Assignment Description:

For this week assignment, create a PowerPoint presentation based on the following case studies.

Read the case studies and answer the following questions:

Apply Guido’s MORAL model to resolve the dilemma presented in the case study described in Ethical Scenario 4-3 on p. 48 which is titled, “When Care Appears Medically Inappropriate,” (Guido textbook 7th edition).

Mrs. R., an 87-year-old patient, has a past history that includes coronary artery disease, a previous stroke, and advanced Alzheimer’s disease. Ten days ago, Mrs. R. was hospitalized for aspiration pneumonia and has been ventilator dependent since being admitted to the intensive care unit in a small rural hospital. Family members visit daily and have repeatedly voiced their concern to the nursing staff about the continued ventilator support that Mrs. R. is receiving, most notably the fact that Mrs. R. would never have wanted such care. They also note that Mrs. R. has not recognized them in past months and that they plan to visit less in future days, but can be contacted should any change in Mrs. R.’s condition occur. Her primary physician has practiced in this community for multiple years; he is well-known for his reluctance to discontinue any type of life support for any patient. When questioned, Dr. G.’s consistent response is, if this were his frail 92-year-old mother, he would prescribe the very same treatment for her. Dr. G. has now requested that the nurses talk to the family about moving Mrs. R. to a major medical center, where she can receive more advanced care, including vigorous rehabilitation and physical therapy, so that she may eventually return to a long-term nursing care facility. How might the nurses in this scenario respond to the physician’s request? How would this scenario begin to cause moral distress among the nursing staff and what are the positive actions that the nurses should begin to take to prevent moral distress.How might the nurses in this scenario respond to the physician’s request?

• How would this scenario begin to cause moral distress among the nursing staff, and what are the positive actions that the nurses might begin to take to prevent moral distress?

Read the following case study and answer the following questions: “You be the Ethicist”, presented at the end of Chapter 3, p. 41, which starts, “Helga Wanglie…” (Guido textbook).

Case Two: Futile use of respirator on an adult in a persistent vegetative state whose wishes are not known Helga Wanglie was an eighty-five-year old woman who was taken from a nursing home to Hennepin County Medical Center when she developed respiratory failure. She was placed on a respirator, and over a period of several months repeated attempts to wean her from the respirator failed. Mrs. Wanglie was discharged to a chronic care hospital that specializes in respirator-dependent patients. At the time of her discharge she was fully conscious, aware of her surroundings and able to communicate. At the new facility, efforts continued to attempt to wean Mrs. Wanglie from the respirator. During one such attempt, her heart stopped, and she was resuscitated and taken to another hospital for intensive care. She remained unconscious, and was later determined to be in a persistent vegetative state. When physicians suggested that life-sustaining treatment be withdrawn since it was not benefiting Mrs. Wanglie, the patient’s husband, daughter, and son insisted on continued treatment (Cranford, 1991).

What are the compelling rights that this case addresses? Whose rights should take precedence?

• Whose rights should take precedence?
• How might the institutions’ organizational ethics policies have impacted the outcome of this case?
• Leaving any legal issues aside, how would you have used ethical principles to decide the outcome of this case, if Helga Wanglie had continued to survive relying on life-sustaining measure?

Now, examine the same Helga Wanglie scenario from the perspective of health care policy.

• How would you begin to evaluate the need for the policy and the possible support or lack of support for the policy from your peers, nursing management, and others who might be affected by the policy?
• Do the 10 framework questions outlined by Malone in chapter 4 (Guido textbook, p. 50) assist in this process?

• What is the problem? • Where is the process? • How many are affected? • What possible solutions could be proposed? • What are the ethical arguments involved? • At what level is the problem most effectively addressed? • Who is in a position to make policy decisions? • What are the obstacles to policy interventions? • What resources are available? • How can I get involved? (Malone, 2005, p. 138)

~Create a process proposal for the organization with possible guidelines, procedures, and policies to address the issues you have identified.

The following specifications are required for this assignment:

• Length: 10 slides minimum; answers must thoroughly address the questions in a clear, concise manner.
• Structure:
  • Title: 1 slide
  • Objectives: 1 slide
  • Guido’s MORAL model: at least 2 slides
  • You be the Ethicist: at least 2 slides
  • Perspective of health care policy: at least 2 slides
  • Conclusion: 1 slide
  • References: 1 slide
  • Additionally, because a good presentation has few words on the slides include a script with the verbiage you would say when presenting; script should be a minimum of 50 words per slide.
• References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least two (2) scholarly sources to support your claims.