Applying The Model For Ethical Decision-Making

Applying The Model For Ethical Decision-making – Mr. Alphonse Martinez and Miss Mary-Jane Case scenario

Applying The Model For Ethical Decision-making

CHOOSE ONE CASE SCENARIO:
Mr. Alphonse is the first case study.

Mr. Alphonse Martinez is a retired Italian man who is married and has two grown sons who still live at home. They are a close family who attend church on Sundays. Mr Alphonse had recently signed an Advanced Health Directive (AHD) stating that if he suffered another serious heart attack, he would not be resuscitated. His wife and two sons were against his Advanced Directive and instructed the staff to disregard it.

Following his myocardial infarction, Alphonse was discharged from the coronary care unit (CCU) and placed in a step-down cardiac ward (MI). The staff felt that he had exaggerated his chest pain while in CCU. That is, when they asked him to rate his pain on a scale of 0 to 10, he sometimes said 12 or 14. In response, staff expressed their displeasure.

During the first evening on the cardiac ward, Alphonse asked Mark, one of the clinical practice student nurses, to contact the hospital priest to come and see him and perform the last rites. Mark did so right away and then returned to his seat with Mr Alphonse.

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Mark’s clinical supervisor (RN) later summoned him to one side and inquired as to why he was sitting with Mr Alphonse. Mr Alphonse was anxious, so Mark (student nurse) sat with him, he explained. “Do you think you’re making him more anxious by sitting with him?” the RN inquired. Mark responded that he didn’t think so, and that he was only saying that until the priest arrived.

The RN then inquired as to why the priest was coming, and Mark replied that Mr Alphonse had requested the priest, so he had contacted him to come. “Didn’t you think you should have told me what you’d done?” the RN asked Mark. Mr Alphonse’s buzzer went off, and as the RN and Mark returned to the room, they noticed Mr Alphonse had a cardiac arrest.

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Mr Alphonse could not be revived despite vigorous and sustained efforts.

Applying The Model For Ethical Decision-making – Mr. Alphonse Martinez and Miss Mary-Jane Case scenario

Miss Mary-Jane Case Study No. 2

Mary-Jane is 14 years old; her parents have recently divorced and both work. She has three younger siblings, and Mary-Jane looks after them a lot. For the past 24 hours, she has been complaining of moderate to severe abdominal pain and vaginal spotting (bleeding). She arrives at her local hospital’s emergency department with her parents, who are concerned about their daughter’s condition. Mary-Jane appears pale, sweaty, dizzy, nauseated, and bloated in her stomach.

On admission, you took her baseline measurements, which were 37.8 degrees Celsius, 118 beats per minute, 90/50 blood pressure, and 28 beats per minute of shallow breathing. An ectopic pregnancy is a possible diagnosis, and a pregnancy test is required to rule this out. As the student nurse and the Registered Nurse caring for Mary-Jane consider legal and ethical issues, such as consent and confidentiality, these and other issues must be considered for Mary-Jane.

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