Case Study of an Ethical Dilemma

Case Study of an Ethical Dilemma Introduction An ethical dilemma arises when the clients and health care providers differ in their understanding of what is right or wrong (Narrigan, 2004). As nurses we often deal with ethical dilemmas in our everyday clinical practice; and as professionals we have the responsibility to analyse and examine any ethical problems that may arise. Any decision should be based on ethical principle that protects the best interest of both the patient and the health care provider. This paper will outline a critical incident which occurred in one of my clinical experience in intensive care unit (ICU).It presents the clinical case, identifies the ethical dilemma, and discusses the principles that apply to this situation. The Case Mrs G was a 76-year old woman who was brought to emergency department (ED) after her carer found her in respiratory distress. The ED doctor noted that the patient was minimally responsive to verbal stimuli, afebrile, normotensive, tachycardic to 130 bpm, and tachypnei c to 30 breaths/min.A chest radiograph revealed a right lower lobe consolidation. Based on her old notes it was found out that she had been recently admitted for investigation of significant weight loss and it was found to be a result of advanced bowel cancer ,with lungs, bone and brain metastases. While in ED Mrs G’s respiratory functions deteriorated and a referral for ICU was made. She was then seen and reviewed by our junior registrar and after discussion from the ICU consultant, Mrs G was admitted to ICU for closer observation. I was then tasked to look after this patient for that shift. After knowing the brief history of the patient from my team leader, I was then asking the doctor of what do we do for this coming admission? Are we going to intubate and ventilate this patient in case she developed respiratory failure? And what are the chances of her recovery from this critical illness? Has it been discussed to the next of kin before the plan for ICU admission? The docto r then replied that it was his consultant’s decision, and so we will just have to wait when this patient will arrive in the unit. . Within 24 hours of being transferred to the ICU, Mrs G’s condition deteriorated rapidly and a decision was made to talk with the family of what we should do in the event of cardiac arrest. Relatives need to be involved in discussions about end-of life issues so that they are fully aware of the appropriate decisions to be made; and that all parties involved understand the situation (McDermott, 2002).The son was immediately informed about his mother’s condition and it was revealed that Mrs G had previously stated to him that she does not want any heroic measures in the event of cardiac arrest. The conversation with Mrs G’s son over the phone resulted in the decision to initiate a not for resuscitation (NFR) order. The purpose of the NFR order is to deliberately withhold life-saving measures when the patient’s respiratory or cardiac function suddenly stops (Costello, 2002).

Understanding Pregnancy and the three Trimesters Essay

Understanding Pregnancy and the three Trimesters - Essay Example The 1st Trimester encompasses the time from the moment of conception to 13 weeks and many experts feel that the 1st Trimester is the most crucial, because it is at this stage that body structure and organ systems are designed (The Regents of the University of California, 2014). During the first two weeks the woman is not technically pregnant, not yet. Conception actually occurs about two weeks after the end of your last menstrual cycle. By the 3rd week fertilization is achieved. At this point the offspring is called a zygote and is made up of the base 46 chromosomes that will account for many of the baby’s future traits, including gender. Week four begins the process called implantation. From here the zygote is now referred to as a blastocyst, which is a ball of multiplying cells. This is also when the placenta begins to prepare itself (Vishton, 2013). Week five begins the embryonic stage of development. The brain, spinal cord, and heart begin to form; inner and exterior skin layers develop, as well as, certain amounts of connective tissue. Week six marks the closing of the neural tube and the embryo’s heart begins to beat independently and buds protrude from the embryos body, which will become arms and legs. The seventh week sees vast change s in the embryo; head develops, including eye sockets, ears, and facial features begin to be defined. However, with all of this change the embryo is no bigger than the end of a pencil’s eraser. During the 8th, 9th, and 10th week the eyelids, fingers, toes, lips, straightening of the torso, and rounding of the head can be seen. By the 11th week the embryo is now a fetus. Red blood cells are forming and genitalia will begin to form. In the 12th week fingernails are forming and the fetus’s profile is clearly human. At this stage the fetus is only, approximately, 2  ½ inches long and weighing a  ½ of an ounce (Mayo Clinic, 2014). Through the definitive 1st Trimester it is not just the baby-to-be that is going

Critically assess the rights and duties of the shipowner under a bill Essay

Critically assess the rights and duties of the shipowner under a bill of lading - Essay Example With the development of mercantilism, these bills started to be used as the label to the products, and the bill of lading was developed in much the same form as we recognise today (Wilson, 2010). The up to date rules on bills of lading were codified by the Hague Statue in 1924. Ship-owners have had and still have huge obligations with regard to this bill (Al Tamimi & Company, n.d). In order to ensure that the goods people are protected when in voyage, the bill of lading set certain rights and duties of ship-owners that should be followed. This paper will critically assess the rights and duties of ship-owners under this bill. When merchandise is transported under the bill of lading, the rights and duties of a ship-owner are recognised by fast clauses in the deed (Australian Government n.d). These are known as "express obligations". The text can also include a Paramount clause confirming that the ship-owner is subject to legislation, for instance, the United Kingdom Carriage of Goods by the Sea Act of 1971 and/or the U.S. Carriage of Goods by the Sea Act of 1936, which impose The Hague-Visby Regulations of 1968 and The Hague Regulations of 1924 respectively. In any scenario, the bill of lading itself might not be liable to legislation, but be affirmed to be liable to The Hague-Visby Regulations and/or The Hague Regulations (Wilson, 2010). The Hamburg Regulations of 1978 are not applicable to the 1991 regulations, but there is nothing to stop a nation, which has accepted these, from passing legislation requiring carriage to and/or from that nation and under bills of lading to be liable to the Hamburg Rules . The duties and responsibilities of ship-owners were put into effect internationally on November 1st, 1992. Various obligations of the ship-owner under these rules are understandable and need not be considered in any depth, for instance the