Case study
Jennie aged 79 , came into st Francis nursing home four years ago. At the time she appeared to have little contact with reality although she had not been declared incompetent by the courts. Her 60 year old daughter, Mary had taken care of her mother until Jennie’s hypertension, diabetes, and several strokes made it impossible for Mary to take care of her. Upon arrival at the nursing home Mary handed her mother’s advance directive to the admitting clerk. The directive showed that Jennie had initialed “ no surgery, heart-lung resuscitation, antibiotics,dialysis, mechanical ventilator or tube feeding.” Together they read it through while Jennie just sat beside them, apparently not comprehending anything about the move. Mary signed all papers. Years passed and Jenny has been eating less and taking more and more to consume the little she does eat. She no longer feeds herself and it takes the aides over two hours to ensure her minimal nutrition standards are met. All she needs is sufficient nutrition and yet the director of nursing suggests to Mary that she should consider a feeding tube for her mother. Mary knows that her mother’s advance directive was made one day when a neighbor was visiting and all that Jennie told her was that she did not want to be “kept alive on a machine”. Mary does not consider tube feeding a “machine” and thinks that her mother most likely did not understand the implications of her initial statement, No Tube Feeding. The daughter agrees with the nurse director that it would be better for Jennie to get feeding tube inserted. But when the administrator was told of the decision, she felt uneasy because she saw the advance directive. What should happen next ? Use the bioethical decision making model to decide if Jennie should have feeding tube inserted.
The paper must be typed using APA format
The student should address the following:
1. Define the scope ethical issue
2. Examine the scope of the issue as it relates to nursing and principles identified in codes of ethics.
3. Identity at least two positions taken on this issue by scholarly experts in the ethics discipline
4. Explore the future for the issue as it relates to nursing practice.
