a.      Discuss why you think the decision reached was ethically and morally sound or why you disagree with the decision. b.      What 2015 American Nurses Association (ANA) Code of Ethics principles should a nurse in a similar situation evaluate for guidance? c.      Would the case you picked be decided differently today, why or why not? e.      Who speaks for the incapacitated patient in the absence of an advance directive in Florida? (Hint: the answer is in the Advance Directives statute, Part IV)

a. In order to assess the ethical and moral soundness of a decision, it is important to consider various ethical principles and perspectives. In the given case, where a nurse made a decision, one possible ethical framework that can be applied is deontology. Deontologists argue that moral decisions should be based on duty and adherence to moral rules and principles. Therefore, if the nurse’s decision aligns with the ethical principles of the profession, it can be considered ethically and morally sound.

b. The 2015 American Nurses Association (ANA) Code of Ethics provides guidance for nurses in various situations, including those similar to the case mentioned. In this specific case, a nurse should evaluate the following principles from the ANA Code of Ethics:

1. Provision 2: The nurse’s primary commitment is to the patient. This provision highlights the importance of prioritizing the welfare and well-being of the patient. The nurse should evaluate whether their decision is aligned with this principle and serves the best interests of the patient.

2. Provision 3: The nurse promotes, advocates for, and protects the rights, health, and safety of the patient. This provision emphasizes the responsibility of the nurse in protecting and advocating for the rights of the patient. The nurse should consider whether their decision reflects advocacy and protection of the patient’s rights.

3. Provision 4: The nurse has authority, accountability, and responsibility for nursing practice. This provision defines the nurse’s professional authority, accountability, and responsibility. The nurse should evaluate whether their decision aligns with their professional authority and responsibilities.

4. Provision 5: The nurse owes the same duties to self as to others, including the responsibility to promote health and safety. This provision highlights the importance of self-care and responsibility. The nurse should consider if their decision reflects a balance between promoting the health and safety of the patient and themselves.

c. It is difficult to predict with certainty whether the chosen case would be decided differently today. However, it is likely that advancements in medical ethics, legal frameworks, and societal attitudes have influenced the way similar situations are approached. Today, there is a greater emphasis on patient autonomy and shared decision-making. Therefore, it is possible that a case like this would be approached with a stronger focus on respecting the patient’s autonomy and involving them in the decision-making process.

Additionally, legal developments and changes in healthcare policies may have also impacted the outcome of such cases. It is important to consider the evolving nature of medical ethics and legal frameworks when assessing whether a case like this would have a different outcome today.

e. In the absence of an advance directive in Florida, the person who speaks for the incapacitated patient is determined by the Advance Directives statute, Part IV. According to Florida law, the patient’s proxy is determined through a hierarchical order of family members or close relatives. The order of priority is as follows:

1. A court-appointed guardian who has the authority to make healthcare decisions.
2. The patient’s spouse, unless legally separated.
3. An adult child.
4. A parent.
5. An adult sibling.
6. An adult relative who has exhibited special care and concern for the patient and is involved in their healthcare decisions.

It is important to note that the surrogate decision-maker must make decisions based on the patient’s best interests and preferences. The hierarchical order of the surrogate decision-maker is determined by state law and may vary in different jurisdictions.