The video on the case of Lewis and Tamparo: How Do You Choose When there is No Choice presents a phenomenon where a 21-years older woman undergoing treatment of Hodgkin’s lymphoma expresses distraught about the chemotherapy side effects. The woman’s situation comes despite having undergone several curative therapies. Therefore, in this case, the nurse befalls an ethical problem condition known as moral distress B.
The woman understands the consequences of the treatment but has an ethical dilemma about undertaking the course of treatment. Here, the locus of authority lies on her to partake in the treatment or not. Contrary, the nurse undergoes ethical distress A (Moral distress) since the locus of power to participate in her chemotherapy lies with the patient. Hence, the nurse feels powerless. Accordingly, the bioethical principle adhered to herein is autonomy. Every patient has the right to make decisions according to their values and beliefs. The nurse must obey the patient’s decision by upholding beneficence.
The 55-years old has a formed religious belief against medical assistance despite requiring chemotherapy in his gastrointestinal organs. The RN faces ethical distress A, where she knows what the profession requires on the condition but has to adhere to the patient’s decision regarding the bioethical principle of autonomy and beneficence. Thus, the RN has to show justice by only giving services to those who need them.
According to the case in the video, the 55-year-elderly man is conceded with a functioning gastrointestinal drain. The patient is a Jehovah’s Witness. He is acknowledged with hemoglobin/hematocrit (Hgb/Hct) of 7/21 and isn’t reacting to treatment. The Hgb/Hct drops gradually every day. Consequently, providers meet with the patient and his family every day to clarify the conclusion and plan of care. The patient keeps on declining treatment and, in the end, becomes lethargic. The family keeps on the patient’s desires and permits palliative consideration until his death. The 55-years of age has a strict conviction against clinical help despite requiring chemotherapy in his gastrointestinal organs. The RN faces moral misery A. She knows what the calling expects on the condition; however, she needs to stick to the patient’s choice concerning the bioethical guideline of independence and advantage. In this way, the RN needs to show equity by giving administrations to the individuals who need them.
The 70-year-old retired lawyer suffers an ethical dilemma and decides to kill himself. The only bioethical principle most suitable here is for the nurse to provide justice to the lawyer’s life. The lawyer wishes to live but gives up on discovering that his conditions cannot be determined.
The RNs in this scenario face moral distress in the locus of authority. As everyone else has specific views of caring for the patient, the question lies in which party has the authority to decide the suitable care practice, given that all suggestions seem appropriate. In this scenario, bioethical principles such as autonomy, beneficence, non-maleficence and justice apply.
In conclusion, nurses face one or more ethical problems, including; an ethical dilemma, ethical distress type A or B, locus of authority, ethical distress (moral distress) type A: constraint, and ethical distress type B: uncertainty. An ethical dilemma refers to two or more acceptable but mutually exclusive courses of action. Consequently, the involved nurse or psychiatrist must identify an applicable bioethical principle, autonomy (exercising or respecting personal freedom), beneficence (doing good), non-maleficence (not harm) and justice (distributing benefits to those deserving of the benefits). The Case of Lewis and Tamparo: How Do You Choose When there is No Choice presents a physical scenario where nurses face a practical ethical problem with their patients.