 - Pages: 12

Free Essay

Blooms Taxonomy

...Bloom’s Taxonomy and Nursing Care Sherrie Fetterman Health and Chronic Disease Management/NUR427 October 3, 2011 Gina Stephens Bloom’s Taxonomy and Nursing Care An estimated 99 million Americans currently suffer from a form of chronic disease and will enter the health care field unknowing what to expect (Annuals of Internal Medicine, 2011). Disease knows no boundaries nor is there any age limitations. What is consistent, is the disease inflicted patients need to learn about their disease and how to live normal lives regardless of their literary level. In 1956, Benjamin Bloom and a group of educational psychologists developed Bloom’s Taxonomy, a classification of levels of intellectual behavior important in learning. The taxonomy has three domains: the cognitive, affective and psychomotor. Each domain begins with the most basic learning level, and increases to the more intellectual level of learning. As Larsen and Lubkin states, “The teaching-learning process is characterized by multifaceted, dynamic, and interactive exchanges that are fundamental to client-family education and nursing practice” (p. 320). Bloom’s Taxonomy of Education equips nurses with the tools necessary to help patients and family members become successful in coping with their chronic illnesses. The findings of the cognitive domains represent use of knowledge and mental skills of the patient, and is further divided into 6 levels from the lowest level to the highest......

Words: 760 - Pages: 4

Premium Essay

Animal Testing

...The number of animals killed each year in the United States alone varies between 17 and 70 million. The Animal Welfare Act (ACA) states that laboratories must report the number of animals used in experiments; yet mice, birds, and rats are not included in this figure. These animals are used in 80 to 90 percent of all animal testing. Because of this, it is impossible to calculate the exact number of animals used in such experiments (PETA, 5). Animal testing might not directly affect ordinary people each day or be an issue on everybody’s mind, yet the actions people do daily can affect animal experimentation. This has been a worldwide issue and an ongoing battle for decades. Vivisection, the practice of lab experimenting on live animals, has been around since the beginning of scientific medicine. It is an alternative to the dissection of human corpses, which resulted from religious leaders’ protests (Choose Cruelty Free). There are numerous reasons why people and organizations want animal testing changed. People of all nations and religions argue differently on this topic. Yet the main factor in deciding the moral correctness of animal experimentation is one’s personal belief. No matter which side a person takes on this topic, they feel there are several things that must be done to benefit their stance and its publicity. A group in opposition of animal testing is the People for the Ethical Treatment of Animals (PETA). Their main claim is put as, “Animals are not ours to...

Words: 1084 - Pages: 5

Free Essay

Pet/Ct vs Ct Purchase

...Abstract In my previous position I worked as the Administrator for a well-established outpatient diagnostic imaging facility. As the Administrator I was faced with having to make various decisions that utilized economics on a daily basis. The decisions that I would have to make would range from very simple to very complex purchases. Regardless of the amount of the purchase the same economic considerations were utilized prior to any purchases.   Introduction In my previous position as Administrator for an outpatient imaging facility I was faced with various daily decision making tasks that would range from something as simple as a supply order that would cost the company a few hundred dollars, to the decision of final equipment purchases that could cost over a million dollars. One particular instance that I was faced with was to utilize additional space within the facility for a different imaging modality. The decision at the time was not completely left up to me, but was my responsibility to present which modality I thought would benefit the company and our patients the most, and how the best options to move forward with overseeing this project. The facility offered various imaging services such as a positional stand up MRI, nuclear imaging, ultrasounds, and high quality x-rays. The new project was to fill the additional imaging room with a service based on my analysis. The options that I had were to bring in a new device to see a different set of patients,...

Words: 2306 - Pages: 10

Premium Essay

Euthanasia

...involuntary euthanasia, the killing of a patient without the patient's knowledge or consent. Some call this "life-terminating treatment." Euthanasia can be either active or passive. Passive euthanasia allows one to die by withholding or withdrawing life supporting means. This is a tricky area because ordinary and extraordinary means of supporting life come into the picture. Ordinary means such as nutrition and hydration are never to be withheld since they are one's basic right in order to survive. However, one is not obliged to use extraordinary or 'disproportionate' means to sustain life. Due to complexity, each situation needs to be looked at individually when discussing extraordinary means. However, as a rule, one can discontinue "medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome." One cannot intend death by withdrawing or withholding treatment, but should, however, obey God and let one die a natural death. To withdraw a treatment as a condition worsens is letting one die and not a direct killing. In this case, it is the disease that is killing and not the one who withdraws the treatment. Active euthanasia or' mercy killing' pertains to the Dr. Kevorkian’s' of the day. This is the direct intentional killing of a patient with either their consent (voluntary), without their consent when impossible (non-voluntary), or without consent but not sought (involuntary). Advocates of this murder have covered their ears......

Words: 591 - Pages: 3

Premium Essay

Administrative Ethics

...while protecting the security and confidentiality of that information (Van der Aa, 2000). The areas addressed for HIPPA are: • Concerns that disclosure of patient medical records could result in embarrassment, insurance declination, loss of employment, or failure to be hired in a new job; • Increasing costs of data exchange in an incompatible and often competing standards environment to exchange administrative and financial data; • Implement processes and systems to reduce fraud (Van der Aa, 2000). HIPPA was signed into law, to help create a standard that will protect patient’s medical records and personal health records. This act is to help the health care employees have more control of a patient’s information and its privacy. This act also gives the patient the right to control their own information. Apart from the right to inspect, amend and correct their confidential health information, patients now have the right to control what information can be released and to whom (Van der Aa, 2000). The following case study is an opportunity to review ethical issues relative to confidentiality. This case study is a backdrop for the ethical analysis of issues by an administrator related to disclosing confidential information concerning an employee. An administrator has responsibilities that extend beyond patient medical information. The growth of information systems make one ethical concern that continually presents itself to the administrator is confidentiality of......

