Paper details:
Final/Research/ Portfolio Paper: Submit by Saturday 11:59 p.m.
• Assignment (260 points) Your paper should be based on the following scenario: You are the director of respiratory therapy at a large regional medical center. There
is an 85-year-old female Hispanic patient in the adult intensive care unit. The admitting
diagnosis for the patient is “stroke.” Prior to admission, the patient had a history of heart
and pulmonary problems and lung cancer (successfully treated by surgery and radiation
10 years ago). Tests conducted since admission ha
ve disco
vered early-stage liver cancer.
The patient has been in a comatose state e
ver since admission, unable to communicate or
mo
ve. Since the patient is unable to breathe on her own, she is also on a ventilator.
The patient was admitted 15 days ago; she is without insurance and has no proof of
citizenship. The hospital business o
ffice wants to know if she can be discharged from
AICU, which costs the hospital $20,000 per da
y, or if the family will agree to disconnect
the ventilator. The attending physician is new on the medical staff and is unsure of the
patient’s prognosis.
The AICU is full, so the discharge planner is under pressure from his supervisor to free up the bed needed for other critical patients. The patient’s family is strongly
against withdrawal of any life support or reducing any care standard. They ha
ve been
adamant that God will perform a miracle and the patient will walk out of the hospital.
The patient’s children are all adults, natural-born citizens of the U.S. who own a
successful, well-known local business.
A local TV station has been ‘co
vering the stor
y’ although they ha
ve not publicly
disclosed the patient’s name. The state go
vernor has come out publicly stating that illegal
aliens are a drain on our state’s resources and should be sent back to their countries of
origin. The go
vernor’s challenger (whose daughter is a nursing student in AICU) says
there is a moral duty to care for e
ver
yone.
You are scheduled to meet with the hospital ethics committee tomorrow. After
the meeting, you, the physician, and the AICU chaplain are to meet with the patient’s
family regarding the patient’s course of care.
How will you prepare for the upcoming meeting with the hospital ethics
committee? What issues do you expect will come up during that meeting? What will you say to the patient’s family?
Prepare the portfolio paper using the following guidelines:
o A minimum of 8 pages not to exceed 12, typed, double-spaced, Times New
Roman font, using APA standard.
o Title page, including title of paper, your name, course name and course number,
date of submission (page 1).
o A minimum of 8 pages, including a summary of your understanding of the
biblical implications for the topic (pages 2-11).
o Apply the “model for making moral decisions” studied in Chapter 4 of Moral
Choices.
o Include an analysis of patient autonomy.
o Include an analysis of rationing of health care resources.
o Apply ethical considerations regarding end-of-life care.
o Include your ethical obligations to the institution.
o Include your ethical obligations to hospital staff.
o Include your ethical obligations to the patient.
o Include your ethical obligations to other patients and the community.
o What documents could the patient ha
ve been prepared to make this situation
easier?
o Address and analyze privacy issues.
o Are there any federal laws that are rele
vant to this patient’s care?
o Does anything change if your hospital: (a) is a state-owned facility; or (b) is affiliated with a certain Christian denomination; or (c) if it is a private for-profit
facility?
o Include anything else you think to be rele
vant.
o Be sure to support all your ideas with citations from both of our textbooks, and
use your outside sources as well.
o A reference page (page 12).
o A minimum of 8 references are required, including the text, the Holy Bible, books
and articles from academic sources (Net Library), and other periodicals