Traumatic Brain Injury in Older Adults Epidemiology, Outcomes, and Future Implications

Traumatic Brain Injury in Older Adults Epidemiology, Outcomes, and Future Implications

J’s autonomy is not being respected. However, this is due to his inability to make independent decisions related to the care that he needs. Autonomy refers to the right of an adult patient to make informed decision concerning their care. The decision that one reaches should be respected by the healthcare providers. This is irrespective of whether the decision contravenes the care being given or not (Peate & Wild, 2017). Patients are perceived to autonomous when they can make sound informed decision. However, Mr. J is not aware of himself. As a result, the care he receives aims at promoting his health. However, he is not part of the decisions being made, hence, the violation of his right to autonomy.
There is a way to promote all the family members in the decision-making process. The healthcare providers should incorporate the inputs from the family members in the planning of the care needs of Mr. J. The success of the involvement largely depends on the communication method utilized in the process. The family members should be informed early about the decisions that need to be made. The healthcare providers should stress the importance of the decisions on the prognosis of the patient’s condition. There is also the need to provide the family members with adequate information concerning the decisions that are being made. They should be provided with options of care they should choose from and guided on the selection process based on the benefits and risks associated with each alternative. The healthcare providers should also be accommodation of the perspectives of the family members for collaborative decision-making (Avery, 2016). Additional resources that might be needed include the visual presentation of the available options of care and reading materials on the same. These resources will assist the family members in making informed decisions on the care needs of the patient.

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There are legal issues that affect the ethical decision-making for the case. Firstly, there is the aspect of informed consent. It is required that the decision on whether to terminate or continue treatment be based on informed consent from the patient. However, informed consent can be obtained from the significant others of the patient under the recommendation or guidance of the physician. The other legal issue is the provision of terminating the patient’s life. The law has provisions that guide euthanasia (Grace, 2018). The laws must be considered when taking the taking Mr. J brother’s consideration on the need to allow him to die peacefully. The last legal issue is the one concerning the use of narcotics. Narcotics have an increased likelihood of causing dependence in patients. Mr. J is at a risk of developing narcotics dependence due to overuse of narcotic medications. Therefore, it raises the concerns on the legal provisions on the use of narcotics in healthcare.

There exist several moral responsibilities of the nurses caring for Mr. J. One of them is their commitment to the patient. They are involved in providing care that is associated with optimum outcomes to the patient. They ensure that care that minimizes pain and other forms of harm is provided to the patient. The other moral responsibility is protecting as well as advocating the rights of patient to safety, quality, and efficient care. they ensure that the best available interventions are utilized to promote care. They also ensure that privacy alongside confidentiality of the patient’s data is maintained. The nurses also promote respect for not only the patient and other healthcare providers but also his significant others too. They ensure that they are treated with equality irrespective of their backgrounds or medical conditions. The nurses also promote justice in the provision of care to the patient. They ensure that all the rights of the patient are safeguarded. This includes the patient’s right to safe, efficient, affordable, accessible, and appropriate care (Scott, 2017).
One of the ethical principles involved in the case stud is the principle of beneficence. The ethical principle of beneficence asserts that healthcare providers should do good to their patients. They should ensure that they do the right thing for their patients. This principle is evident in the administration of narcotic and non-narcotic medications to manage the pain of the patient. The healthcare providers are ensuring that the patient is free from pain, hence, his health and wellbeing. The second ethical principle that is evident is justice. This principle asserts that fairness should be considered in the provision of healthcare. The disease state or background of the patient should not inform the treatment decisions (Peate & Wild, 2017). The healthcare providers have provided all the care to Mr. J without considering his health status or prognosis of his condition.
One ethical issue that the case raises is when to consider euthanasia in patients with chronic conditions or poor response to treatment. It raises concerns on whether the significant others of the patient have the right to make decisions related to euthanasia or not. Through this issue, one questions the respect of patient autonomy in relation to ending life in chronic conditions.

References

Avery, G. (2016). Law and ethics in nursing and healthcare: An introduction. Los Angeles; London, UK: SAGE.

Grace, P. J. (2018). Nursing ethics and professional responsibility in advanced practice. Burlington, MA: Jones & Bartlett Learning.

Peate, I., & Wild, K. (2017). Nursing Practice: Knowledge and Care. Newark, NJ: John Wiley & Sons, Incorporated.

Scott, P. A. (2017). Key concepts and issues in nursing ethics. Cham, Switzerland: Springer.

In this assignment you will review a case that deals with client autonomy, moral reasoning, and ethical decision making. After reviewing the case, answer and submit the questions that follow.

Case:

Mr. J. a 56 year old man was in a serious automobile accident and suffered a major head injury and extreme trauma. He spent several weeks in the intensive care unit and then a month in the hospital. He is now in a rehabilitation facility and has minimal awareness of his surroundings. He is able to eat but with a feeding tube and appears to be in pain most of the time as evidenced by groaning and often times thrashing about in his bed.

The doctor has him on pain medication which is as needed. He has both narcotic and non-narcotic pain medication available and administered by the assessment and determination of the nursing staff. When he is on narcotics he sleeps most of the time and when he is on non-narcotics he is much more restless and often time restraints are necessary to be sure he does not pull out his feeding tube.

His wife is a constant visitor and believes ”he will wake up”. She does not like when he is overmedicated for pain. In fact, she has complained several times to administration that she feels the staff are overmedicating him so that he is not ”such a bother”. Mr. J.’s brother also visits often and does not feel he will ever recover. He feels that his brother should just ”die in peace”. The children do not come often and when they do they try to comfort and support their mother.

Questions:

Is Mr. J.’s autonomy being respected? Explain.
Given so many different perspectives on Mr. J.’s care, is there a way to involve all of the
family members in the decision making? What other resources might be needed?
Are there any legal issues that impact the ethical decision making for this case?
What are the nurses’ moral responsibilities in the care of Mr. J.?
List two the ethical theories/principles involved in this case and your rationale for
selection?
Are there other ethical or legal issues that this case raises? If so, explain.