Competency 726.1.8: Principles of Ethics, Bioethics, & Nursing Regulation – The graduate demonstrates decision-making skills that reflect a professional and ethical framework and adhere to the guidelines and regulations set by professional and state regulatory bodies.
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Nurses are confronted with ethical decisions every day, ranging from decisions about routine vaccination to issues of death and dying. It is important, therefore, that nurses know how to analyze a bioethical issue based on nursing ethical values, principles, and facts in order not only to make ethical decisions about their practice but also to help support patients and families as they struggle with ethical decisions.
Matt, a 20-year-old white male, was brought into the emergency department unconscious with a needle protruding from a vein in his left forearm. It was determined from his lab work that he had been taking opiates, and a heroin overdose was suspected. After Matt was intubated and placed on mechanical ventilation, he was stabilized and transferred to the intensive care unit. Matt’s family was notified, and they rushed to his bedside within a half hour. After speaking with the physician, the family told the healthcare team that they wanted to do everything possible to save their son’s life.
An hour later, Matt’s heart stopped, and after a full code, Matt was stabilized but was still not breathing on his own. Matt’s heart stopped two more times over a span of three hours. Dark blood was becoming visible in the suctioning canister, but Matt remained in a full code status, and the family refused to assign him a “Do Not Resuscitate” (DNR) status after five codes.
Currently, the physician does not want the patient to have any further resuscitation. EEG shows no brain activity. The nurse is torn between supporting the family and following through with the physician’s desires. The nurse manager informs the nurse that she should do as the physician says. The nurse also dislikes caring for drug abuse patients. The patient did not have a DNR order on file. If he had a DNR, there would have been an agency policy to follow it. The hospital also has an ethics committee.
A. Analyze (suggested length of 1–2 pages) the bioethical issues found within the scenario.
1. Provide relevant facts that relate to the issues.
2. Discuss how the nurse and the family members have ownership in the given scenario.
3. Discuss how the ethical principles of autonomy, beneficence, and non-maleficence relate to the given scenario.
B. Analyze (suggested length of 1–2 pages) two bioethical issues in the given scenario in terms of a specific ethical theory of your choice.
1. (principle-, relationship-, or consequence-based).
2. Explain how the chosen theory can relate to the given scenario.
3. Discuss a state law or nursing statute that can be applied to the scenario.
C. Discuss (suggested length of 1–2 pages) two alternative actions that could affect the patient outcome.
1. Apply the ANA Nursing Code of Ethics to guide these actions.
D. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
Note: When bulleted points are present in the task prompt, the level of detail or support called for in the rubric refers to those bulleted points.
Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section.
Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from sources, even if cited correctly.