MEDICAL INDICATIONS
The principle of Nonmaleficence and Beneficence
The patient has severe chronic obstructive pulmonary disease and adult onset diabetes mellitus. However, the patient’s acute diagnosis is heart attack. This is a critical situation and need to have immediate decision to save her life. However, this is not a terminal situation.
The goal of treatment is to prolong the patient’s life.
Only if the patient signed an advance directive with DNR(Do Not Resuscitate), the medical treatments are not indicated.
The success rate of the surgery or procedure is relatively low due to patient’s age and comorbidities.
This patient’s life will prolong if the caregiver provided treatment for heart …show more content…
Barrish is not a legally surrogate to make the treatment decision in the file. He is one of patient’s son who is an emergency contact during her residency in the extended care facility.
The patient is willing and able to cooperate with medical treatment.
QUALITY OF LIFE
The Principle of Beneficence, Nonmaleficence, and Respect for Autonomy
The patient will not return to normal life without treatment. Also,she will die within days if no treatment or intervention is given. Since Jamilah has diabetes mellitus, her wounds may take longer time to heal. Her COPD also prolongs her recovering time.
The patient is 90 years old and with different chronic co-morbidities, one might judge that her quality of life would be undesirable after the surgery or procedure.
The biases may be the patient resided in an extended care facility for many years. She had an experience that she accidentally collapsed at her bedside. Her age is also one of the bias that might prejudice the provider’s evaluation of the patient’s quality of life.
The ethical issue of autonomy is that the patient has the right to determine she is living in a quality of …show more content…
The ethnic status of suicide conflicts with beneficence nonmaleficence and autonomy.
CONTEXTUAL FEATURES
The Principles of Justice and Fairness
The conflict of interest is created between the social worker and the cardiology physician. The social worker intends to follow the patient’s wish, whereas the cardiology physician decides no comfort care, according to Bashir’s decision and Jamilah’s multiple comorbidities.
The family members are the other parties who interest in the clinical decision. Bashir is one of the sons and the patient also has 2 other sons who may have different opinions on the clinical decision.
Since the patient’s critical situation, it is necessary to discuss the treatment decision to the immediate family. The is no limits imposed on patient confidentiality as the next of kin document from the extended care facility is provided.
Barhars is struggling financially that may create conflict of interest in clinical decision. Since the patient had been in the extended care facility for a long period of time, a financially burden may arise due to the long term care payment.
There is no indication of allocation of scarce health resources that affect clinical