Identify and articulate a specific ethical issue in a practice area (when patients asks for assistance with death) provide practical leadership strategies to address the issue
Timothy Jenkins was a patient in the Cornwall County Hospital Oncology Department for over five years, during which time he was finally diagnosed with terminal cancer of the lungs, possible due to forty years of smoking. Our physicians had done all they can for him using all the latest medical information and technology, but this had cause his family thousands of dollars in medical expenses, after their insurance coverage was terminated
The family came to the writer secretly one night, after visiting their suffering relative, and asked if the suffering could be done by rendering assisted suicide with or without the doctors knowing about it, but the issue became even more challenging the next day when the patient himself, with as much effort as he could summon made the same request. In response, both parties were told that the matter would be looked into and a report conveyed to them later.
Face with a morally challenging issue of this nature for the first time from a nursing perspective, and realizing that professionalism and strong ethical leadership were critical elements in the making the right decision, the matter was taken to the Chief Medical Officer for the institution, who then promptly assembled his team of experts to iron out an ethically and sustainable way acceptable way forward.
The decision to take the matter to a higher authority was borne out of the fact that many physicians as well as nurses think it was unethical, morally wrong and against the Hippocratic Oath to take a person’s life intentionally, even if the patient request it (Ardelt, 2003). Additionally, according to the American Medical Association’s Code of Medical Ethics, physicians-assisted death contradicted physicians’ role as healers (Kass, & Ladd, 1996).
Historically also, the matter had no precedent for the hospital, and could not stand up under scrutiny, should a court case develops, especially due to the fact that the practice was only legal in Belgium, the Netherlands and in the State of Oregon in the United States, according to Ardelt (2003).
While the medial team contemplated the issue, this writer considerations turned to contemplate whether the right ethical leadership was provided, in that the family was grieving as time passed, with heavy financial and emotional burdens adding more to their situation, the patients also was also feeling guilty and selfish for having used up so much of the family savings as well as the vital hospital resources, that could have been allocated to save perhaps hundreds of other patients’ lives, who would then be able to make significant contributions to societal developments in the future (Brogden, 2002, & Osgood, 2000).
The choice could have been made to secretly, in concert with a willing physician, to assist the family and allow the patient to die in dignity, but the medical records of the patient showed that they were all of the Catholic Faith, and by this religion, physicians-assisted suicide and euthanasia were unacceptable, due to the belief that life was regarded as a gift from God, and should be treated as sacred (Ardelt, 2003).
Critically speaking, it was a possibility that after this family had put their bereavements behind them that they could, with the ethical leadership of their priest, bring lawsuits against the hospital as well as myself and other members of staff that could have been implicated in the process, and thereby perpetuate the destruction of reputations and careers of valuable and well meaning individuals in the institution..
The medical team considered the issue and ruled in the midst of the family and this writer that they could not accede to the family request, due to the legal implications and the possible effects of the negative publicity that may develop as a consequence of the actions of churches and other stakeholders.
Disappointment and tears were obvious on their faces, but there was nothing this nurse could do after taking appropriate ethical leadership on the position. This was indeed an ethical dilemma and it remained the same even after Jenkins died six weeks later. The family was spared further financial expenses, but may have lost trust in the hospital; especially the nurse whom they may have perceived failed then in their time of need.
Finally, the hospital may have been spared the bad publicity of an ugly lawsuit, but its reputation as far as that family and future families with similar problems were and will concern, will not escaped untarnished going forward, despite the fact that ethical leadership was exercised.
Ardelt, M. (2003). Physicians –Assisted Death Retrieved from: www.clas.ufl.edu/users/ardelt/physicians_assisted_Death.pdf on 01/30/2012
Brogden, M. (2001). Geronticide: Killing the Elderly Jessica Kingsley Philadelphia Attitudes and the Older Adults: Theories, Concepts and Applications edited by Adrian Tomas Brunner- Routledge, Philadelphia
Kass, L.R. & Lund, N. (1996). Courting Death: Assisted Suicide, Doctors and the Law Commentary 201 17-29
Osgood, N.J. (2000).Ageism and Elderly Suicide in Death The Intimate Connection pp.157-173