N 520- Legal and Ethical Issues in Health Care Module 6 Assignment
Read the case study presented at the end of Chapter 8 (Guido, p. 150)
Is the patient correct in asserting that he has a right to know the names and status of individuals who will be performing this procedure?
Does the manner in which the student introduced herself and the two other team members have relevance in this case?
Was the informed consent deficient to the degree that there was a lack of informed consent by the patient?
How would you decide this case?
A patient is admitted to your surgical center for a breast biopsy under local anesthesia. The surgeon has previously informed the patient of the procedure, risks, alternatives, desired outcomes, and possible complications. You give the surgery permit form to the patient for her signature. She readily states that she knows about the procedure and has no additional questions; she signs the form with no hesitation. Her husband, who is visiting with her, says he is worried that something may be said during the procedure to alarm his wife. What do you do at this point? Do you alert the surgeon that informed consent has not been obtained? Do you request that the surgeon revisit the patient and reinstruct her about the surgery? Since the patient has already signed the form, is there anything more you should do?
Now consider the ethical issues that such a scenario raises. Which ethical principles is the husband in this example most portraying? Which ethical principles should guide the nurse in working with this patient and family member?
Jimmy Chang, a 20- year- old college student, is admitted to your institution for additional chemotherapy. Jimmy was diagnosed with leukemia 5 years earlier and has had several courses of chemotherapy. He is currently in an acute active phase of the disease, though he had enjoyed a 14- month remission phase prior to this admission. His parents, who accompany him to the hospital, are divided as to the benefits of additional chemotherapy. His mother is adamant that she will sign the informed consent form for this course of therapy, and his father is equally adamant that he will refuse to sign the informed consent form because “Jimmy has suffered enough.”
You are his primary nurse and must assist in somehow resolving this impasse. What do you do about the informed consent form? Who signs and why? Using the MORAL model, decide the best course of action for Jimmy from an ethical perspective rather than a legal perspective. Did you come to the same conclusion using both an ethical and a legal approach?
Robbing the Dead: Is Organ Conscription Ethical?
The topic of organ donation is a pressing concern in numerous nations due to the undeniable advantages of transplantation, which can potentially save the lives of numerous individuals. However, this matter also elicits moral inquiries among a significant portion of the population (Lewis et al., 2020). The policy of organ conscription has generated considerable controversy due to the state’s practice of procuring organs from deceased individuals who did not explicitly decline this procedure during their lifetime. This paper aims to examine the ethical considerations associated with organ conscription policies and propose an alternative approach to enhance the number of organ donations, thereby assessing the fairness and pertinence of the policy.
According to the organ conscription policy, all dead individuals whose organs were not refused during their lifetimes had their organs transplanted onto patients in need (Zambrano, 2023). However, the family members of the dead individual are not requested and their rejection is not tolerated. Many ethical issues are raised by this strategy, including how it restricts freedom of choice and hurts the sentiments of family members. For example, the argument that everyone has a moral duty to give organs and that because of this, we have the right to harvest organs with or without permission might be used to support the idea of organ conscription. The rationale for believing that organ donation is morally required originates from a comparable explanation for “simple rescues,” or situations in which saving a person’s life requires little to no personal expense, effort, or hardship. In most cases of easy rescue, it is believed that a person has a responsibility to assist someone in a critical situation when they can do so with ease (Etheredge, 2021). Consenting to have one’s organs taken after death is an example of simple rescue since, in the instance of organ donation, one has already passed away and the organs are worthless in a dead body.
When the dead person’s intentions are unclear and no protest has been noted, organ harvesting is considered to be acceptable; the deceased person’s agreement is assumed to have been provided. When there is implied permission, the state does not disregard a person’s preferences, as it arguably ought to (Ahmad et al., 2019). Policies based on assumed permission seem to be intended to respect the notion that consent is necessary for organ donation while still allowing for harvesting in circumstances when a person’s desires are unknown. But if our procurement strategy is going to be based on consent, it should do so fully, not only in part.
Just and Faire
Understanding how the bulk of the people views the policy can help you determine how fair it is. However, a minority will always consider any policy to be unjust in whatever community. Therefore, the primary goal of state policy should be to persuade the vast majority of people of the advantages of organ donation by emphasizing the need of the living and the lack of damage to the dead. The fairness of organ distribution is another issue raised by the conscription of organs (Dickens, 2019). Owing to this policy, everyone who has not objected to the surgery is a donor; nevertheless, if they are put on the waiting list due to the allocation process, they could not get an organ. However, more patients obtain the required transplants as more individuals become donors after passing away.
Munson makes three main points: first, that the supply of organs should be increased; second, that both donors and recipients should be shielded from exploitation; and third, that morally weighing the complex moral issues surrounding transplantation can be accomplished by telling stories about specific people (Ahmad et al., 2019). His first argument is supported by reasoning that is well-known and simple to comprehend. Even though it is a challenging procedure that even under ideal conditions leaves chronic illness in its wake, organ transplantation saves lives. The lack of accessible organs causes thousands of deaths each year.
Although there are ethical concerns associated with organ conscription, its relevance, and effectiveness are evident. The foremost objective of the government should be to disseminate information to the populace regarding the policy, thereby enabling individuals who hold dissenting views to make an informed decision to abstain from becoming donors during their lifetime. The implementation of these procedural measures will effectively mitigate a significant portion of the ethical considerations surrounding organ transplantation, while concurrently facilitating an augmentation in the overall supply of available organs.
Ahmad, M. U., Hanna, A., Mohamed, A.-Z., Schlindwein, A., Pley, C., Bahner, I., Mhaskar, R., Pettigrew, G. J., & Jarmi, T. (2019). A Systematic Review of Opt-out Versus Opt-in Consent on Deceased Organ Donation and Transplantation (2006–2016). World Journal of Surgery, 43(12), 3161–3171. https://doi.org/10.1007/s00268-019-05118-4
Dickens, B. M. (2019). Post‐abortion care: Ethical and legal duties. International Journal of Gynecology & Obstetrics, 147(2), 273–278. https://doi.org/10.1002/ijgo.12951
Etheredge, H. R. (2021). Assessing Global Organ Donation Policies: Opt-In vs Opt-Out. Risk Management and Healthcare Policy, 14, 1985–1998. https://doi.org/10.2147/rmhp.s270234
Lewis, A., Koukoura, A., Tsianos, G.-I., Gargavanis, A. A., Nielsen, A. A., & Vassiliadis, E. (2020). Organ donation in the US and Europe: The supply vs demand imbalance. Transplantation Reviews, 35(2), 100585. https://doi.org/10.1016/j.trre.2020.100585
Zambrano, A. (2023). Organ Conscription and Greater Needs. Cambridge Quarterly of Healthcare Ethics, 32(1), 123–133. https://doi.org/10.1017/S096318012200055X
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