Ethical Aspects of Resuscitation in Nursing.

Ethical Aspects of Resuscitation in Nursing.

Principles of bioethics can be valuable in assessing and debating ethical dilemmas. In many cases where curative care is not possible or is not desired, the goal of medical care at the end of life is to provide comfort to the patient and family, rather than initiating technological interventions that are unlikely to benefit the patient.Ethical Aspects of Resuscitation in Nursing.

Challenging issues confront emergency physicians routinely when performing cardiopulmonary resuscitation (CPR). Principles of bioethics can be valuable in assessing and debating ethical dilemmas. Some of the important issues and dilemmas commonly encountered in emergency medicine are discussed. In many cases where curative care is not possible or is not desired, the goal of medical care at the end of life is to provide comfort to the patient and family, rather than initiating technological interventions that are unlikely to benefit the patient.Ethical Aspects of Resuscitation in Nursing.

PRINCIPLES OF MEDICAL ETHICS

Ethics has been defined as the way of understanding and examining the moral life, and as a theory or a system of moral values. Codes of medical ethics have been established by organisations or individuals as standards of moral and ethical medical care. The Hippocratic Oath is considered one of the oldest codes of medical ethics. In recent years, the American Medical Association (AMA) Code of Ethics (earliest version from 1847), The American College of Emergency Physicians (ACEP) Code of Ethics (1997), and The Society for Academic Emergency Medicine Code of Conduct (1999) have been established to provide guidance to physicians in application of ethical principles to clinical practice. Most ethical codes address common elements, such as beneficence (doing good), non-maleficence (doing no harm), respect for patient autonomy, confidentiality, honesty, distributive justice, and respect for the law. Ethical dilemmas often arise in clinical practice when there is a real or perceived conflict between two ethical principles or values. Ethical dilemmas are resolved by several approaches, which may include elements such as physician judgment, additional information gathering, meetings with health care professionals, patients, and families, and consultants, such as ethics, risk management, or social work consultants. Although the involvement of the institutional ethics committee or the judicial system is helpful in many clinical settings, decisions at the end of life often do not permit the time necessary for such consultations.Ethical Aspects of Resuscitation in Nursing.

RESUSCITATION

At the end of life, attempts at CPR are commonly performed. In many cases, this is appropriate and has a reasonable likelihood of improving outcome. However, in many other cases where the patient is near the end of life, resuscitation attempts are unlikely to benefit the patient, and may not be in accordance with the values and treatment goals of the patient and family. Understanding the literature regarding resuscitation, outcomes, factors relating to outcomes, and alternatives, are essential to medical decision making regarding resuscitation.Ethical Aspects of Resuscitation in Nursing.

There are numerous ethical issues related to resuscitation. Decisions must be made rapidly, and decisions are often based on information available to the emergency physician, which may be incomplete or erroneous. When making decisions in the resuscitation arena, many factors must be considered, including potential benefits of resuscitation (restoring life to the patient, a sense of closure and resolution of guilt for the survivors) and potential risks (financial and resource investments, resuscitation to a suboptimal quality of life, etc).Ethical Aspects of Resuscitation in Nursing.

Making decisions about end of life in acute care is intricate, involving hard decisions, such as whether to initiate cardiopulmonary resuscitation (CPR) or whether to discontinue or initiate life support in the event of a cardiac arrest.  Do not resuscitate decisions are commonly made in healthcare but they can be a source of legal challenge and ethical concern. The paper analyzes do not resuscitate as an ethical issue related to the end of life issues.Ethical Aspects of Resuscitation in Nursing.

A description of a specific scenario

Mrs. is a 35- year- old woman with multiple myeloma who started to experience acute pain in her lower abdomen. At noon, Mr. M’s husband took her to the ED for diagnosis and treatment. Mrs. M was diagnosed with acute appendicitis.  Mrs. M. stated that CPR should not be initiated in case he suffers a respiratory or cardiac arrest.  When Mrs. M’s chart was brought to the ED, i