Guido’s MORAL Model

Assignment:

Complete both case studies:

1.  Apply Guido’s MORAL model to resolve the dilemma presented in the case  study described in EXERCISE 4–3 (Guido textbook). How might the nurses  in this scenario respond to the physician’s request? How would this  scenario begin to cause moral distress among the nursing staff, and what  are the positive actions that the nurses might begin to take to prevent  moral distress?

2.  Read the case study entitled You be the Ethicist, presented at the end  of Chapter 3 (Guido textbook). What are the compelling rights that this  case addresses? Whose rights should take precedence? Does a child  (specifically this competent 14-year-old) have the right to determine  what will happen to him? Should he ethically have this right? How would  you have decided the outcome if his disease state had not intervened?  Now, examine the scenario from the perspective of health care policy.  How would you begin to evaluate the need for the policy and the possible  support or lack of support for the policy from your peers, nursing  management, and others who might be affected by the policy? Do the 10  framework questions outlined by Malone in chapter 4 (Guido textbook)  assist in this process? Create a process proposal for the organization  with possible guidelines, procedures, and policies to address the issues  you have identified.

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EXERCISE 4–3

Mrs. R., an 87-year-old patient, has a past history that includes coronary artery disease, a previous stroke, and advanced Alzheimer’s disease. Ten days ago, Mrs. R. was hospitalized for aspiration pneumonia and has been ventilator dependent since being admitted to the intensive care unit in a small rural hospital. Family members visit daily and have repeatedly voiced their concern to the nursing staff about the continued ventilator support that Mrs. R. is receiving, most notably the fact that Mrs. R. would never have wanted such care. They also note that Mrs. R. has not recognized them in past months and that they plan to visit less in future days, but can be contacted should any change in Mrs. R.’s condition occur.