NCM 119 ETHICAL CASE ANALYSIS

On the given cases , write your ethical and moral OPINIONS . EXPLAIN your answers on the ff cases

CASE 1 The Case of Joe

"Joe" is a 62 year old building contractor who has been in an ICU for the past 10 weeks. Per chart notes,
he is not improving sufficiently to warrant hope for recovery. The best that can be hoped for now, says
his critical care physician, is discharge to a long-term acute care hospital (L-TACH). The prognosis does
not include any likelihood of return to baseline, or to home. The situation is dire, and Joe seems to "get
it". On the Saturday of Joe's tenth week in ICU, he mouths a message to his nurse, and then to the
physician who is summoned, and then to an ethics consultant also. "Stop everything. Give me
something. I want to die." What will do as the nurse on duty?

Case 2 - Opposition to Organ Donation

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 in a vegetative stat. Would you discuss ORGAN DONATION to the relatives?

Case 3 - DO NOT RESUSCITATE( DNR )for an Adult with Down Syndrome

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. Do you think DNR will be the BEST OPTION in this case as the nurse on duty?
CASE #4

Questions:

1. Should Ms. Moore, in asking for consultation, press for treating Mrs. Lyons only if she believes
Mrs. Lyons was making an adequately autonomous choice when she appeared to reverse her
choice? Or should she press for treatment regardless of her assessment of Mrs. Lyons’s mental
status because she believes the welfare of the recently born twins is in jeopardy?
2. If you were Ms. Moore, would you notify the physician that Mrs. Lyons had changed her wishes?
Why or why not?