NU4027 Nursing Ethics

Questions

Case 1

I was working on a mixed ward for more able intellectually disabled residents. Mary was 54 years of age and approximately two stone overweight according to her height-weight ratio. She enjoyed her food and had no medical problems. However, the ward sister decided that she should be placed on a reducing diet. Mary was generally well behaved and was capable of going into town on her own, dressing herself and maintaining her own hygiene. However, after a few days of being on her diet, she was caught stealing food from other residents and on more than one occasion, taking food from the rubbish bins.    


On one particular Friday, it was fish on the menu. All of the other residents had fried fish and chips, but Mary was given boiled cod. She expressed her dislike of the food and said she did not want to eat it. One of the qualified staff forced her back into her seat and repeatedly shouted at her saying, ‘You will eat this food’. When Mary still refused, the nurse attempted to force feed her.
Mary became very distressed over the incident and gradually appeared withdrawn and depressed. I spoke to the ward sister, saying that I felt it was unkind, that Mary should have some choice in the matter of her diet especially as she was a voluntary resident, and that force feeding isn’t even allowed in prison.

The sister brushed aside my complaints saying, ‘It will be good for Mary to lose weight and anyway we can’t let her get the better of us, can we?’. The sister’s attitude was made much worse by the fact that she herself was at least three stones overweight.

Identify and discuss at least one of the ethical issues that arise in this case with reference to appropriate ethical principles and values or any relevant duties imposed by professional and legal standards.

Case 2

A young mother, whom the High Court ordered should be given a blood transfusion against her will in a bid to save her life, was recovering at a Dublin maternity hospital last night. The 23-year-old Congolese woman suffered massive blood loss following the birth of her first child at the Coombe Women’s Hospital early yesterday. However, speaking in French and through an interpreter, she told hospital staff she did not want a blood transfusion as she was a Jehovah’s Witness.    

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The hospital’s master, Dr Chris Fitzpatrick, rushed to the High Court for direction and, at an emergency lunchtime sitting, Mr Justice Henry Abbott was told the woman, known only as Ms K, had lost 75-80 per cent of her blood and was likely to die within hours unless a transfusion was authorised by the court. The judge directed the hospital to do everything in its power to save the life of the woman and said staff could restrain her if she physically attempted to stop doctors administering to her a life-saving transfusion. He said the interest of her newborn child, a boy, who he was told was ‘in good shape’, was paramount and the baby could be left with no one in the State, as far as was known, to look after its welfare, if its mother passed away. (Eithne Donnellan, The Irish Times, 22 September 2006)
 
Identify and discuss at least one of the ethical issues that arise in this case with reference to appropriate ethical principles and values or any relevant duties imposed by professional and legal standards.
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