Order Description
Read the following case study information and answer these 2 questions. (the case study is at after the questions)
1. Use the ethical decision making principles and frameworks you have studied in this unit to conduct an ethical review of the issues raised by the case study situation.
2. Discuss factors, processes and strategies which contribute to the development of successful teamwork in professional health contexts.
Case study of Mrs Hilda James.
The Scenario:
Mrs James is a 79-year-old widow living with her daughter and son in law. Her 19-year-old grandson lives with his parents and is a trained first-aider. Mrs James has had a long history of heart failure dating from a heart attack in 1989. She is increasingly debilitated by the heart problem. She rarely goes out but appears to have a reasonable quality of life. She is an independent, clear minded individual, and has made an ‘Advance Statement’ that should she have a ‘heart attack’ she wishes to be left to die with ‘dignity’. This includes hospital treatment. Her GP, daughter, and son-in-law are aware of this.
One evening her daughter and son in law go out to play Bingo and the grandmother decides to cook a meal for her grandson. During the evening Mrs James tells her grandson that she has heart burn. At 9.30 p.m. Mrs James collapses. Her grandson initiates resuscitation and telephones for an ambulance. Mrs James is taken to the local district general hospital’s A&E and then transferred to ICU where she is intubated and ventilated. She requires high doses of medication to support her cardiac function. When her daughter and son-in-law return home they quickly determine the facts and go straight to the hospital to see the medical practitioner in charge of her care. They show a written copy of the ‘Advance Statement’ made by Mrs James to the clinician and, allied with medical evidence; the decision is made to withdraw treatment. Mrs James is extubated and medication is ceased. Three days elapse before Mrs James dies. The case sparks a long debate among the ICU staff as to the difference between withholding and withdrawing treatment and to what constitutes care and what constitutes treatment.
