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Essay Question:

Read through the following case(100 Marks)

Scenario 1: Vicky

Vicky is an 70 year old Greek woman, who lives in her own home and has a daughter, Helena living nearby. She migrated from Greece with her family 20 years ago; she is non-English speaking and her daughter Helena, who is her next of kin acts as her translator. She is in good health for her age, however recently she has been diagnosed with Dementia. For the last two months she has had a persistent cough that is worse at night.

This week she became unwell with a fever, shortness of breath and is coughing up brown mucous with some blood. Helena takes her to visit the doctor who finds her to be hypotensive, tachycardic and pale. Her breathing worsens at the clinic so an ambulance is called and she is transferred to hospital, where she has immediate access to treatment. Vicky is made comfortable in the emergency department. Oxygen is applied, blood tests are taken and a chest x-ray is ordered. The nurse looking after her rings Helena to inform her of the situation and Helena says that she will be in to visit later that night.

During the ward admission that evening, the enrolled nurse Ben asks Vicky how she feels about being in hospital. During this time Ben discovers that Vicky can’t speak English very well, so he organizes an interpreter. With the interpreter present, Vicky reveals that she is really happy at home, and has plenty more living to do. Later, Ben was running late and does not document this conversation. Instead, he decides that he could do it tomorrow.

Later that night, after Helena leaves, Vicky’s condition deteriorates and she begins to go in and out of consciousness. The results of the x-ray reveal that she has a tumour on her lung and the blood tests confirm that she has lung cancer that is causing her symptoms. The nurse calls Helena into hospital and tells her the doctor would like to talk to her. Helena arrives and the doctors explain that despite the lung cancer diagnosis, they believe that Vicky could benefit from treatment that might prolong her life. However, Helena disagrees and insists that her mother should not be told of the cancer diagnosis, nor should she receive active treatment; but to be allowed to die peacefully. She is concerned that her mother might suffer during treatment and would not choose active treatment if she had a choice.

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The next morning during handover, the nurses report the change in Vicky’s condition. She has regained consciousness but is now receiving morphine to help to settle her breathing. The nurses stated that the doctors expected her die in the next 24 hours and that her daughter as next of kin had instructed that she is not for resuscitation. They reported the daughter’s concerns that her mother might suffer during active cancer treatment and she would prefer her to die peacefully.

Ben realises that these are not Vicky’s wishes. He remembers that Vicky expressed a clear wish to receive treatment and live out her life. He also realises that he did not document or report Vicky’s wishes to receive treatment. Ben is unsure about whether or not Vicky is able to make decisions about her treatment as she has Dementia.

After handover, Ben calls in to see Vicky. She looks comfortable, sleeping and breathing peacefully. Ben thinks: perhaps Helena is right? The cancer health care could be very distressing for Vicky, and it might be better that she is allowed to die in peace because she already has dementia, and she may not even understand she has cancer.

He wonders what to do next. Is it too late to report the conversation and would he get in trouble for failing to document this information? This might change the management plan and give Vicky a chance to receive treatment for her cancer. Or should she stay quiet and let things remain as they are? This would respect Helena’s wish that her mother does not suffer any unnecessary distress. Read about Health Safety Hospitality.

Essay question:

 Identify the ethical problem or dilemma in the scenario.
 Identify and define the relevant ethical principles involved and explain why they are related to the scenario.
 Identify which ethical principles are in conflict and explain why.
 Identify any legal principles that should be considered.
 Discuss the options and possible outcomes that Ben should consider before making his decisions
 Ben has to act one way or the other. State the action that Ben should take and show how it can be ethically justified.

This assignment is worth 40% of the final mark for this unit. Total marks for this assignment is 100. A mark of 50/100 or more is required for a pass. You must pass this assignment to pass the unit. If you receive a mark of 30/100 or less, you may not be permitted to re-enrol in the subject next semester.

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