Mrs.
ST, an 80 years old woman who lives in Barangay Mungo, Tuao, Cagayan was
rushed at St. Paul Hospital Tuguegarao by her three daughters due to extreme dizziness
which caused her sudden collapsed after taking a bath one morning. Upon arrival at the
emergency room of the said hospital, they immediately got her vital signs and noted a
high blood pressure reading. They also performed an ECG to Mrs. ST and the result
seems not normal. After a series of laboratory tests, she was diagnosed of hemorrhagic
stroke, hence admission.
Three months prior to admission, the patient experienced intermittent flu and arthritis in
both knees. While on this condition, the patient’s blood pressure keeps elevating at a
range of 150/80mmHg to 190/100mmHg. The patient’s daughter also reported that the
patient experienced pain in her left hip due to fall accident.
Mrs. ST is a housewife and a widow for 14 years already. She has 4 daughters and 3 sons
but 2 of her sons are already deceased. Her hobbies include doing house chores every
morning and watching dramas and talk shows on TV.
According to the patient’s daughter, the patient has a previous heart disease and has a
history of hypertension, along with her family members. The paternal side of the patient
has a history of pulmonary tuberculosis and the mother side of the patient has a history
of hypertension and heart disease. The patient is taking hypertensive medications as her
maintenance and thrombolytic drugs as ordered by her physician. The patient has no
surgical history.
Upon admission in the ICU, the patient was on a mechanical ventilator. The physician,
however, explained to her children that their mother was hooked on a mechanical
ventilator but she is not in a good condition and anytime the patient will die. The
physician also told the patient’s children that it’s up to them if they will put off the
mechanical ventilator or will continue the machine. Meanwhile, her children can’t
decide whether to keep her alive or to stop her suffering from her situation even after
the physician had explained the situation.
ACTIVITY 1:
1. Identify the ethical dilemma in your scenario.
The ethical dilemma is identified as “the situations between the children of patient S.T
on how they are going to decide if they will accept the fact that their mother S.T is no
longer can survive her situations regarding that she was diagnosed in haemorrhagic
stroke and in their undecided decisions if they are going to put off the MV, so that her
suffering won’t prolong”.
2. Is it ethically or morally sound? Why?
Someone doesn't need to be moral to be ethical. Someone without a moral compass
may follows ethical codes to be in good standing with society. On the other
hand, someone can violate ethics all the time because they believe something
is morally right.
3. What is/are the principles of ethics applicable? Why?
Autonomy. Because it is where the ability of one person to explain one’s needs and
make fully informed decisions about one’s health. Illness may threaten a patient’s
autonomy.
4. If you are one of the health team caring for the patient in the scenario, what will you
advice the family? Why?
As a healthcare provider, I’m going to humbly explain the situations to the SO of the
patient. And also, nurses must respect their patients at all times, but they’re not required
to accept the actions their patients take and the consequences of those actions.
Therefore, it is essential to make them decide for what’s better to have good outcomes.
5. If you are one of the children of the patient, what will you do: put off or sustain the
mechanical ventilator?
The scenario is very hard on what will I’m going to choose, even on everyone else. I want
the patient to live but if I see to it that the patient is in suffering. Therefore I’m going to
put off the mechanical ventilator so that she won’t suffer more. It is hard to accept but
for the sake of the patient, I don’t want to prolong her suffering.
6. Construct a brief reflection on the dilemma.
For me, the meaning of autonomy in my life is wherein engage the nurse to do a
certain actions for it requires the patient to have autonomy of thought, intention,
and action when making decisions regarding health care procedures. Therefore, the
decision-making process must be free of coercion. In order for a patient to make a
fully informed decision, she/he must understand all risks and benefits of the
procedure and the likelihood of success. Because it highly technical and may involve
high emotions, it is difficult to expect patients to be operating under fully-informed
consent.
