1. A woman who has a history of chronic back pain and has been using opioids...

1. A woman who has a history of chronic back pain and has been using opioids for over 10 years, has been admitted with a stroke. Unable to understand what is said to her (receptive aphasia) or reply (expressive aphasia), the woman can not tell the nurse if or when she is having pain. The patient can use her non-dominant hand. The doctor orders a PCA (patient-controlled-analgesic) pump. The family keeps pushing the button to dispense pain medication. Is this an ethical dilemma? Explain your answer.

2. The 78-year-old patient has bone cancer with metastasis to the liver. The patient does not want extra-ordinary measures implemented in the event of cardiac or respiratory arrest. He wants to be a DNR. The family says he is depressed and he should be a full code. Is this an ethical dilemma? Explain your answer.

3. A patient who is a poor historian, fails to tell the staff he is allergic to iodine. When the patient has a CT scan with contrast, the patient goes into antiphallic shock. Before the patient can be intubated, the patient dies. Is this an ethical dilemma? Explain your answer.

Expert Solution

1.yes,its an ethical dilemma because there might not be same reason every time patient uses non dominant hand, there might be other reasons other than pain, which patient wants others to figure out ...every time giving pain medication is not good. But at the same time its very difficult for family members or nurse to figure out the exact problem of patient, or what the patient is going through.

2.yes...Patient knows that he is a terminal patient, he has lost hope, as he old and suffering with this deadly disease..and so wants a natural death which is reasonable as he has already suffered a lot..but at the same time its very difficult for Doctor to give up on his patient and stop trying and give a DNR..(do not resuscitate)that is no code..

3.No's its not an ethical dilemma because poor historian patient can be an old age person or patient with limited English proficiency (LEP),or a drug addict patient so extra care should be given to such patient. So all details give by patient should not be expected..Medical caregivers should have taken extra care.

Nightingale answered 1 year ago

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