Catanduanes State University
College of Health Sciences
Department of Nursing
SITE ONE SITUATION FROM ETHICAL / LEGAL PRINCIPLES AND ISSUES. ( PROS AND CONS)
BASED ON NURSING RESPONSIBILITIES.
Situation: A patient with a terminal illness has expressed their wish to discontinue life-sustaining
treatment, such as mechanical ventilation, in order to die peacefully. However, the patient's
family strongly disagrees with this decision and insists on continuing aggressive treatment.
Ethical dilemma: The ethical dilemma in this situation revolves around the conflict between
respecting the patient's autonomy and honoring their end-of-life wishes, while also considering
the values and emotions of the patient's family.
Ethical principles and issues/ Pros and Cons (Nursing Responsibilities):
1. Autonomy: Respecting the patient's autonomy is an ethical principle that recognizes their
right to make decisions about their own healthcare. In this situation, nurses have a
responsibility to advocate for the patient's autonomy and ensure that their wishes are
respected.
- Pros: Respecting autonomy promotes patient-centered care, empowers patients to make
decisions about their own lives, and upholds their dignity and self-determination.
- Cons: Respecting autonomy may create conflicts with the values and wishes of the patient's
family, leading to emotional distress and strained relationships.
2. Beneficence: The ethical principle of beneficence requires healthcare professionals to act in
the best interest of the patient. Nurses must consider the potential benefits and harms of
continuing aggressive treatment versus honoring the patient's end-of-life wishes.
- Pros: Honoring the patient's wishes for comfort-focused care and allowing them to die
peacefully aligns with the principle of beneficence by prioritizing their well-being and quality of
life.
- Cons: Continuing aggressive treatment against the patient's wishes may prolong suffering,
decrease quality of life, and go against the principle of beneficence.
3. Non-maleficence:
Pros: Avoiding unnecessary harm aligns with the principle of non-maleficence. Discontinuing
treatment may reduce suffering and provide a more dignified death.
Cons: May be seen as causing harm by hastening death. May be perceived as failing to fulfill the
duty to preserve life.
4. Justice:
Catanduanes State University
College of Health Sciences
Department of Nursing
Pros: Ensures fair and equitable treatment for all patients, regardless of their illness or family
dynamics. Respects the patient's right to self-determination.
Cons: May create conflict with the family's wishes and desires. May be seen as prioritizing
individual rights over the collective well-being of the family.
5. Veracity:
Pros: Requires honesty and transparency in communication with the patient and family.
Provides accurate information about treatment options and prognosis.
Cons: May lead to difficult conversations and potential distress for the family. May require
balancing the patient's right to know with the need to protect emotional well-being.
Legal considerations:
1. Informed consent: In many jurisdictions, obtaining informed consent is a legal requirement.
Nurses have a responsibility to ensure that the patient's decision to discontinue life-sustaining
treatment is based on informed consent.
- Pros: Respecting the patient's decision and obtaining informed consent protects the legal
rights of the patient and healthcare providers involved.
- Cons: Legal challenges may arise if there are conflicts between the patient's wishes and the
desires of the family, leading to potential disputes and legal interventions.
2. Advance directives: Advance directives, such as living wills or healthcare proxies, allow
individuals to express their healthcare preferences in advance. Nurses should be aware of any
advance directives and consider them in decision-making.
- Pros: Following the patient's advance directives provides legal guidance and ensures that their
wishes are respected.
- Cons: If the patient does not have an advance directive or their wishes are not clearly stated,
legal ambiguities may arise, requiring further legal interventions and decision-making.
3. Patient Confidentiality:
Pros: Protects the patient's right to privacy and control over their personal information. Ensures
sensitive information is not shared without consent.
Cons: May conflict with the family's right to information and involvement in decision-making.
May require balancing individual rights with the need for family support.
Catanduanes State University
College of Health Sciences
Department of Nursing
4. Negligence:
Pros: Protects patients from harm caused by medical professionals. Ensures adherence to
standards of care and professional ethics.
Cons: May lead to legal liability for nurses who fail to uphold their professional obligations. May
create a culture of fear and defensiveness in healthcare settings.
Additional Considerations:
Communication and conflict resolution: Effective communication with the patient and family is crucial to
address concerns, answer questions, and reach a shared understanding.
Ethical consultation: Consulting with an ethics committee or other specialists can provide valuable
guidance and support in complex cases.
Palliative care: Providing palliative care can improve the patient's quality of life and comfort during their
final days.
Name: TAOPA, JENNY G. Date: 12/11/2023
P/Y/B: BSN3D
Prof: Mrs. GEOZABETH PADUA
NCM 114
CARE OF THE OLDER PERSON
Quiz #3
Catanduanes State University
College of Health Sciences
Department of Nursing
Situation: Ms Jane a junior nursing student who is doing clinical rotation in a long care facility.
She is assigned to care for resident who occupies a double room. The resident assigned to Ms
Jane are named juliene and julie both resident are elderly women and have some initials, while
passing out medications. Ms Jane ask the nursing attendants to identify Ms. Juliene because the
residents do not wear arm bands. Ms.Juliene picture is missing from medication book. Ms Jane
administer medication to the resident all then her room mate enters the room and ask where
the medication are? Jane ask the woman's name and she states she is juliene. Jane realizes that
she has administered medication to Julie.
Questions:
1.What should Jane do immediately in this situation?
In this situation, Jane should immediately take the following steps:
Inform her clinical instructor or supervisor about the mistake.
Document the incident accurately and thoroughly.
