I have take a side in an ethical dilemma I have/or might experience working in the nursing field. If a nonverbal 98 year old cancer patient on a feeding tube is a full code because he is his daughter’s only family, I think the ethics committee should be involved. If he codes, I do not think it is fair to torture his body with CPR if treatments are futile. Due date is Saturday, December 8. Requirements 5-7 pages long. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552960/
Title: Ethical Dilemma in Nursing: Involvement of the Ethics Committee in Full Code Cases for Nonverbal Cancer Patients
Introduction:
Ethical dilemmas frequently arise in the nursing profession, requiring healthcare professionals to navigate complex choices that impact the well-being and quality of life of their patients. One such dilemma concerns the management of nonverbal, terminally ill patients who are on life-sustaining treatments such as a feeding tube. When these patients are classified as “full code,” meaning that cardiopulmonary resuscitation (CPR) will be administered in the event of cardiac arrest, the question of whether continuing futile treatments becomes a subject of ethical debate. In this context, this paper argues that involving an ethics committee can help healthcare providers assess the appropriateness of using CPR and ultimately make the best decision for the patient’s well-being.
Ethics Committees:
An ethics committee is an interdisciplinary team of healthcare professionals who provide guidance and recommendations for ethical dilemmas. They play a crucial role in ensuring ethical decision-making within healthcare institutions. These committees typically consist of physicians, nurses, social workers, lawyers, ethicists, and other stakeholders, each contributing their expertise toward reaching ethically sound conclusions.
The Role of the Ethics Committee in Full Code Cases:
The involvement of an ethics committee in full code cases for nonverbal cancer patients is necessary due to the complexity of such situations. While the patient’s nonverbal state and desire for receiving CPR due to familial relationships may appear straightforward, there are crucial factors to consider, including the patient’s prognosis, potential benefits and risks of CPR, and the burden it could impose upon the patient’s physical and emotional well-being.
Prognosis and Futility of Treatments:
One of the primary considerations in assessing the appropriateness of CPR is the patient’s prognosis. Nonverbal 98-year-old cancer patients with feeding tubes typically have significant medical comorbidities, and their life expectancy may be limited. Without a reasonable likelihood of meaningful recovery, the administration of CPR may be futile and even distressing to the patient.
Futility of treatments refers to interventions that are unlikely to achieve the desired outcome. In cases where CPR is administered despite the futility of treatment, it may prolong the dying process, increase suffering, and provide no significant benefits. Involving an ethics committee allows for a comprehensive evaluation of the patient’s medical condition, prognosis, and the potential benefits and burdens associated with CPR, providing a more objective decision-making process.
Patient’s Quality of Life:
It is essential to evaluate the impact of CPR on the patient’s quality of life. For nonverbal patients who are already suffering from the effects of cancer and advanced age, CPR can cause additional trauma, pain, and distress. It is important to consider the patient’s overall well-being and to prioritize their comfort and dignity. In cases where CPR is deemed futile and the potential negative impact on the patient’s quality of life outweighs the potential benefits, an ethics committee can provide an unbiased assessment, considering medical evidence, ethical principles, and the patient’s best interests.
Family Dynamics and Emotional Considerations:
Another factor to weigh when contemplating the involvement of an ethics committee in full code cases is the emotional impact on the patient’s family. In the given scenario, the patient’s daughter desires that all measures be taken, reflecting her emotional attachment and the family’s values. However, it is essential to recognize that families may not always possess the medical knowledge or experience to fully understand the implications of CPR for their loved one. By involving an ethics committee, healthcare providers can engage in open and transparent conversations with the family, offering a supportive environment in which to discuss the medical evidence, prognosis, and the patient’s best interests.
Conclusion:
Ethical dilemmas in nursing, such as deciding whether to administer CPR to nonverbal cancer patients on feeding tubes, necessitate careful assessment and consideration of various factors. The involvement of ethics committees can provide a structured approach to decision-making, considering the patient’s prognosis, the futility of treatments, the impact on the patient’s quality of life, and the emotions and dynamics within the family. By engaging in ethical dialogue, healthcare providers can ensure patient-centered care that respects autonomy, promotes well-being, and upholds the highest ethical standards in the face of complex and emotionally challenging situations.