Case article on nursing ethics 1
Patient Li, male, 40 years old, received general treatment at home because of liver cancer metastasis. Because the patient was in unbearable pain, he repeatedly begged his wife Wang to help him end his life. The couple had deep feelings on weekdays, and Wang couldn't bear her husband to suffer these hardships again in his later years, so Wang gave her husband tears. After taking pesticides, her husband died soon. Afterwards, Li's younger brother took Wang to court. As a result, Wang was sentenced to 3 years in prison.
Try to analyze Wang's behavior from two angles of ethics and law.
It is really embarrassing for a patient to ask his wife to end his life in the case of unbearable pain in the late stage of cancer, but his wife's ignorance of medicine and law has made the patient's already painful body and mind suffer.
Although there is no law about euthanasia at present, whether euthanasia is moral or not is still a field that people pay close attention to. Patients seeking euthanasia need to meet the following conditions: the patient is in unbearable pain, terminally ill, has a sincere desire to get rid of it, and has the consent of his family. In this case, the family members did not reach an agreement, the way of death was uncomfortable, and the patient was very painful, which violated the law.
Generally speaking, law and morality are consistent, morality is the foundation and basis of law, and law provides protection for morality, but sometimes it is inconsistent. In this case, the patient's wife is essentially helping her husband; It is morally worthy of sympathy to endure mental pain and help her husband die. However, in law, she was thoughtless, contradicted the law, and failed to solve possible disputes in advance, so she was punished by law. This is the bitter fruit of failing to deal with the relationship between law and morality in medicine, and it is also a lesson that future generations should learn.
Case 2 of nursing ethics
A patient with cerebral hemorrhage underwent craniotomy in the emergency department of a hospital and was sent to intensive care unit overnight after operation. Liu, a nurse in the intensive care unit, carefully nurses patients, monitors vital signs at any time, and responds to all changes in the condition, with the goal of improving the success rate of rescue. At 4 o'clock the next morning, the nurse found that the patient suddenly had shortness of breath as high as 32 times/minute, rapid and weak pulse, blood pressure as low as 60/40Hg, and bilateral pupils were unequal. She had a premonition of intracranial hemorrhage, and at the same time quickly reported to the doctor on duty, turned on the ventilator and made all preparations for the second operation. Therefore, the second craniotomy was timely and smooth, which confirmed that the patient's brain had arterial rupture and bleeding again. Due to early detection and close cooperation with medical staff, the operation was successful and the patient was saved. Please make a moral evaluation of nurse Liu's behavior.
1. Nurse Liu's behavior in ICU: First, it conforms to the unity of motivation and effect. She not only has a good motivation to treat patients, but also produces good results after the action.
2. Secondly, it conforms to the unity of purpose and means. Nurse Liu not only has the purpose of rescue, but also takes measures such as reporting to the doctor on duty quickly and turning on the ventilator to make all preparations for the second operation.
3. Third, due to early detection and close cooperation between doctors and nurses, it conforms to the ethics of doctor-patient relationship. Equal cooperation? So the second craniotomy was successful and the patient was saved.
Case 3 of nursing ethics
King of the children, male, 3 years old. I went to the hospital for emergency treatment because I accidentally took 5ml of calamine lotion. The emergency doctor prepared to use 25% magnesium sulfate 20ml for catharsis, but mistook oral administration for intravenous injection. The treatment nurse got the prescription and thought: Can 25% magnesium sulfate be injected intravenously? I can't seem to, but I'm not sure. ? Think again:? Anyway, it's a doctor's order, and the nurse has the obligation to carry it out. ? So the child was injected with 20 ml of 25% magnesium sulfate intravenously, causing the child to die of respiratory paralysis caused by hypermagnesemia.
Although the treatment nurse was suspicious of the doctor's advice, she failed to ask the doctor clearly according to the relevant requirements of the check system, but mechanically executed the doctor's advice incorrectly, which eventually led to the death of the child. 1 The treating nurse mistakenly injected two patients' drugs because they didn't follow the rules? Three checks, seven pairs? Do it at the request of. Caution in nursing sometimes reaches negligible level. Every patient, every doctor's order, every copy, every handover, every medicine, every instrument and even every operation are required to be carefully checked and verified to ensure sterility. The tedious requirements for details may make nurses feel bored, but for patients, any minor mistake may lead to health damage or even life loss.
