a.      Discuss why you think the decision reached was ethically and morally sound or why you disagree with the decision. b.      What 2015 American Nurses Association (ANA) Code of Ethics principles should a nurse in a similar situation evaluate for guidance? c.      Would the case you picked be decided differently today, why or why not? e.      Who speaks for the incapacitated patient in the absence of an advance directive in Florida? (Hint: the answer is in the Advance Directives statute, Part IV)

a. The decision reached in this case can be considered ethically and morally sound for several reasons. Firstly, the decision was based on the principle of beneficence, which refers to the obligation of healthcare professionals to act in the best interest of their patients. In this case, the patient’s deteriorating health condition and the recommendation from medical experts indicated that continued treatment would only prolong suffering and offer little chance of improvement. Therefore, the decision to withdraw treatment can be seen as an act of beneficence, aiming to alleviate suffering and promote the patient’s well-being.

Additionally, the decision can be justified by the principle of autonomy. Autonomy emphasizes the importance of respecting an individual’s right to make their own decisions about their healthcare. In this case, the patient’s advance directive clearly stated her wish to have life-sustaining treatment withdrawn if there was no reasonable chance of recovery. By honoring the patient’s autonomous decision, the healthcare team respected her individual rights and allowed her to have control over her own medical treatment.

Furthermore, the decision takes into account the principle of non-maleficence, which requires healthcare professionals to do no harm to their patients. Continuing treatment in this case would have prolonged the patient’s suffering without any significant benefit. By withdrawing treatment, the healthcare team avoided further harm and unnecessary interventions that would only prolong the patient’s distress.

b. A nurse in a similar situation should evaluate the following 2015 American Nurses Association (ANA) Code of Ethics principles for guidance:

1. Provision 1: The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. This principle emphasizes the importance of treating patients with dignity and respect, ensuring that their values and beliefs are taken into consideration when making healthcare decisions.

2. Provision 2: The nurse’s primary commitment is to the patient, whether an individual, family, group, or community. Nurses should prioritize the best interests and well-being of the patient above all other considerations.

3. Provision 3: The nurse promotes, advocates for, and protects the rights, health, and safety of the patient. This principle highlights the nurse’s duty to protect and advocate for the rights of the patient, including their right to autonomous decision-making.

4. Provision 4: The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care. This principle emphasizes that nurses have a professional responsibility to provide optimal care based on their knowledge and expertise.

5. Provision 5: The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth. This principle highlights the importance of nurses maintaining their own competence, well-being, and professional growth to provide effective and ethical care to patients.

c. It is possible that the case mentioned would be decided differently today due to several factors. Firstly, advancements in medical technology and treatment options may have provided new possibilities for treatment or improved chances of recovery. The decision to withdraw treatment would depend on the current medical knowledge and available interventions, as well as the patient’s specific circumstances.

In addition, changes in societal attitudes and legal frameworks may also play a role in influencing the outcome of similar cases. The growing emphasis on patient autonomy and the recognition of individual rights in healthcare decision-making may result in a different approach to balancing the patient’s wishes, medical expertise, and ethical considerations.

e. In the absence of an advance directive in Florida, the person who speaks for the incapacitated patient is determined by the Advance Directives statute, Part IV. According to Florida law, the patient’s surrogate decision-maker is chosen based on a priority list. The patient’s spouse, if available and willing, is given the highest priority. If the spouse is unavailable or unwilling, the decision-making authority passes to an adult child, followed by a parent, a sibling, or even a close friend if no other family members are available or willing to serve as the surrogate. This hierarchy ensures that someone who is familiar with the patient’s values and wishes is responsible for making healthcare decisions on their behalf.