Ethical Concerns

CASE STUDY II: A 49-year-old cancer patient named BC was taken into the emergency department after experiencing cardiac arrest. Her spouse and one of her kids also rode in the ambulance with her.

With clients who have received a fatal diagnosis, such as advanced-stage cancer, it is imperative to have a dialogue regarding end-of-life care and preferences. In this case, the patient arrives with cardiac arrest in the emergency room with a confirmation of an advanced-stage cancer diagnosis. Her spouse and child were all with her. An ECG result would be used to diagnose cardiac arrest, and then the ACLS procedure would be followed for life-saving actions (Molnar & Isaac, 2020). I would first check with the spouse to determine whether the patient has an advance directive or living will on her resuscitation status after the patient is stabilized. In a legal document called an “advanced directive,” a patient specifies their preferences for actions they would like taken to save their life in the event of a cardiac emergency. In the state of New Jersey, the next of kin, in this example, the patient’s spouse, would have the power to overturn the advanced directive’s instructions if the patient is asleep or incapable of making important decisions (Anderson, 2020). The patient would be stabilized to the best of our ability before resuscitation was ultimately decided upon.

The physician must honor the patient’s and family’s preferences in situations this grave. Additional investigation of the patient’s survival and brain function must be undertaken if the patient’s family accepts that they want all therapies, and the clie

nt is only sustained with life-supporting measures (Bak et al., 2018). To determine the extent of brain impairment and cardiovascular and pulmonary stability, the provider might use diagnostic tests to evaluate the patient’s state and survivability.

A brain death study that comprises a head CT scan, head MRI and EEGs can be carried out to determine if the patient has clinically significant brain damage. Brain death is the complete cessation of all brain processes, such are those in the brainstem. The three main indicators of brain death are brainstem reflexes not functioning, a coma, and apnea. Once this has been determined, the medical practitioner can discuss organ donation choices with the patient’s family as well as ending life support and changing the client’s resuscitation stance to do not resuscitate. Before changing the patient’s status against their preferences, professionals should make every effort to acquire the family’s approval to avoid moral dilemmas.

References

Anderson, P. L. (2020). Family Involvement: What Does a Loved One Want at the End of Life? Surgical Decision Making in Geriatrics, 399–407. https://doi.org/10.1007/978-3-030-47963-3_31

Bak, M. A. R., Blom, M. T., Tan, H. L., & Willems, D. L. (2018). Ethical aspects of sudden cardiac arrest research using observational data: a narrative review. Critical Care, 22(1). https://doi.org/10.1186/s13054-018-2153-3

Molnar, A., & Isaac, M. (2020). Palliative and End-of-Life Care. Refugee Health Care, 181–192. https://doi.org/10.1007/978-3-030-47668-7_12

Spagnolo, A. G., Corsano, B., & Sacchini, D. (2021). Shared Decision-Making at the End of Life. Emergency Laparoscopic Surgery in the Elderly and Frail Patient, 335–342. https://doi.org/10.1007/978-3-030-79990-8_36

Grid View

	Excellent	Good	Fair	Poor
Main Posting	45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	10 (10%) – 10 (10%) Posts main post by day 3.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not post by day 3.
First Response	17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

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