It is agreed that health care staff should provide treatment to patients according to their wishes regarding consent. Legal documents proclaim that a patient has the right to refuse treatment or any other type of medical interference even if this would lead to his or her disability or death. However, this regulation is only applicable to patients who are mentally incompetent to make decisions. In such a case, a nurse must exercise the actions that would work best for a patient’s health.
The case of Ann, who has Alzheimer’s disease, calls for deciding what actions should be taken if she is admitted to a hospital. The case study provides the information that Ann refused to speak and eat after being put in a clinic with pneumonia. Her relatives cannot decide whether doctors should use a tube to feed her since Ann refused a similar procedure of breathing intubation. However, a nurse must insist on this procedure. The ethical reasoning here would be that the patient could possibly change her mind regarding such treatment methods if she was mentally competent. Recognizing that the patient is old and could wish to spend the rest of her days at home is important. However, since Ann cannot formulate her will, any medical treatment cannot be regarded as a violation of patient autonomy (Burkhardt & Nathaniel, 2014, p. 62). In this case, a nurse should insist on feeding the patient with the help of a tube. Firstly, it is not the same as keeping someone alive by using a machine when certain body parts are not functioning anymore. Secondly, the patient presents a threat to herself, which cannot be ignored. It is unknown why Ann refuses to speak or eat. It could be one of the behavior types caused by her mental illness.
The Declaration on the Rights of the Patient is a legal document that regulates the behavior of health care staff to people admitted to hospitals (World Medical Association, 2015). It states that doctors and nurses must first acquire a patient’s consent for any medical procedures. Otherwise, it may result in suing a hospital and its staff for inappropriate treatment. However, the document also identifies that in the case when a patient is mentally incompetent, he or she must have a legal representative (usually a close relative like a spouse or an adult child) to perform the decisions.
It is important for a nurse to bring Ann’s husband and daughter that she must be fed through a tube. The patient’s well-being must be the top priority. If Ann’s representatives do not agree with a nurse, a hospital should file a claim to a court to give the decision of medical staff legal support.
Advice to Family
However, it would be very unfortunate to pass the case to a court. A nurse should try to speak to Ann’s relatives and to ensure that feeding is the only right option. Leaving this woman without treatment would be equal to murdering her, as dying from starvation is a very painful process that is similar to torture.
Every hospital case is different, yet nurses should always put patients’ wellbeing at the top of their priorities. The case of Ann requires feeding her with a tube despite her possible objection. Dealing with mentally incompetent patients may be ethically challenging. However, ensuring they do not present harm to themselves is the best strategy to take in such situations.
Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics and issues in contemporary nursing (4th ed.). Stamford, CT: Cengage Learning.
World Medical Association. (2015). WMA Declaration of Lisbon on the Rights of the Patient. Web.