Almeda’s nurses and attending physicians want her long-time friend Barney to help them determine the direction her treatment should take now that she needs dialysis. She’s already on a ventilator, a feeding tube, and receiving high doses of antibiotics. She would be better, Barney thinks, if she could watch TV a little. If that is […]
Grace is a retired teacher who is suffering from Alzheimer dementia, who lives in a nursing home. She has not been feeling well lately. Her brother gives consent for her to be transferred to a hospital to discover what is going on, but after they have run a lot of tests, he asks, “Why are […]
George is a 23-year-old man who has Down’s syndrome. He is in an accident in which he sustains a severe brain injury is and shows no signs of consciousness. In order to withdraw life-sustaining treatment, his parents must present convincing evidence. George did not state his wishes in an advance directive. What part, if any, […]
JD is a 25-year-old patient who sustained massive head trauma and neurological injury in a motorcycle accident. He is not brain dead, but after 4 weeks in MICU and several neuro consults, the prognosis for “meaningful recovery” is said to be less than 1%. JD has not regained consciousness and is apt to remain permanently […]
Omer was a 94-year-old widower who had lived independently for many years. He had always been eager to get health problems fixed, including the most recent issue, which required colon surgery. When Omer doesn’t recover well, issues arise as the physicians do not speak directly with Omer’s children. What part does this patient play in […]
Mary Jo is diagnosed with bladder cancer but does not wish to have surgery. After refusing surgery twice, her doctor tells her that he cannot be her doctor any longer. What dilemmas occur when a patient does not heed the advice of a doctor? What obligations do the patient and doctor have in maintaining the […]
A nurse experiences moral distress with being told to continue monitoring a 100-year-old patient’s blood work as long as she remains on blood thinners. What is the nurse’s responsibility if he fears the patient will bleed to death if he continues to stick her? Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) […]
Freda is a 32-year-old lady living in a long-term care facility who is chronically ill with multiple sclerosis. She voices desires to die peacefully and not to have a feeding tube placed. She is taken by her mother to a neurologist and when she returns, she has a feeding tube. What is the nurse’s responsibility […]
Baby K is an infant female born with anencephaly. Permanently unconscious, she has only brain stem function. During the initial hospital stay, hospital personnel “urged” the mother to permit a DNR order, but she insisted on the use of the ventilator. When a therapy is “futile” how much power should the mother have to demand […]
After an emergency c-section, Baby Girl X undergoes many surgeries to remove parts of her colon. When she subsequently gets sepsis and shock again, the parents are faced with the decision to continue aggressive treatment, leaving her to only receive nutrition by IV and possibly not live past about a decade, or to allow her […]
Camille M. Renella, RN, CME, LNC
Clinical Medical Ethicist/Legal Nurse Consultant
Institute of Medicine Chicago (IOMC) Fellow
Executive Director