1. Determine the stakeholders including two health care professionals in the case scenario;
2. Differentiate the ethical and legal conflicts and explain them from the following perspectives:
• The dignity and rights of all stakeholders in this case
• The principles and virtues of health care ethics that inform professional practice
• The relevant codes of ethics and/or codes of professional conduct
3. Propose a legally and ethically defensible resolution to these conflicts
Scenario: lsie Lee, 88 years old had recently moved to a Residential Aged Care Facility (RAC). She had difficulty mobilising due to severe rheumatoid arthritis as well as short-term memory and vision impairment. Elsie also had a history of AMI, removal of bilateral cataracts, and a (L) hip replacement four years ago.
On admission to the RAC facility, on Tuesday afternoon, the Nurse Manager suggested that Elsie consider making out an advanced care directive (ACD), indicating what she would want done in the event that her health should deteriorate. Elsie agreed and awaited the help of her family when they visited on Sunday. She was pleased to have this opportunity as, although she had discussed her wishes with her family, she wanted to make it clear to staff caring for her that she did not want aggressive treatment of any kind and did not want to be resuscitated.
On Friday night, Elsie developed severe chest pain which radiated down her (L) shoulder, an irregular pulse and a BP of 73/48 and the RN on duty called the ambulance. Elsie pleaded with the paramedics to leave her ‘as she was'; the R.N. insisted that they transport Elsie to hospital as she had not filled out an ACD indicating otherwise. In transit to the hospital, Elsie suffered a cardiac arrest. The paramedics attempted resuscitation but were unsuccessful.
On arrival to the ED, Elsie was pronounced dead. Her family determined that Elsie's death was brought on by the stress of being moved to hospital. They decided to sue the R.N., the paramedics and the RAC facility for assault and battery.