Subject: Nursing Ethical Dilemma

Case Study (5- 7 pages):

This is a formal APA-format case study.

Choose a case; state the dilemma clearly, identify the agents involved and their interests, examine the advantages and disadvantages of both sides, list at least two different possibilities for solution relating to theory and/or ANA code of ethics and/or BRN 2725 and then propose a solution to the case explaining the ethical reasoning/theory you used.

Make sure you state the dilemma in the paper correctly action >outcome vs action >outcome

Nurses face ethical decision every day where their values, beliefs, and faith may be the same or different from their patients. The ethical dilemma I would like to write about is about a patient and the family that is a Jehovah’s Witness. Jehovah’s witness believe that it is against God’s will to receive blood and, therefore, they refuse blood transfusions. The question that remains during an ethical dilemma, is whether the patient should receive multiple blood transfusions to save their life or to respect the patients religious beliefs.

Please use this case:

A sixteen-year-old male member of Jehovah’s Witnesses incurred injuries in an auto accident. The injuries required surgery. He had informed both ambulance personnel and the hospital of his wish not to receive blood transfusions. Surgery was performed without use of blood transfusions. (further information about this case is in this link:

https://practicalbioethics.org/9-uncategorised/587-case-study-a-minor-requiring-blood-products.html

NEGATIVE OUTCOMES:

The first negative outcome is that the patient can die if he is not receiving blood transfusions.

The second negative outcome is that the patients religious beliefs are not respected. Their beliefs are that it is against gods will to receive blood… this can result in spiritual distress. Sometimes it can even lead to expulsion from and ostracization action by their religious community.

Another negative outcome could be that if in a life threatening situation a patient refuses blood transfusions, it can put the physician and nurse at risk for negligence… failure to act may lead to criminal charges of negligence. Intervention, however, could even lead to criminal charges of trespass against physical integrity.

Further resources about this:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934270/

More information about the case (incase the link does not open):

A sixteen-year-old male member of Jehovah’s Witnesses incurred injuries in an auto accident. The injuries required surgery 

He had informed both ambulance personnel and the hospital of his wish not to receive blood transfusions. Surgery was performed without use of blood transfusions.

Frequent blood tests revealed steadily declining hemoglobin and hematocrit readings. Physicians attempted to persuade patient and his mother (divorced, with custody of her son) to consent to blood transfusion, but they resolutely declined.

After the surgeon expressed his opinion that patient was in imminent danger of life-threatening consequences, legal counsel for the hospital filed a late afternoon petition in the state court for appointment of a guardian ad litem, without notice to either the patient or his mother. On same evening, informal hearing was held by the state judge, attended by only the hospital’s risk manager and two hospital attorneys. The state judge appointed a guardian ad litem.

The following morning, the state judge was told by the risk manager that the patient’s condition had deteriorated more during the night. The judge directed that a further hearing be held forthwith at the hospital, and directed who should be present (did not specify either patient or his mother, and neither attended or was consulted). Surgeon and a second treating physician testified to medical need for transfusion. State judge, at guardian ad litem’s request, entered order permitting transfusion. Patient was physically restrained and transfused with three units of packed red blood cells, on afternoon of day of the hearing and order.

Patient recovered, without adverse physical reaction from the transfusion, and was discharged one and one-half months later.

Subsequently mother initiated this action in federal court, on behalf of her son and for-herself, against the hospital, the risk manager, the surgeon, the second treating physician, and the two hospital attorneys (also sued another physician, but shortly conceded to that physician’s exclusion). The claims were premised on various theories of liability under the Civil Rights Act (1983) and on various state law claims (ultimately dismissed, without determination of the merits, for lack of federal court jurisdiction upon dismissal of all federal law claims).

All defendants filed motions for summary judgment in their favor on each of the federal law (civil rights) claims (asserting that no genuine issue of fact existed on the respective claims and theories of action).