Words: 1750 - Pages: 7

Premium Essay

Physician Assisted-Suicide

...* Quality of life - only the patient is really aware of what it is like to experience intractable (persistent, unstoppable) suffering; even with pain relievers. Those who have not experienced it cannot fully appreciate what effect it has on quality of life. Apart from physical pain, overcoming the emotional pain of losing independence is an additional factor that only the patient comprehends fully. * Dignity - every individual should be given the ability to die with dignity. Prolongation of dying - if the dying process is unpleasant, the patient should have the right to reduce this unpleasantness. In medicine, the prolongation of living may sometimes turn into the prolongation of dying. Put simply - why should be patient be forced to experience a slow death? Most physicians have received one or more requests to help a patient end his or her life prematurely. This module focuses on the skills that the physician can use to respond both compassionately and with confidence to a request, not on the merits of arguments for or against legalizing physician-assisted suicide (PAS) or euthanasia, but using solid clinical skills. To respond effectively, physicians must know the reasons why patients ask for assistance. Depression, psychosocial factors, and anticipated distress are common reasons, but current physical suffering can also be a factor. Physicians need to be able to assess the root causes of the specific request, make a commitment to the patient’s care, address......

Words: 2055 - Pages: 9

Free Essay

Business Research Methods Res/351

...“Conflicted Medical Journals and the Failure of Trust” the issue of pharmaceutical businesses and their research, and how it is presented is outlined. The article covers one of the largest controversies with business research conducted by GlaxoSmithKline (GSK) and how the results were skewed and then reported by many medical journals as fact, even though the research did not support what was reported. The study was GSK 329, which showed a particular drug to be effective in adolescents with depression, even though the testing showed otherwise. (Jureidini & McHenry, 2011) The biggest unethical behavior that was demonstrated by GSK, and medical journals was the skewing of results of a study. Medical journals published articles that misrepresented the findings of GSK’s research. Internal reports by the company showed that their trials of the drug had failed to benefit adolescents with depression, and positively showed that there were negative results. (Jureidini & McHenry, 2011) The internal report states that “it would be commercially unacceptable to include a statement that efficacy had not been demonstrated, as this would undermine the profile of paroxetine,” and that “to effectively manage the dissemination of data in order to minimize any potential negative commercial impact.” (Jureidini &McHenry, 2011) This indicates that they skewed the results of the study so that only selective data would be published. The authors also place blame on the medical......

Words: 854 - Pages: 4

Free Essay

Hcr 210

...The Patient Self-Determination Act of 1990 required consumers to be provided with informed consent, information about their right to make advance health care decisions. This act is also called advance directives. The act requires that patients be given information about state laws that impact legal choices in making health care decisions. Health care facilities in every state are required by this act to notify patients 18 or older of their right to have an advance directive in their medical records. Advanced directives include living wills; do not resuscitate (DNR) orders, medical power of attorney, health care proxy, or organ or tissue donation. Every patient must be informed in written form by health care facilities of the laws in their state that are related to advance directives. Every patient has to sign the advance directive notification form stating that they have been informed of their right to have advance directives. This provides proof for the facility that they have informed the patient. This form has made laws concerning patients right’s stricter. Records management procedures have had to make some changes to the way they do things in order to respond to this legislation. They have had to make sure when a patient comes to the hospital that they find out if they have advanced directives. Before this act this was not a question they asked when you came to the hospital. Doctor’s and the health care team have to pay closer attention to what the patient wants and do......

Words: 320 - Pages: 2

Premium Essay

Should Marijuana Be Legalized for Medical Purposes?

...Should Marijuana be legalized for Medical Purposes? Brian Daniels INTRODUCTION I. Should Marijuana be legalized for Medical Purposes? a. Should Marijuana be legalized for Medical Purposes? i. Some people agree and help aid the move to get marijuana legalized for medical use. ii. Other people disagree and help aid the move to keep marijuana illegal for medical and personal use. b. I both agree and disagree with the move to legalize medical marijuana. i. I agree the marijuana should be legalized for medical use. ii. But also disagree the marijuana should be legalized for the fact of abuse. II. Facts and information. a. As of 2012 18 states and Washington DC have legalized marijuana for medical use. b. As of November 7, 2012 there are 4 states Pending Legislation to Legalize Medical Marijuana. c. However, I am in favor for them to legalize medical marijuana in all 50 states, under strict guidelines to control the use of medical marijuana. BODY I. Pros a. It could be a source of additional tax revenues. b. Medical benefits such as those for cancer patients. c. Police and court resources would be freed up for more serious crimes II. Cons a. Marijuana is often used as a stepping-stone drug b. Driving while under the influence and other dangers would be increased. c. Some consider use of the drug as morally wrong III. Ethical, moral, or legal issues. a. Some religions prohibit the use of intoxicating substances (marijuana......

Words: 324 - Pages: 2