Assess the resident, Julie, to determine if there are any adverse effects from the
medication administered.
Notify the healthcare provider responsible for Julie's care and inform them of the error.
Follow the facility's policies and procedures for medication error reporting and
documentation.
2. What could and should have been done to prevent such error from occuring ?
To prevent such errors from occurring, several measures could and should have been taken:
Proper identification of residents, such as using arm bands or other identification
methods.
Ensuring that all residents' pictures are present in the medication book.
Double-checking the resident's identity before administering any medication.
Following a standardized medication administration process, including verifying the
medication with the resident and cross-checking with another healthcare professional.
3. Who is responsible to Jane's mistake? What about the accountability of clinical instructor?
In terms of responsibility, Jane bears accountability for the mistake since she administered the
medication to the wrong resident. However, the clinical instructor also shares some
responsibility for ensuring that Jane is adequately trained and supervised during her clinical
rotation. The clinical instructor should provide guidance, oversight, and ensure that proper
protocols are followed to prevent errors.
Catanduanes State University
College of Health Sciences
Department of Nursing
4.What are the ethical and legal implications in these situation?
From an ethical standpoint, this situation raises concerns about patient safety, trust, and the
duty of care. Administrating medication to the wrong resident can have serious consequences
and is a violation
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decision and insists on continuing aggressive treatment.
5. Discuss what might happen if this mistake occured in the facility that you are practicing.
If this mistake occurred in a facility, the consequences could vary depending on the severity of
the error and the facility's policies. It could lead to an internal investigation, disciplinary actions,
additional training for staff, and changes in protocols to prevent similar errors in the future. The
facility may also be required to report the incident to regulatory bodies or face legal
repercussions.
SITE ONE SITUATION FROM ETHICAL / LEGAL PRINCIPLES AND ISSUES. ( PROS AND CONS)
BASED ON NURSING RESPONSIBILITIES.
Ethical dilemma: The ethical dilemma in this situation revolves around the conflict between
respecting the patient's autonomy and honoring their end-of-life wishes, while also considering
the values and emotions of the patient's family.
ETHICAL AND LEGAL PRINCIPLES & ISSUES
Catanduanes State University
College of Health Sciences
Department of Nursing
Ethical principles:
Autonomy: The patient's right to self-determination and to make decisions about their own
body and medical care.
Beneficence: The obligation to do good for the patient and avoid causing harm.
Non-maleficence: The duty to avoid causing harm to the patient.
Justice: The principle of fairness and equality in the allocation of resources and the provision of
healthcare.
Legal principles:
Right to refuse treatment: Most jurisdictions recognize the right of a competent patient to
refuse medical treatment, even if it will result in death.
Substitute decision-making: If the patient lacks decision-making capacity, a surrogate decision-
maker, such as a family member, may have the authority to make medical decisions on their
behalf.
Informed consent: The patient has the right to be informed about their diagnosis, prognosis,
and treatment options, and to give informed consent to any medical intervention.
Issues:
Balancing the patient's autonomy with the family's wishes: The nurse must respect the
patient's autonomy but also consider the family's emotional distress and their desire to keep
their loved one alive.
Assessing the patient's decision-making capacity: The nurse must ensure that the patient is
competent to make their own decisions.
Managing conflict: The nurse may need to mediate between the patient and the family to help
them come to a mutually acceptable decision.
Providing emotional support: The nurse should provide emotional support to both the patient
and the family during this difficult time.
PROS AND CONS OF DISCONTINUING TREATMENT (NURSING RESPONSIBILITIES)
PROS:
1. Respects patient's right to autonomy: Allows the patient to die with dignity and according to
their own wishes.
2. Reduces suffering: May alleviate pain and other symptoms experienced by the patient.
Catanduanes State University
College of Health Sciences
Department of Nursing
3. Provides comfort and peace: Allows the patient to spend their final days surrounded by loved
ones.
4. Reduces healthcare costs: Avoids unnecessary use of expensive medical resources.
5. Allows family to grieve: Gives family time to prepare for the patient's death and begin the
grieving process.
6. Respects the nurse's ethical obligations: Aligns with the principles of autonomy and non-
maleficence.
7. Reduces moral distress: Helps nurses avoid feeling conflicted about prolonging a patient's
suffering.
8. Avoids futile treatment: Stops interventions that are unlikely to improve the patient's
outcome.
9. Promotes patient-centered care: Focuses on the patient's wishes and values.
10. Supports palliative care principles: Encourages comfort and quality of life in the finalstages
of illness.
CONS:
1. Goes against family's wishes: May cause conflict and distress for the family.
2. Shortens life: May hasten the patient's death.
3. Raises ethical concerns: May be difficult for some nurses to reconcile with their personal
beliefs.
4. Requires skilled communication: Nurses need to be able to discuss sensitive topics with the
patient and family.
5. Emotionally challenging: May be difficult for nurses to deal with the patient's death and the
family's grief.
6. Legal implications: Nurses need to be aware of the legal requirements for informed consent
and substitute decision-making.
7. Requires cultural sensitivity: Nurses need to be sensitive to different cultural beliefs and
practices regarding death and dying.
8. Requires collaboration with other healthcare professionals: Nurses need to work with
physicians, social workers, and chaplains to provide comprehensive care.
9. Requires ongoing education and support: Nurses need to have access to training and
resources to help them deal with the ethical and emotional challenges of end-of-life care.
10. May not be appropriate for all patients: Some patients may not be ready to die or may
benefit from further treatment.