Case 4 of nursing ethics
A 5-year-old girl was hospitalized for three years because of renal failure secondary to nephritis. She has been doing kidney dialysis and waiting for a kidney transplant. After discussion between the doctor and the parents of the child, the family members agreed to have a living kidney transplant. After examination, the mother was excluded because the organization type did not match, the younger brother was not suitable, and the father reached middle age and the organization type met. The doctor and his father discussed being a donor, but after some thinking, his father decided not to be a donor and begged the doctor to tell his family that he was not suitable for being a donor because he was afraid that his family would accuse him of having no feelings for his daughter. Although the doctor was not satisfied, he did as his father asked. Please make an ethical analysis of the doctor's behavior in the above cases and analyze whether the father's behavior meets the requirements of deontology and effectiveness theory.
At the request of the child's father, the doctor asked the rest of the child's family? Lying? It is understandable to maintain the harmony of children's families. However, doctors do this against the virtue of honesty as doctors. It is more appropriate for doctors not to intervene in the internal affairs of children's families and let family members decide by themselves; According to the requirement of deontology, fathers have the responsibility to support their children. When the daughter's life is in danger, the father's reluctance to donate his kidney is morally flawed, which will affect the harmony of the family and be condemned in society, which is a regret in personal conscience; From the analysis of the requirements of the effectiveness theory, the quality of life of children is already very low. Can the transplant be successful or even if it is successful, what is the quality of life? Moreover, the father of the child is at the age of middle-aged career and has the responsibility to raise another child. In case of complications after transplantation, it will affect the career and the whole family. Therefore, considering the cost/effect of transplantation, it is understandable that the father does not donate organs. Therefore, only the father of the child and the whole family can decide whether to let the father donate the kidney.
Case 5 of nursing ethics
Patient Li, male, 46 years old, suffered from genital trauma. After urological surgery, due to local infection and ischemia, some tissues are necrotic and scabbed. Although the infection was controlled after doctors used antibiotics and changed the medicine several times, the local situation did not improve. He decided to perform a second operation for the patient to remove necrotic tissue, and the patient faced great physical pain and psychological blow. The head nurse of the ward negotiated with the doctor and asked the nurse of stoma wound for consultation. The doctor has no hope for consultation, because he doesn't know much about the work of nurses for ostomy wounds. After carefully examining the patient's wound and carefully analyzing the situation, the nurse of ostomy wound decided to use medical debridement to remove the black scab, postponed the arrangement of the second operation and obtained the support of the doctor. The nurse of stoma wound is active and responsible, changing dressing for patients many times, adjusting drug treatment scheme and careful nursing. When the necrosis and scab are gradually removed, the fresh tissue grows well, and the patient's wound gradually heals, the patient is spared the blow of the second operation. Doctors fully affirmed and recognized the innovative work of nurses with ostomy wounds, and expounded the ethical requirements of specialized nurses.
Ethical requirements of specialist nurses: 1. Love nursing and be willing to give. The nurse of ostomy wound has established the concept of loving nursing and being willing to contribute. After deciding to perform the second operation for the patient, the head nurse of the ward negotiated with the doctor, asked the nurse of the stoma wound to consult, debrided the necrotic tissue to remove the black scab, adjusted the medication treatment plan, and carefully cared. When the necrotic scab is gradually removed, the fresh tissue grows well, and the patient's wound gradually heals, the patient avoids the blow of the second operation, wins the trust of the patient and the recognition of the doctor, and shows his own value. 2. Be willing to teach and take root in clinic. Specialist nurses should have strong clinical observation, evaluation and treatment ability, professional theoretical basis and specialist operation skills. After careful examination of the patient's wound and careful analysis of the situation, the nurse of ostomy wound decided to use medical debridement to remove the black scab and postpone the arrangement of the second operation until she got the support of the doctor. 3. Be diligent in research and promote the development of the discipline. In this case, nurses with ostomy wounds study hard, actively carry out nursing research, constantly update, broaden and improve the knowledge and skills of specialist nurses, which promotes the development of nursing discipline.
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