Patient, Who is Dying of Leukemia - Essay Example

The case study is about a patient, who is dying of Leukemia, and he is receiving chemotherapy. A nurse, who is involved in his care, learns that the patient has not yet received information concerning alternative therapies, and she decides to share the information with the patient. The patient decides to leave the hospital after consultation with his family, in order to make arrangement of trying the alternative therapies. After the patient, inform the oncologist about his decision and the source of information. The oncologist considers the act as unprofessional and he asks for nursing license belonging to Nurse L to be revoked, but the nurse argues that the patient has the right to acquire information about the alternative therapies, since failing to informing him is a violation of informed consent to the chemotherapy. 1. Was Nurse L acting in morally correct way when she gave Michael G the information? This case relates to the ethics, which refers to application of values and moral rules to human activities. In order to determine whether the nurse was acting morally, there is a need to focus on the subsection of ethics, which are a part of applied ethics and the use of ethical principles in making a decision. In this case, ethics can be applied in seeking reasoned, consistent and defensible solutions to moral issues; thus, the Clinical bioethical reasoning is the primary base of the case. Moreover, the clinical practice depends of the general rules and case-based experiences, bioethical reasoning that relies on learned and accepted moral rules. Therefore, bioethical decisions are derived from manifestation and recognition of factors in a certain situation, which differentiates the cases (DeGrazia, Mappes, Brand- Ballard, 1). In the case, nurse L decided to share the information with the patient concerning the alternative therapies, but this was against the bioethical rules in the hospital. Therefore, nurse L was not morally correct because she fail to apply the Clinical bioethical reasoning by focusing on the rules as she made the decision of disclosing to the patient about alternative therapies. In this situation, nurse L was not obligated to make patient-centered, value-driven ethical decision; instead, she should have focused on the bioethical reasoning in relation to the morally accepted rules in the hospital. 2. Should the physician in charge have the final word about the information a patient receives? There are laws stems from legislative statues, administrative agency rules and court decisions, which varies in various ways and they are enforced by different jurisdiction. Therefore, the decisions made by the physician in charge may be considered final in some situations while in others ethics is incorporated through the values and beliefs of appropriate conduct. Nevertheless, the bioethical principles are not altered due to geography, interpretation of principles and evolution that occur because of change in the societies. Evolutions occur within the law, and ethics are used to make moral law, but this moral law does not necessarily make reasonable ethics. Therefore, by giving the physician the responsibility of giving the final word, laws and ethical principles are incorporate in the decisions making process. There are substantial overlaps relating to the legal and ethical decision-making, whereby the ethical analysis in bioethics committee deliberation is vital to the case based reasoning in relation to the physician decisions. Therefore, the responsibility of the physician in relation to determining information to be received by a patient requires incorporating the societal values and forming a basis for developing policy within the health care. The bioethics differs in some areas in relation to the decisions made by the physician in relation to information conveyed to the patients. For example, areas in which the law operates under adversarial process rule, whereby there is no room allowed for deviation. Bioethics consultations are adjustable to comply with situations in institutions, instead of being adversarial. Bioethics principles are designed for weighing situations on their merits, though the major difference between bioethics and law depends substantially on patients’ ideals. Therefore, for a physician to make a decision related to information received by the patient, intervention of bioethicists and medical personnel in order to make an ethically sound decision is necessary. 3. If Michael G did not know about the alternative therapies was his agreement to the chemotherapy informed consent. Informed consent refers to a process of fully informed patient that participate in choices about the health care decisions. In this case, the ethical duty of the physician relates to the health care, thus for the patient’s consent to be considered, there is a need to make a competent decision, though his consent is vulnerable. On the other hand, in order to encourage the voluntariness, physicians ensure that they have clarified to patients about participation in the decision-making process, thus the informed consent process is perceived as an invitation to participation in the health care decisions. Agreement of Michael G to chemotherapy without the knowledge of the alternative therapies can be considered an informed consent, since the physician had provided the necessary recommendations and shared the reasoning process with the patients. In this case, comprehension of the patient’s part can be considered significant as the information provided to them. In this case, if the discussion about the chemotherapy was held in layperson’s terms, the patients understanding should be assessed in the course of treatment. Consent relates to the making patients to understand things that physician is asking them and seeking to know if they are satisfied. For instance, the patient should make the decision of undertaking chemotherapy on merits. There are standards that allow the physician to decide about information, which is suitable to reveal to patients. Nevertheless, some situations the recommendations by the physicians are not enough since they tell them remarkably little; thus, the standards are considered inconsistent with the goals of informed consent. Therefore, focus on the physicians’ decisions is not necessary, instead of things that patients need to know are significant to in health care. Patients need to know things concerning their health and participate in decisions, in fact, there are standards are considered, as the things that patients need to know for understanding the decisions at hand, as reasonable patents standards. On the other hand, there are subjective standards that patients need to understand in order to make an informed decision. Nevertheless, these standards are challenging and they are incorporated into practice in the requirement of customizing the information delivered to each patient. States have legislation, and legal cases, which focus on determining the required standards, informed consent, for instance the Washington uses "reasonable patient standards" as legislation (Edwards, 1). Nevertheless, the approach focusing on questions related to the sufficiency of information requires a focus on professional obligation for providing the best care and respect to patients. There are policies related to health care interventions, which require a signed consent form by a patient to ensure that the right of the patient to participate in the health care decision is observed. For instance, if the patient had signed a form that result to a dialogue that facilitates the patient’s informed participation in clinical decisions related to undertaking chemotherapy then, his agreement to chemotherapy involved an informed consent. In conclusion, the paper has explored issues related to ethics, whereby a situation involving the rights of a patient to receive information about their health is discussed in order to answer relevant questions. The paper seeks to establish whether the nurse was morally right, if the physician has the final word about the information received by the patient and if agreement of the patient to undertake chemotherapy involved informed consent. Woks Cited DeGrazia, David, Mappes Thomas, Brand- Ballard, Jeffrey. Biomedical Ethics. New York NY: McGraw-Hill. 2010 Edwards Kelly. "Informed Consent". Ethics in Medicine: University of Washington School of Medicine. Available at: http://depts.washington.edu/bioethx/topics/consent.html [Accessed on 21 October 2012]   Read More