I have take a side in an ethical dilemma I have/or might experience working in the nursing field. If a nonverbal 98 year old cancer patient on a feeding tube is a full code because he is his daughter’s only family, I think the ethics committee should be involved. If he codes, I do not think it is fair to torture his body with CPR if treatments are futile. Due date is Saturday, December 8. Requirements 5-7 pages long. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552960/

Title: Ethical Considerations in the Treatment of Nonverbal Elderly Cancer Patients on Feeding Tubes as Full Codes

The field of nursing encompasses a diverse range of ethical dilemmas. One such dilemma pertains to the treatment of nonverbal elderly cancer patients who are on feeding tubes and designated as full codes. In this scenario, the patient’s daughter believes that full resuscitative measures, including cardiopulmonary resuscitation (CPR), should be employed in the event of cardiac arrest. However, considering the patient’s advanced age and the futility of such treatments, it becomes crucial to explore the involvement of an ethics committee to ensure proper decision-making in accordance with ethical principles. This paper aims to discuss the ethical considerations surrounding this scenario and the importance of involving the ethics committee.

Ethical Principles:
In the realm of nursing ethics, several principles are typically utilized to guide decision-making. These principles include respect for autonomy, beneficence, non-maleficence, and justice. Respect for autonomy acknowledges an individual’s right to make decisions regarding their own healthcare. Beneficence entails promoting the well-being and best interests of the patient, while non-maleficence emphasizes the duty to do no harm. Justice encompasses the fair distribution of resources and the avoidance of discrimination. In the case of the nonverbal elderly cancer patient on a feeding tube, these principles must be thoroughly analyzed to determine the most ethical course of action.

Feeding Tubes and Full Code Status:
Feeding tubes are often used to provide nutrition and hydration to patients who are unable to consume food orally. In the case of the nonverbal elderly cancer patient, the feeding tube is essential for his sustenance. However, his designation as a full code means that if he experiences cardiac arrest, healthcare providers are obligated to perform CPR and take all possible measures to revive him. This designation is usually made based on the patient’s expressed wishes or, in the absence of clear directives, by a designated surrogate decision-maker. In this case, the patient’s daughter has assumed this role, asserting that her father’s full code status must be upheld due to her being his only family.

Futility of CPR and Treatments:
Considering the patient’s advanced age, cancer diagnosis, and nonverbal status, the efficacy of resuscitation efforts must be critically evaluated. Cardiopulmonary resuscitation involves aggressive chest compressions, intubation, and administration of medications to restore cardiac function. However, research and clinical experience indicate that CPR in critically ill elderly patients often yield poor outcomes, with low success rates and a high likelihood of causing additional harm. Moreover, CPR can lead to rib fractures, pneumothorax, and other complications. Therefore, performing CPR on the nonverbal elderly cancer patient might go against the principles of non-maleficence and beneficence, as it has the potential to cause unnecessary suffering and harm without a realistic chance of success.

Importance of Involving the Ethics Committee:
Given the complexity and ethical implications of the scenario, involving an ethics committee becomes pivotal. An ethics committee, consisting of professionals from various disciplines, can provide a comprehensive evaluation of the situation in accordance with ethical principles, legal guidelines, and institutional policies. The committee can offer a platform for open and informed discussions, exploring different perspectives and potential courses of action. Furthermore, the involvement of an ethics committee ensures transparency, accountability, and a fair and just decision-making process. It also safeguards against potential conflicts of interest and the undue influence of emotional factors on critical decisions.

In conclusion, the case of a nonverbal 98-year-old cancer patient on a feeding tube designated as a full code presents an ethical dilemma for nursing professionals. The futility of CPR and treatments, coupled with the patient’s advanced age and lack of verbal communication, necessitates thoughtful consideration. Involving an ethics committee can provide a comprehensive evaluation of the ethical implications, enabling a fair and informed decision-making process. Ensuring adherence to ethical principles of respect for autonomy, beneficence, non-maleficence, and justice is imperative in providing appropriate and compassionate care for these vulnerable patients. The involvement of an ethics committee serves as a valuable resource to guide healthcare professionals and enhance the overall quality of care in such complex situations.