Ethical and legal issues resolution requires exemplary level of professionalism and theoretic preparedness on the part of nursing professionals (Hamric, Hanson, Tracy, & O’Grady, 2013). Not only the situation is complex because the nursing practice is regulated by a large scope of legislative norms but the main influential factor is the implications that a nurse’s decisions may have for the lives of patients and their family members (Griffith & Tengnah, 2014). The situation that took place in Ann’s case is one of such complex situations that require professionalism and excellent legal and ethical theoretic knowledge. The following paper will address the given case to discuss the ethical and legal decisions that a nursing professional should make, and a piece of advice that one should provide to Ann’s husband and daughter.
First, addressing the matter from the legal point of view, it is important to note that Ann did not express her will in the paper form, and therefore, the statement she made has the limited judicial power since there are only two witnesses, and they are her closest relatives (Burkhardt & Nathaniel, 2013; Griffith & Tengnah, 2014). Based on this information, my legally-based decision would be to use a feeding tube to support Ann’s life.
Next, speaking about the ethical decisions I would make in this case, I will need to evaluate Ann’s will information more closely. In discussion with her husband, the patient stated that if there was no chance of survival, she would not want to be hooked to the breathing machine. Analysis of this expression demonstrates two important points: (1) the will statement refers to the situation without a chance of survival, and (2) the will statement addresses the breathing machine rather than other medical equipment. Therefore, a conclusion can be made that the situation does not fully coincide with the circumstances described by the patient. According to Morton and Fontaine (2013), elderly patients have chances to survive pneumonia. In addition, the breathing machine is quite a different mechanism as compared to the feeding tube. Although Ann refuses to eat, we cannot say that she does so deliberately because according to Monroe, Herr, Mion, and Cowan (2013), Alzheimer’s disease may cause such deviations from normal behavior as refusal to consume food, and therefore, we may not be sure that Ann is aware of what she is doing. Based on the rationale provided in this passage, my ethical decision will be to insert the feeding tube to support her life and provide the body with the necessary resources to survive pneumonia.
Finally, addressing the recommendations I would provide to Frank and Sarah, I would recommend them to evaluate Ann’s will statement more attentively and have their special focus on the points she stressed such as ‘no chance of survival’ and ‘whether breathing machine is the same equipment as the feeding tube’. I would also educate them about the limitations that Alzheimer’s disease places on an individual’s ability to think and make sound judgments that suggests that Ann might refuse eating without understanding what she is doing (Wolf, Berlinger, & Jennings, 2015).
In conclusion, the ethical and legal decision I would make in Ann’s case is to insert the feeding tube and provide Ann with all necessary medications that would help her survive pneumonia and stabilize her situation. I would also recommend her relatives to analyze her will statement in more detail to find answers to their questions.
Burkhardt, M., & Nathaniel, A. (2013). Ethics and issues in contemporary nursing. London: Cengage Learning.
Griffith, R., & Tengnah, C. (2014). Law and professional issues in nursing. New York, NI: Learning Matters.
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2013). Advanced practice nursing: An integrative approach. London: Elsevier Health Sciences.
Monroe, T. B., Herr, K. A., Mion, L. C., & Cowan, R. L. (2013). Ethical and legal issues in pain research in cognitively impaired older adults. International Journal Of Nursing Studies, 50(9), 1283-1287.
Morton, P. G., & Fontaine, D. K. (2013). Essentials of critical care nursing. New York, NI: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Wolf, S. M., Berlinger, N., & Jennings, B. (2015). Forty years of work on end-of-life care—from patients’ rights to systemic reform. New England Journal of Medicine, 372(7), 678-682.