Ethical Dilemma Paper

Ethical Case Paper
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July 28, 2020
Understanding the rules and regulations when it comes to deciding about a person’s healthcare is important for any nursing practitioner. It allows him to be able to make a more objective decision based on a set of circumstances that would be in line with the different virtues of ethical nursing. In this paper, the author would discuss the role of these virtues in the case of a patient who has suffered severed thermal burns and is on the brink of death. This analysis would include the different variables that must be considered by a nurse practitioner in making his decisions. All in all, the author strongly believes that although patient autonomy must be given priority in making one’s decision, it is the nurse’s responsibility to determine whether these decisions would be the best for a patient’s long-term well-being.
The Case
The case at hand involves a male patient who has suffered a 50% burn in his Total Body Surface Area. Due to his injuries, he had been in and out of consciousness ever since the accident. In one instance, the patient woke up and said that he does not want to proceed with any life-saving measures. However, he does not have any advance directives in place and his wife opposes his idea of removing the life-saving measures.
Objective Measurement of Ethical Dilemma
Due to the conflicting wishes between the patient and his wife, together with his state of mind, a careful analysis of the four ethical principles is in order.
Autonomy
The first ethical principle that should be taken into consideration is autonomy. According to Haswell (2019), autonomy refers to the ethical principle wherein the patient’s directive must be given precedence. He furthered that although the nurse may provide suggestions to the patient, any coercive measures could be violative of this principle. In line with the case, it could be seen that the patient has explicitly requested that all his life-saving measures be removed. Thus, at first glance, following his orders would seem the proper way since it was his own request.
Although heeding to the patient’s order would seem like the best way to respect his autonomy, the question is whether the patient is really capable of making sound decisions regarding his life. As stated earlier, the patient has been in and out of consciousness for the duration of his stay. Although he has said that he wants to terminate of life-saving devices, there are no advanced directives that enforce his decisions but rather a verbal communication of his wishes. In one article written by Zuscak et al. (2016), the authors noted that “assessments of capacity should involve a general cognitive ability assessment, followed by a decision-specific assessment tool or question set for the decision facing the patient”. Accordingly, given that burn patients could suffer from psychological disorders such as PTSD, this suggests that a further inquiry into the other principles must be done (Bond et al., 2017).
Justice
The principle of justice suggests that the healthcare practitioner must utilize an element of fairness in his decision making. This fairness must stem...