Palliative and End-of-Life Care Across the Continuum

Type: Essay

Subject: Case Analysis

Subject area: Nursing

Education Level: College

Length: 2 pages

Referencing style: APA

Preferred English: US English

Spacing Option: Double

Title: ETHICAL PRINCIPLE APPLICATION

Instructions: scenario you have been working as a nurse in the adult oncology unit for the past year. you have developed a close relationship with many of your patients, but mr. newcomb has a special place in your heart. he has been diagnosed with stage 4 pancreatic cancer and has undergone aggressive chemotherapy. each day his wife has come to the unit to be with her husband. they have been married for over 40 years and share a deep love. mr. and mrs. newcomb have made the decision to no longer continue with treatment and have decided that hospice care is needed. over the past few days, you have watched mr. newcomb’s health decline, and you can tell from your experience that he does not have much time left to live. mr. newcomb has been very open about discussing his death, and you have had the opportunity to learn about his life and the legacy he will leave behind. while you are completing your rounds, you stop in mr. newcomb’s room to see how he is doing. you ask, “is there anything else i can do for you?” mr. newcomb has rarely asked for anything, but today he has one request. mr. newcomb states, “before i die, i would like to see my mistress one more time. mrs. newcomb is always here. do you think you could tell her that i will be busy for a few hours tomorrow so i can make arrangements to see my mistress one more time?” reflect on the following questions before you begin working on this task: • what would you do in this scenario? • how can your knowledge of ethical principles be utilized to determine your response to mr. newcomb? • how would this affect you as a nurse and direct provider of care for mr. newcomb? requirements your submission must be your original work. no more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. an originality report is provided when you submit your task that can be used as a guide. you must use the rubric to direct the 

Case Analysis

Mr. Newcomb requested me as (the nurse) to tell his wife that he will be busy for some time to allow him see his mistress without the knowledge of his wife. There are two main decisions that can be made by the nurse in this scenario which are to inform his wife that he is busy hence enable him achieve his wish or refuse to inform his wife. The nurse being a professional should make the decision based on the principles of beneficence, non-maleficence, autonomy, and justice to the scenario.

The principle of autonomy states that the patient should have total control over their bodies (Dove et al. 2017). Medical professionals should not suggest, persuade or coerce the patient in making certain decisions. Based on the principle, I should reserve my opinion concerning the risks of talking to his mistress without the knowledge of his wife. Additionally, I should not inform or threaten to inform his wife concerning his intentions in an effort to influence his decision. The patient has the right to talk to his mistress without my interference. However, I am not under any obligation to enforce his wish by lying to his wife hence failure to lie to his wife does not contravene the principle in any way.

The principle of beneficence states that the health provider should do all they can to benefit the patient in every situation (Muir et al. 2019). The health provider must strive to do most good to the patient. The most good to the patient in the case under consideration is to protect his marriage with his wife. In this regard, the nurse should not facilitate the meeting with his mistress to protect the marriage. Based on the principle of beneficence, I should not lie to his wife but I should also not inform his wife concerning his intentions to save their marriage.

The principle of non-maleficence states that the medical professional should do no harm to the patient. In the case under consideration, harm to the patient can be viewed in terms of informing his wife regarding his wish hence endanger the relationship and also lie to his wife which would also compromise their union. Lying to his wife would harm his wife who is a close person to the patient. Therefore, based on the principle of non-maleficence, I should not lie to the patient’s wife as requested.

The principle of justice states that the medical practitioner should be fair in all medical decisions. When acting professionally, the nurse should not lie or misrepresent data and information for the sake of his patients. Mr. Newcomb should not be treated exceptionally where the nurse lies to achieve his wish. Therefore, the nurse should not lie to his wife. Based on the principles above, the nurse should not lie to Mr. Newcomb’s wife to achieve his agenda. However, if Mr. Newcomb decides to inform his wife himself that he will be busy, the nurse should not inform his wife bout his intention or talk to the patient to persuade him from meeting his mistress.

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Personal Belief

I believe that people should be faithful to their spouses hence having an extra marital affair is wrong. However, I have learned not to judge people including my patients hence deciding whether they are wrong or right in engaging in extra marital affair is unprofessional. Therefore, I should not allow my belief concerning marriage influence my decision in the case under consideration. Meeting his mistress should also not affect how I relate to the patient after the event. I also hold honesty and being truthful as important values. The values influenced my decision concerning lying to Mrs. Newcomb. 

Self-care

Self-care involves necessary human regulatory function under individual control. There are various strategies to promote self-care that can be adopted for patients under palliative care including Mr. Newcomb. First, patents should be advised to engage in exercises regularly. Regular exercises reduce stress and improve blood circulation. Secondly, patients should be advised to maintain a balanced diet. Eating nutritional food improves energy levels. Lastly, patients should be encouraged to ask for help when needed and accept it.

References

Dove, E. S., Kelly, S. E., Lucivero, F., Machirori, M., Dheensa, S., & Prainsack, B. (2017). Beyond individualism: Is there a place for relational autonomy in clinical practice and research?. Clinical Ethics, 12(3), 150-165.

Muir, H. J., Coyne, A. E., Morrison, N. R., Boswell, J. F., & Constantino, M. J. (2019). Ethical implications of routine outcomes monitoring for patients, psychotherapists, and mental health care systems. Psychotherapy, 56(4), 459.