Assignment task: You are caring for a patient who has become unresponsive after surgery. Prior to surgery, the patient stated that he did not want heroic or life-sustaining measures if anything should happen. This conversation occurred in front of his family, who made light of the comment because the surgery was considered routine. No papers regarding his wishes (living will, DNR, or advance directives) were signed. At this time, you are unable to contact any of his family members. You inform the attending physician of the patient's wishes and lack of documentation to that effect. The physician decides to call a code and initiate lifesaving measures. The patient never regains consciousness.
1. How could you, as the nurse in this scenario, apply the ethical principles of autonomy, beneficence, nonmaleficence, fidelity, justice, and veracity? Be specific and use the Nursing Today book as your reference to support the response.
2. Was the nurse correct in telling the physician about the patient's wishes and would this be considered an ethical dilemma? Why or why not?
3. With ethical reasoning and determining who owns the problem, explain the four guidelines noted in the Nursing Today book that should be used to determine who owns the problem.
4. Nurses can be in violation of the law at moments of life and death if they do not follow advance directives for a patient. What are advance directives and how do these differ from informed consent?