Feeding and intravenous therapy

You work as an RPN at a major metropolitan hospital on a medical unit.

Mr. Cote has end-stage Alzheimer’s Disease. He has had a stroke and is hospitalized in your unit. He can no longer swallow. Prior to the stroke, Mr. Cote did have some brief moments where he was lucid and able to converse. After his stroke, he deteriorated very quickly and no longer has any moments where he is lucid or has the capacity to make any decisions.  His physical health has deteriorated and the healthcare team estimates that with a feeding tube, he may live another 2 to 6 months.

In the past month, Mr. Cote has pulled out his feeding tube twice. Now he needs to have his arms restrained to stop him from pulling out the tube. The healthcare team wants to stop all feeding and intravenous therapy and let Mr. Cote die.

His wife insists that he have a feeding tube. She says that if he does not have the feeding tube, she will be responsible for ending his life. She adds that if the team does not re-insert the tube when he pulls it out they will be responsible for his death.

Mrs. Cote says her husband does not know what he is doing and the tube must remain.

You are in a team meeting to discuss what to do next and your manager says to you. “You took a class that discussed ethics. What do you think is the right thing to do in this case?” Question:

 What is the ethical dilemma? State specifically what the issue here is.  What is the actual ethical dilemma the persons (nurse, client, Dr. etc) are facing in your scenario?

Identify the ethical principle and explain why?

 

What are the roles? Who was involved?who is responsible to make the decision? And who is affected by the decision, and why they are affected by the decision and/or scenario.

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