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Using the Bioethical decision making model found in here, analyze the following case study. this should be an in
depth description and will probably take at lease 3 pages to adequately address the issues.
Bioethical Decision Making Model to follow:
1- Identify moral aspects
2-Gather all relevant facts
3-Determine ownership of the decision-Who will make the decision?
4-Clarify and apply personal values- What is important?
5-Identify ethical theories and principles.
6-Identify applicable laws or agency policies.
7-Get interdisciplinary help-literature,chaplain,social worker.
8-Develop possible actions and plans with potential outcomes.
9-Apply the nursing code of Ethics.
10-risk and consequences of each action.
11-participate in decision making.
12-implement plan.
13-evaluate plan.
Case Study for ethical decision Making:
the case
Jennie M age 79, came into St. Francis Nursing Center four years ago. At that time, she appeared to have little
contact with reality although she had not been declared incompetent by the courts. Her 60 year old daughter,
Mary, had taken care of her mother until Jennie’s hypertension, diabetes and several small strokes made it
impossible for Mary to do all for her mother that she hoped to do. upon arrival at the nursing center, Mary
handed her mother’s advance directive to the admitting clerk. the directives showed that Jennie had initialed no
surgery, heart-lung resuscitation, antibiotics,dialysis,mechanical ventilator or tube feeding. Together they read
through it while Jennie sat beside them, apparently not comprehending anything about the move. Mary signed all
paper. from that time on she visited her mother frequently and has always been cooperative when the nursing
center has requested information or guidance. The year passed; Jennie has been eating less and taking more and
more time to consume what little she does eat. She no longer feeds herself and often in the assisted eating
dinning room, aides spend over two hours to ensure that minimal nutrition standards are met for Jennie’s intake.
The director of nursing has mentioned to Mary that consideration ought to be given to the insertion of a feeding
tube. Jennie is not acutely ill; clearly she is an elderly woman with multiple disabilities by she is not in
danger of imminent death. All she needs is sufficient nutrition, yet the director of nursing feels she cannot
justify and aide’s time being devoted to one patient for so long a period three times a day. Mary knows that her
mother’s advances directive was made one day when a neighbor was visiting and all that Jennie told her about it
was that she didn’t want to be "kept alive on a machine". when Mary and the director of nursing are
talking, Mary says she does not consider tube feeding a "machine" and her mother most likely did not
understand the implication of her initial statement, "No tube feeding". the daughter concurs with the
nursing director that it would be better for Jennie if a tube is inserted. But when the administrator was told of
the decision, she felt uneasy because she saw the advance directive. What should happen next? Use the bioethical
decision making model to decide if Jennie should have a feeding tube inserted.
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