Nursing Ethics

Paper Summary:

The paper overviews ethical concerns and the nursing practice standards in palliative care settings. The paper focuses on the ethical implications of the DNR (do not resuscitate) order from the nursing perspective. The paper maintains that good palliative care is all about reducing the distress of the patient as much as possible and helping him attain a peaceful end. The paper asserts that this can sometimes demand a sense of moral detachment.

Outline:
Introduction
The DNR (Nursing Implications)
Conclusion

From the Paper:

"The DNR (do not resuscitate) order is a request which advices against the use of Cardiopulmonary resuscitation for revival of the heart function of the patient who has a cardiac or pulmonary arrest. Typically, the request for DNR is given as an advance directive by the patient, but in cases where the patient is in comatose state the physician discusses it with the family before recording the DNR order. [Hanna Mari Hilden et.al, 2004] The DNR order in effect takes away the obligation on the part of the attending nurse or the physician to revive the failed heart using CPR. Nurses in palliative care have to face cases where the DNR is applied consistent with the patient's autonomy."

Sample of Sources Used:

• EPEC Team, "Last Hours of Living", Accessed on March 16th, 2007 http://www.ama-assn.org/ethic/epec/download/module_12.pdf
• Field D, James N 1993 "Where and How People Die: The Future of Palliative Care", Open University press
• Steve Lliffe, Linda Patterson & Mairi M Gould, 1998, "Health Care for Older People ", BMJ Books.
• Ariana G Gross, 'End of Life Care: Obstacles and Facilitators in the Critical Care Units of a Community Hospital', Journal of Hospice and Palliative Nursing, Vo8, no 2 Mar Apr 2006
• Hanna Mari Hilden, Pekka Louhiala, Marja Lisa Honkasalo and Jorma Palo, "Finnish Nurses Views on End of Life Discussions and a Comparision with Physicians Views", Nursing Ethics, 2004

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