Severe stroke
You work at a local nursing home. One of your patients is 37 years of age. He has resided at the nursing home for the last five years. He had had a severe stroke when he was 32 years of age. He watches the activity around him; however, he has expressive aphasia. He is unable to swallow. He has had a gastrostomy tube (G-tube) for the last four years for G-tube feeding. He is in decerebrate posturing. The staff try to get him out of the room in a recliner every day for a change of scenery, but there is no apparent response. He simply stares.
The patient’s wife has a sales job and is out of town frequently, so she rarely visits. It has been over a year since the last time she came into the nursing home. The patient is a full code. Today, the patient’s wife came into the nursing home with her boyfriend, and asked to have the patient’s status changed to “Do Not Resuscitate.” Also, she asked for hospice to be called in so that they could order the G-tube feedings and medications discontinued. The physician wrote the order for a DNR and hospice consult, and hospice has been called and have visited with the patient and his wife. You receive the order to discontinue the g-tube feedings, fluids via g-tube, and all medications. You know that discontinuing the feeding and fluids will result in the death of this patient and feel uncomfortable following this order.
· Briefly describe the type of ethical problem described in this scenario.
· Discuss ethical principles related to this scenario.
· What ethical principles can be beneficial as you attempt to resolve this issue?
· What do you think your response should be in this situation? Why?
· What values are involved within this dilemma?
· Discuss how your personal values influenced how you resolved this dilemma.
· Discuss the ANA Code of Ethics Provisions that support your resolution to this dilemma.
· How do these provisions relate to this situation?
