PHI-FPX3200 Assessment 5 Tonya Archer Case Study
Case Study: Tonya Archer
Tonya is admitted to the hospital:
Tonya Archer is a fifteen year-old who has been admitted to Saint Anthony Medical Center for surgery to repair an ACL injury she suffered while playing softball. Tonya and her family have met with her surgeon and understand that while all surgery carries risks, this is a straightforward procedure that he has performed many times with no complications.
The surgery goes as expected, but as Tonya is being transferred from the recovery room to her hospital room, she goes into cardiac arrest. While Tonya received immediate medical attention, it took over seven minutes to restore cardiac function and the loss of blood circulation resulted in brain damage. During the attempt to resuscitate Tonya, she was intubated and placed on a ventilator. The medical staff has determined, though, that the loss of circulation caused brain death.
Doctors recommend ending life support:
Tonya’s doctors explain to her family that the damage Tonya sustained is irreversible and that she suffered whole brain death, which means that there is no neurological function, even at the most basic functions such as respiration or cardiac function. They tell the family that the next step is to take Tonya off the ventilator. Tonya’s parents’ reaction is of steadfast refusal. They tell the doctor that they understand that Tonya has had a serious accident, but they point out that her body is warm, her heart is beating, and that she therefore is not dead.
Hospital administrator and medical ethicist:
The doctors, hospital administrator, and the hospital’s medical ethicist tell the family that while the ventilator and other interventions can sustain the body’s functions, the damage done by the cardiac arrest will get worse and there is near certain expectation that Tonya will not recover any brain function. The family is told that there is no reasonable hope of benefit to Tonya by continuing the ventilator and other treatment.
Complete the Case Study: Tonya Archer media activity, which is linked later in this assessment.
Before you begin creating your submission for this assessment, make sure you have worked through the Tonya Archer case study. This will provide the foundational context for the assessment, for which you will be carrying out independent research by using the Internet to complete the following:
- Identify the professional code of ethics for your professional specialty or a specialty that you are interested in.
- With a local hospital in mind (perhaps one you work for), locate the mission, vision, and values statement of that hospital.
After you identify the professional ethics code and the hospital mission, vision, and values statements relevant to your work and interests, it may be useful to complete the following:
- Identify which item in the ethical code you believe is the most important and explain why.
- Name something in the code you would like to see addressed in more depth.
- Which item in the code do you think would be the most challenging to follow and why?
- Does your code make an explicit distinction between what is legal and what is ethical? That is, is the code clear that, while an action may be legal, it may not be ethical?
- Finally, how well does your professional code of ethics align with the mission and values statement of your hospital? Can you imagine a situation in which following one would make it challenging to follow the other?
For this assessment you will apply some concepts we have learned in the course, particularly those relating to the basic principles of health care ethics, professional codes of ethics, and values of health care institutions.
Write a paper that answers the following questions as it relates to the Tonya Archer
- What are the most relevant end-of-life issues in health care ethics as they relate to this case?
- What should the hospital do? Should doctors simply keep Tonya on life support, as the parents want? Or, since all medical evidence indicates that Tonya’s brain damage is permanent, should life support be removed?
Support your answer with the following considerations in mind:
- Explain which principles of health care ethics and which moral theory are the best philosophical foundations for your view.
- Is your view supported by your professional code of ethics? If so, explain how. If not, explain what your code gets wrong about a case like this.
- Is your view consistent with the mission statement and values of the hospital you identified in your independent research you conducted to prepare to complete this assessment?
- Would an accrediting body, like the Joint Commission, support your choice? Why or why not?
Your paper should meet the following requirements:
- Written communication: Written communication is free of errors that detract from the overall message.
- APA formatting: Resources and citations are formatted according to current APA style and formatting guidelines.
- Length: 2–3 typed, double-spaced pages.
- Font and font size: Times New Roman, 12 points.
Sample Student Approach — Incomplete
The most relevant health care ethics are Provision 1, of American Nurses Association indicating the nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. Provision 2 of American Nurses Association indicates that the nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.
The engagement of the medical decisions as well as the end-of-life issues consist of some psychosocial complications in the health care and the ramifications plus the penalty with a significant effect on pain plus on the quality of living plus dying are some of the concerns that should be addressed (Brännström et al.,2019).
