Anyone suffering from Rheumatoid arthritis seems to be partially paralyzed because the disease affects their joints making them swell and became stiff. The person is usually in a lot of pain, has a fever and feels sick and tired at all times. Rectal hemorrhage is a disease that affects the rectal system of a human being causing it to bleed. Symptoms for the disease are presence of blood in the stool. Bowel obstruction is damage to the intestine hindering the digestion process, passage of the intestinal wastage accompanied by bloating of the lower abdomen, abdominal pain, vomiting, dehydration due to vomiting and constipation.
From the above it is clear that Angela is suffering and as more time is wasted her condition becomes complicated as one disease leads to another. Surgery may solve her problems but leave her with complications that will make her life miserable or the doctors may let her die a natural death and rescue her from this misery as her granddaughter suggests. I would rather do everything I can to save her life and if she dies in the process let it be, than do nothing and later question my conscience.
No medicine practitioner can decide the fate of Angela, the code of ethics of registered nurses will be used to lay guidelines to such a case (McCormick and Min 1994). Ethics are solutions to any conflicting matter, which give principles that enable one to solve the matter. In medicine practice there is a code of ethics that every registered medical physician should follow to book. These principles help them to solve difficult situations especially those pertaining to death. Angela cannot be given her right to autonomy because she is confused and cannot communicate.
The Autonomy principle protects the right of patients to decide over their life, so long as the person is in a capacity to decide. Before this right is given to an individual, the physician should make sure the patient understands the implications of the disease, the treatment procedure and its results. He should make sure the patient repeats or rephrases what he had just explained to be sure the patient fully understood. The patient should be able to tell the physician his decision regarding to his rank of importance to rights.
The physician should ensure that the patient’s decision is consistent by asking him many times at different times and day. The principle of Beneficence, lays it clear that the medical physicians should always do good to their patients. They should always suggest positive ideas that favor the patient. In Angela’s case the doctors will have no right to end her life unless she is on the verge of death. In such an instance only Angela can decide the fate of her life. The maleficence principle stipulates that no medical doctor should cause harm.
The doctor will always remove harm from the way of his patients. In this instant the doctor will prefer to see Angela go through medical processes to correct her illness. The principle of telling the truth proves that the patient understood the consequences of both actions and gave consent as to his decision. Angela is in a state of confusion and therefore can not give any consent on to what she has decided. Here again the doctors will have to save Angela’s life in accordance to the other codes of ethic.
A patient has a right to respect and confidentiality to his decisions. For example if he does not want his family members to know his decision, then doctors have a right to keep it that way. Therefore whichever decision will be made in Angela’s case it should be respected and dealt with utmost confidentiality (Ridley, 1998). According to ethical principals, as a nurse am not supposed to take relatives or close friend advice. Therefore my judgment should not be based on Angela’s daughter or granddaughter advice.
Angela is in a critical situation but as a registered nurse I have to follow the code of ethic which in this case guides me to preserve Angela’s life not unless her situation is out of hand then I can remove the machines that support some of the major functioning of her body. Angela’s limbs are out of use since they have been adversely affected and if she goes to surgery there is a high possibility all her limbs will be amputated. Due to the swelling of her body, sever rectal hemorrhage was developed. This means that she is internally bleeding and from time to time will need blood transfusion before surgery which may take a while.
Furthermore, Angel has got a bowel obstruction; she cannot eat solid food because her body cannot digest it as her intestines are damaged. Also she cannot excrete intestinal waste. This means that Angela cannot eat and needs to be fed glucose and water to enable her body to continue functioning. To sum this up her condition is worsening turning her to a retard since she is confused and cannot communication, her brain functions are starting to be affected and this may eventually turn her into a vegetable especially if the situation is not corrected at an early stage.
Going by this assessment the ethical code would favor my suggestion since the chance of survival for Angela even after surgery is minimal. The NANDA (North America nursing Diagnosis Association) nursing diagnosis also adds evidence to my plan of action as it stipulates the same principles (Ridley, 1998). After diagnosis a nurse should know if the patient has any survival chances. Looking at Angela’s case her chances of survival are minimal or even if she survives chances are that she will not live for long. This is especially so because of the brain damage exhibited by her state of confusion and incoherent speech.
Thus undergoing surgery will be a waste of time and resources especially if her condition does improve or show any changes. Before any decision is done Angela’s condition must be monitored to see if there is any change. Appropriate medication should be given and followed to the book. These duties should be delegated to other staff members to ensure each and every moment is noted. As the nurse I will use Angela’s record book to determine if there has been any progress made in her health condition, to meet any of the goals set during the implementation process.
If no change has occurred then it will be under no harm to remove all the machines that support Angela’s body functions. If any considerable change has been noted then appropriate measures to save Angela’s life should be carried out (Penslar, 1995) Word Count: 1118 Reference List McCormick and Min (1994). Principles of Biomedical Ethics. New York: Oxford University Press. Penslar (1995). Research Ethics: Cases and Materials. Bloomington: Indiana University Press. Ridley (1998). Beginning Bioethics. New York: St. Martin’s Press.