Ethically, is there a difference between a competent person making a well-thoughtthrough request as opposed to an irrational one?
What will be an ideal response?
Suggested response: In this case, it appears that Kerrie presented the doctors with a well-considered and well-thought-through advance directive. However, would the outcome have been different under other circumstances? For example, what would have ensued if Kerrie had presented to the emergency department and been assessed as having capacity but holding an advance directive that appeared to the healthcare team to include irrational requests and statements? What if Kerrie's immediate next-of-kin had strongly objected to the healthcare team taking no action to preserve her life? In common law, there is no requirement for refusal of medical treatment to have been well considered by the person or, from the perspective of the health professional, be rational and well thought through. In Kerrie's case the contents of the letter and subsequent assessment of her mental capacity indicated to the medical and legal team that she fully understood the consequences of refusing life-preserving treatment. Ethically, autonomy was the highest order principle to be applied given Kerrie was deemed competent. However, given medical acts and omissions of this nature have such dire and fatal consequences, it is imperative that the health team act in accordance with legal obligations and apply ethical principles in a well-considered way where all alternatives are considered and principles ranked in meritorious, defensible order.
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A Caucasian nurse is caring for an African American client who has a history of myocardial infarction and is receiving atorvastatin (Lipitor)
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The nurse is preparing to administer an enteral feeding for the patient. The patient has been on enteral feedings for 2 days. The nurse knows that the most appropriate technique for implementing enteral feeding is:
a. weighing the patient weekly. b. measuring the gastric residual every hour. c. changing the formula every 12 hours in an open system. d. leaving the formula in place in an open system for up to 24 hours.
What is the major objection to the disengagement theory?
a. The theory justifies ageism. b. The theory addresses the diversity of older adults. c. The theory does not clarify the aging process. d. The theory diminishes the self-esteem of the older adult.