How will you prepare for the upcoming meeting with the hospital ethics committee? What issues do you expect will come up during that meeting?

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 have discovered early-stage
liver cancer.
The patient has been in a comatose state ever since
admission, unable to communicate or move. 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 office wants to know if she can be discharged from AICU,
which costs the hospital $20,000 per day, 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 have 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 ‘covering the story’ although
they have not publicly disclosed the patient’s name. The state governor 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 governor’s
challenger (whose daughter is a nursing student in AICU) says there is a moral
duty to care for everyone.
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 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 have been prepared to
make this situation easier? o Address and analyze privacy issues.
o Are there any federal laws that are relevant 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?

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