Assignment:
Read the case study presented at the end of Chapter 8 (Guido, p.133) which begins, “The patient was hospitalized for extreme low back pain…”
- Was there informed consent for the initial medications given to the patient?
- How would you determine that informed consent had been given for the MRI and the medications needed for sedation for the test?
- Was the informed consent deficient to the degree that there was a lack of informed consent for the patient for the second dose of medications?
- How would you decide this case?
Read the case study presented at the end of Chapter 9 (Guido, p. 150) which begins, “Jimmy, a Floridian, has undergone two liver transplants.”:
- What questions would you anticipate the judge to ask Jimmy to ascertain his level of maturity, understanding of the full consequences of his lack of action, and possible alternative reasons for requesting that he be allowed to make his own medical decisions?
- How should the judge evaluate the mother’s response to her son’s request?
- Does the state of residency factor into the judge’s decision?
- Are there additional issues that should be addressed prior to deciding the outcome of this case?
- How would you decide the case?
Jimmy Chang, a 20- year- old college student, is admitted for additional chemotherapy. Jimmy was diagnosed with leukemia 5 years earlier and has had several courses of chemotherapy. He is currently in an acute active phase of the disease, though he had enjoyed a 14- month remission phase prior to this admission. His parents, who accompany him to the hospital, are divided as to the benefits of additional chemotherapy. His mother is adamant that she will sign the informed consent form for this course of therapy, and his father is equally adamant that he will refuse to sign the informed consent form because “Jimmy has suffered enough.”
You are his primary nurse and must assist in somehow resolving this impasse.
- What do you do about the informed consent form?
- Who signs and why?
- Using the MORAL model, decide the best course of action for Jimmy from an ethical perspective rather than a legal perspective.
- Now decide the best course of action based on a purely legal perspective.
- Did you come to the same conclusion using both an ethical and a legal approach?
Please combine all of these responses into a single Microsoft Word document for submission. Submit only completed assignments (not partial or “draft” assignments). Be thorough in your responses to adequately address all aspects of each question.
Submit only the assignments corresponding to the module in this section.
Assignment Expectations
Length: 1500 words; answers must thoroughly address the questions in a clear, concise manner.
Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.
References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.
Format: Save your assignment as a Microsoft Word document (.doc or .docx).
File name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”)
Expert Solution Preview
Introduction:
As a medical professor, it is essential to teach medical students about ethics in medicine, specifically informed consent. The case studies at the end of Chapters 8 and 9 in Guido’s book present several scenarios that involve informed consent, and it is necessary to evaluate each case to ensure that students understand the ethical and legal implications of informed consent.
Answer to Question 1:
The case study in Chapter 8 of Guido’s book does not provide detailed information on whether there was informed consent for the initial medications given to the patient. However, it is safe to assume that the healthcare provider obtained informed consent from the patient or a legal representative before administering any medication. Informed consent is a legal and ethical principle in medical care that requires healthcare providers to get permission from a patient or a legal representative before carrying out any medical intervention. Informed consent ensures that patients are aware of the risks, benefits, and alternatives to a medical intervention before giving permission.
Answer to Question 2:
To determine whether informed consent had been given for the MRI and the medications needed for sedation for the test, the healthcare provider should have provided sufficient information to the patient or legal representative beforehand. The information should have included the risks, benefits, and alternatives to the test and the medication. The healthcare provider should have also ensured that the patient or legal representative understood the information and had the capacity to make an informed decision. Informed consent for any medical intervention is only valid if the patient or legal representative understands and agrees to the terms.
Answer to Question 3:
It is difficult to determine if the informed consent was deficient for the second dose of medications without sufficient information on the case study in Chapter 8 of Guido’s book. However, if the healthcare provider provided adequate information to the patient or legal representative before administering the first dose of medication, it can be assumed that the consent for the second dose was not deficient. The patient or legal representative should have been informed of the risks, benefits, and alternatives to the second dose of medication.
Answer to Question 4:
To decide this case, several factors will come into play, including the patient’s capacity to make an informed decision and the healthcare provider’s adherence to the principles of informed consent. If the patient had the capacity to make an informed decision, their decision would be respected, even if it went against the healthcare provider’s recommendation. However, if the healthcare provider believed that the patient’s decision would lead to significant harm, they could enlist the help of the court to overturn the patient’s decision.
Answer to Question 5:
To ascertain Jimmy’s level of maturity, understanding of the full consequences of his lack of action, and possible alternative reasons for requesting that he be allowed to make his own medical decisions, the judge would ask several questions. Some of the questions that the judge might ask include what Jimmy understands about his medical condition, the possible treatment options available to him, and the risks and benefits of each option. The judge might also ask if there are any alternative reasons why Jimmy wants to make his medical decisions, such as religious beliefs or personal preferences.
Answer to Question 6:
The judge should evaluate the mother’s response to her son’s request critically, considering whether the mother is acting in Jimmy’s best interest or based on her own biases or preferences. The mother’s response should be evaluated alongside the patient’s wishes and best medical interests.
Answer to Question 7:
The state of residency might factor into the judge’s decision if the state has specific laws governing informed consent and the rights of patients to make medical decisions. However, the judge should prioritize the patient’s best interest over the state’s laws or regulations.
Answer to Question 8:
Before deciding the outcome of this case, it is essential to address several additional issues, including the patient’s capacity to make an informed decision, the healthcare provider’s adherence to informed consent, and the patient’s best medical interests. Several medical and ethical experts might be consulted to provide guidance on the best course of action.
Answer to Question 9:
The best course of action for Jimmy from an ethical perspective would be to respect his autonomy and let him make his own medical decisions if he is competent. However, if Jimmy has lost his capacity, the healthcare provider should take into consideration the patient’s best interest and act in accordance with it, even if it goes against the patient’s previously expressed wishes.
Answer to Question 10:
The best course of action based on a purely legal perspective might involve enlisting the help of the court to make a decision on Jimmy’s behalf, especially if the patient’s decision would lead to significant harm. The court would evaluate the patient’s best interest and make a decision based on it.
Answer to Question 11:
The ethical and legal approaches to Jimmy’s case might not lead to the same conclusion because the ethical approach prioritizes the patient’s autonomy, while the legal approach prioritizes the patient’s best interest. The best course of action might depend on the specific details of the case and the parties involved.
References:
Guido, G. W. (2018). Legal and ethical issues in nursing. Pearson.
