Discussion: Ethical Dilemma in healthcare examples and solutions

Discussion: Ethical Dilemma in healthcare examples and solutions

Discussion: Ethical Dilemma in healthcare examples and solutions

            The case study assigned presents a 57-year-old male patient with a primary diagnosis of motor neuron disease for the past 2 years. He is currently experiencing a rapid decline in his condition and would prefer to be admitted to the inpatient unit against his wife’s wish for home care. Before helping the patient make an informed decision, it is necessary to conduct a further assessment for a better understanding of the progress of the disease. The purpose of this discussion is to illustrate additional information needed to confirm the patient’s diagnosis and ethical concerns that may arise from end-of-life care.

ORDER A PLAGIARISM-FREE PAPER HERE ON; Discussion: Ethical Dilemma in healthcare examples and solutions

The patient will need to provide information about his symptoms of weakness, unsteadiness, difficulties with swallowing and speech, stiffness, muscle spasms, abnormal reflexes, hyperreflexia, twitching muscles, foot drop, breathing difficulties, muscle atrophy or depressed reflexes (Foster & Salajegheh, 2019). The patient’s diagnosis will be based on signs of degradation of lower motor neurons following neuropathologic or electrophysiological examination, signs of degradation of upper motor neurons following clinical examination, and progressive spread of signs and symptoms within either of the two regions evident by neuroimaging or electrophysiology (Ngo et al., 2020). Additional lab works that will be ordered to confirm the diagnosis and rule out the differentials include blood tests for biomarkers of diseases that mimic motor neuron disease and genetic testing. Imaging studies such as CT scans and MRIs of the spinal cord and the brain may also be ordered based on the patient’s clinical presentations.

            Motor neuron disease has no cure. However, several treatment options are available to reduce the significance of the symptoms in the patient’s quality of life. Lifelong interventions for the patients will include Riluzole as the only medication therapy (Arora & Khan, 2021). The patient will also require respiratory care, and antioxidant therapy. Supportive interventions will be based on presenting symptoms, with adequate nutrition and feeding. An interdisciplinary team will be needed to help reduce the length and frequency of inpatient stays and improve the patient’s quality of life. However, during the terminal stages of the disease, end-of-life care will be preferred. The patient in the provided case study considered being admitted to the inpatient unit for end-of-life care, which would have been beneficial in promoting his quality of life and well-being for the remaining part of his life. However, his wife was against the decision, wanting the patient to spend the remaining time at home.

            The patient being an adult gives him a legal right of making independent decisions concerning his health. The patient has a right to self-determination which require informed consent for all medical treatment and interventions (De Panfilis et al., 2019). Consequently, the healthcare provider must respect the patient’s autonomy, and observe ethical principles such as nonmaleficence and beneficence with the use of their clinical judgment to help the patient make an informed decision concerning his health.

Conclusion

Most of the medical treatment and intervention at end-of-life care for patients with motor neuron disease requires an interdisciplinary team of medical professionals which can only be accessed in a hospital setting. As such, the patient’s admission to the inpatient unit will help reduce the progress of the disease and improve his quality of life. However, it might be very costly, and the patient might fail to spend most of his time with his family, which might have made his wife consider home care. However, the final decision will be made by the patient, which is being admitted to the inpatient unit for end-of-life care.

References

Arora, R. D., & Khan, Y. S. (2021). Motor Neuron Disease. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560774/

De Panfilis, L., Di Leo, S., Peruselli, C., Ghirotto, L., & Tanzi, S. (2019). “I go into crisis when …”: ethics of care and moral dilemmas in palliative care. BMC Palliative Care, 18(1). https://doi.org/10.1186/s12904-019-0453-2

Foster, L. A., & Salajegheh, M. K. (2019). Motor Neuron Disease: Pathophysiology, Diagnosis, and Management. The American Journal of Medicine, 132(1), 32–37. https://doi.org/10.1016/j.amjmed.2018.07.012

Ngo, S. T., Restuadi, R., McCrae, A. F., Van Eijk, R. P., Garton, F., Henderson, R. D., Wray, N. R., McCombe, P. A., & Steyn, F. J. (2020). Progression and survival of patients with motor neuron disease relative to their fecal microbiota. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 21(7-8), 549–562. https://doi.org/10.1080/21678421.2020.1772825

BUY A CUSTOM PAPER HERE ON; Discussion: Ethical Dilemma in healthcare examples and solutions

This paper you will think of situations about Ethical Concerns where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?
CASE STUDY B
A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is
experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient
unit at a hospice to receive end-of-life care, but his wife wants him to remain at home.

Select one scenario from above, and reflect on the material presented throughout this course.
What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?
Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.

The Lab Assignment
Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number).
Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.