You are the student nurse caring for Ms. Cranford. She is a mentally competent w

Question

You are the student nurse caring for Ms. Cranford. She is a mentally competent woman, age 87, who has lived alone since her husband died 10 years ago. She presented to the ER with chest pain, feeling faint, a pulse of 48, and a blood pressure of 98/56. The doctor and the nurse team stabilized Ms. Cranford with medications and intravenous uids and admitted her to the intensive care unit. The intensive care unit doctor and nurse later informed Ms. Cranford and her only son that she would need a heart pacemaker to regulate her heartbeat. After the doctor explained the procedure and risks involved, Ms. Cranford pondered the situation for a long while before discussing it with her son and doctor. Her medical history includes long-term adult-onset diabetes, chronic renal failure, and arterial insufciency. She felt very tired and decided that she did not want the pacemaker. Once Ms. Cranford told her son her wishes, he was quite upset and apprehensive about her decision. The son met with the doctor to discuss the options. Together, they approached Ms. Cranford in an attempt to persuade her to change her mind, but she continued to refuse the recommended treatment. Ms. Cranford and her son argued. The doctor tried to explain to Ms. Cranford that the pacemaker was in her “best interest,” and would involve minimal risks to her. She felt as if they were “ganging up” on her. Once the registered nurse became aware of the problem, you and the nurse decide to visit with Ms. Cranford and her son to assess and evaluate the ethical issues involved with her case.

Case Study Question

Use the Four Topics Method (medical indications, patient preferences, quality of life, and contextual features) to discuss issues, to identify additional needed information, and to analyze this case. What are your recommenda-tions on behalf of the ethics committee?

Explanation / Answer

Ms Cranford ,though aged 87 years can still live a little longer after using a pacemaker. She feels that perhaps this surgery would be very painful and would take a toll of her life. Probably she wants to die in peace. Our recommendations to her and her son would be to convince her mentally that her quality of life ( whatever is remaining) would definitely improve after this surgery. We would inform her about the consequences of the stage, in case she refuses for pacemaker.We will create a picture infront of her explaining that it would be more painful to die without a pacemaker. As she will not die in peace , instead she will slowly die in pain if not used a pacemaker.Because the heart beat she is having has made her pale and weak and if it continues ,it would even be difficult for her to breathe,eat and even sit.

After the use of pacemaker at least her quality of life would improve. She will not feel faint and would certainly improve her longevity and quality of life and then she can die in peace. Because death is inevitable but what we can do is we can make it wait in a proper manner, without falling a prey to it so easily.

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