A Background Statement
This case study presents a scenario involving a 93-year-old Centerville Estates Nursing Home resident Mr. Warden. In regards to his medical history, he has suffered from multiple strokes. He has lost motion in his joints due to fake ion contracture. Additionally, Mr. Warden struggles with a bacterial infection of decubitus ulcer over his sacrum. His heart functions poorly and cannot pump blood properly since he has congestive heart failure. He barely responds to painful stimuli and does not acknowledge any of the nurses or doctors.
Imperative Information Prior to the Family Meeting
As an administrator of the facility Mr. Warden resides in, I would ensure I have all the data necessary before meeting with the patient’s family. First, I would have to gather medical records and receive updates on his condition in order to inform his children of the challenging situation we face. Second, I would discuss Mr. Warden’s short- and long-term prognosis. I believe that delivering this information to the family determines whether they consider the option of limiting their father’s treatment to comfort care only or convinces them to refuse a do not resuscitate (DNR) order instead. Apart from conducting and structuring research regarding the condition of Mr. Warden to present accurate information to his family, it would be crucial to examine the nursing home records. This way, I could go into the meeting with prior knowledge of how close Mr. Warden and his children or grandchildren are. From the case study, it is apparent that Mr. Warden does not seem to remember his family, any of the members of which have visited him in the past 6 months.
Ethical Dilemmas Specific to the Case
The first dilemma this case presents is related to Mr. Warden’s autonomy: Should anyone else besides Mr. Warden control key aspects of his treatment, particularly making end-of-life decisions? The second dilemma arises from the principle of beneficence: Can medical staff interfere with Mr. Warden’s family’s decisions on the basis of ensuring that the patient’s quality of life is suffering? Another dilemma stems from the healthcare professionals’ obligation before Mr. Warden to guarantee him justice. Thus, the question is: Who should make the final decision regarding Mr. Warden’s treatment and the possibility of a DNR order, in particular?
Existing DNR Laws in Illinois
One of the primary issues in Mr. Warden’s case is determining who has the final say in making decisions regarding his life-sustaining treatment. Physicians deemed Mr. Warden to be unable to make such decisions on his own. Thus, based on the Illinois legislature in regards to advance directives, his son would have the authority to make the final decision through the power of attorney is given to him (Illinois Department of Public Health, n.d.). If Mr. Warden did not leave his son with the power of attorney or provide a will, the hospital’s physicians in cooperation with the ethics committee would have the authority to issue a DNR order (Schweikart, 2019). In this case, it is important to note that the medical professionals would be obligated to follow the principles of beneficence and act in the patient’s best interest.
Leadership Traits Essential for the Case
As for the final thoughts regarding the course, I would like to note that I have learned a lot. Healthcare is not necessarily about medical skills as it implies constantly making life-altering decisions, which pose a number of ethical issues. In the case of Mr. Warden, nursing home staff and doctors would have to display assertiveness, problem-solving skills, as well as compassion in communication with the family. The task of the healthcare professionals is to ensure they inform Mr. Warden’s children of his condition and prognosis. At the same time, they have to think ahead and have the ability to take a step back in order to follow the appropriate legal procedures and conduct all of the procedures in accordance with the ethical codes.
References
Illinois Department of public Health. (n.d.). Advance directives. Web.
Schweikart, Scott J. (2019). Who makes decisions for incapacitated patients who have no surrogate or advance directive? AMA Journal of Ethics, 21(7), 587–593.