These ethical issues are very relevant, more so to the end of life issues. The ventilator and intubation are a process of life support that tends to increase or prolong someone’s life. In this case, after the surgery, some of the complications include cardiac arrest and the loss of blood circulations in the body (Blank, 2019). This assessment is going to focus on some of the ethical issues in the health care sector as related to the case. This health-related end of life issues are very crucial especially if the medical caregiver wants to make some decisive decisions concerning a case of the patients bearing in mind some of the outcomes or results that might come afterward.
Provision 1, of American Nurses Association indicates the nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. With the reference provided above, directives of the family or parents play a very integral role since they are also acknowledged to be representing the desires or the wishes of the patient, thus important for the healthcare providers to follow and comply with them (Blank, 2019).
For instance, in the case of Tonya, the doctors and the nurses have carried out the assessment and conclude that the condition or the damage that has been caused after the routine surgery has damaged the brain forever and there is no chance of her getting back or regaining her consciousness.
As a result of this condition, the doctors feel that they should remove Tonya from the life support machine, a decision that is highly refuted by her parents since they can still feel that her heart is beating. With the immovable decision that their child must remain on the life support machine tends to outline some ethical related issues in the Medicare field. This decision violates provision 1 as per the American Nurses Association.
The Quality Of Life Of The Patient
Provision 2 of American Nurses Association indicates that the nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population. Life quality of a person is very paramount in all aspects and it is illustrated as the degrees of satisfaction of the life value of a person as a complete. In medical facilities or the health care areas, the health care providers must always attempt any means possible and strive to give a quality life to the patient as dictated by this principle of quality life for all.
This ethical principle of beneficence is very important as every health care provider should abide and comply with it. This ethical principle states that the right to do good plus the right to do good things for the patients. This means however much the condition of the patient is, the health care providers must be able to ensure the patients get an excellent form of the car (Close et al., 2019).
For example in the case of Tonya, the medical practitioners should have by any means abide by the ethical principles of the quality of life even though they had known that Tonya’s brain was permanently damaged and could not regain her consciousness again. They should not have arrived on the decision to take her off the life support devices. Since the first commitment for nurse’s practices for the patients this illustrates that the nurses shall have been violating the professional code.
The Mission of Saint Anthony College of Nursing, a private Catholic college, is to provide quality nursing and health care education in an environment that encourages open inquiry and lifelong learning, and to serve all persons with the greatest care and love. In this case of Tonya the doctors had failed to show love and care to the patient to the level of willing to remove the life support off.
The vision of Saint Anthony College of Nursing, a private Catholic college, is to be leaders in Nursing and Health Care Education, Practice, and Service through the vision of this facility it has not been evidently how they will be leaders yet they have not following their vision since they depict some insufficient moral ethics by conducting some surgery causing brain damage.The hospital should still keep Tonya under life support since the hospitals are usually accredited by the accreditation body like Joint commission to provide quality health care services to all individuals.
The ethical principle, in this case, should be observations of the quality of life and the beneficence as the health caregivers must ensure they provide the best quality of care to the patient. This quality of life should embrace and improve the comprehensive mechanisms in ensuring the patient gets good care to improve their conditions and should not leave the patient to die or suffer from the pain (Close et al., 2019). The moral-ethical issues, in this case, are that the doctors are arriving at the decision of taking Tonya out of life support; this means that they want to see Tonya dying. It is very immoral and unacceptable by the code of conduct of a medical care professional to enhance a process of end of life without any ethical issues considerations from either the parents or the patient’s autonomy.
- Blank, R. H. (2019). End-of-Life Decision Making for Alzheimer’s Disease Across Cultures. In Social & Public Policy of Alzheimer’s Disease in the United States (pp. 121-136). Palgrave Pivot, Singapore.
- Brännström, M., Fischer Grönlund, C., Zingmark, K., & Söderberg, A. (2019). Meeting in a ‘free-zone’: Clinical ethical support in integrated heart-failure and palliative care. European Journal of Cardiovascular Nursing, 1474515119851621.
- Close, E., White, B. P., Willmott, L., Gallois, C., Parker, M., Graves, N., & Winch, S. (2019). Doctors’ perceptions of how resource limitations relate to futility in end of-life decision making: a qualitative analysis. Journal of medical ethics, medethics-2018