Intravenous dose of opiate analgesic

A nurse discovers that an excessively large intravenous dose of an opiate analgesic has been prescribed by an attending doctor. Based on her knowledge of pain management regimens and a clinical assessment of the patient, the nurse is concerned that if the prescribed dosage is administered as ordered, the consequences to the patient could be dire. (Specifically, it would, in all probability, hasten the patient’s death.) She checks with the prescribing doctor, who confirms that the medication is to be administered as prescribed and that, even though its administration will probably result in hastening the patient’s death, this is not the intended outcome. He explains that the dose prescribed is ‘in the best interests of the patient’ and is ‘necessary to alleviate the patient’s pain and suffering’. He further states that the prescription in question is ‘good medical practice’. The doctor upholds this view despite knowing that the patient has requested ‘everything possible be done’ to prolong her life and has expressed a preference not to be medicated in a manner that would render her unconscious. To answer the following questions, it is necessary to have some understanding of what an ethical issue looks like. In other words, the characteristics of what constitutes a moral/ethical issue need to be clarified

1. In which of these three scenarios does the medication order constitute an ethical issue, as opposed to, say, a clinical (practical) issue or a legal issue?

2. Discuss the elements of the case that you believe indicates the elements of the ethical issue and identify which aspect of the Code of Ethics is at risk of being breached.