Reflective Response essay

Guidelines: Reflective Response essay should be written as a paper in APA format, including a separate title page at the beginning and references page at the end. Response has few, if any, grammatical, punctuation, or spelling errors. Paper should be 3-4 pages in length but is not to exceed four pages in length excluding the title and reference page. The paper should be evidence based. Simply stating an opinion without further elaboration or support will not earn full credit. You should take a clear stance in your work, but your position should be supported by appropriate, accurate sources outside of the textbook. Inviting introduction that draws the reader in and clearly defines point of view; concise concluding paragraph that does not introduce new ideas or information. Utilizes ANA Code of Ethics in analyzing the case study provided below Utilizes ethical argument while analyzing the situation Identifies, defines, and cites relevant ethical theories. (examples: Deontology, Utilitarianism) Explains how each ethical theory could apply to the case study. Identifies, defines, and cites relevant ethical principles( Examples of ethical principles: autonomy, maleficence, beneficence, justice, veracity, fidelity) Explains how the ethical principles come into conflict. Includes appropriate, accurate, and significant information from outside sources to support point of view. In-text citations provided. Information must be relevant to discussion and cited in proper APA format. Describes and refutes opposing point of view Paper is based off of the following: Reflective Response Case Study Baby K was born in an anencephalic state, (she was born missing almost all of her brain) with only the brain stem (the part of the brain responsible for control of respiration, the heartbeat, and blood pressure). She has no cognitive abilities or awareness. She cannot see, hear, or otherwise interact with her environment. She does have brain stem functions such as respirations and brain stem reflexes. When baby K had difficulty breathing on her own at birth, the hospital physicians placed her on a mechanical ventilator. The respiratory support allowed the doctors to confirm the diagnosis. They provided Baby K’s mother the diagnosis and prognosis of her condition. The doctors explained that most anencephalic infants die within a few days of birth due to breathing difficulties and other complications. Because aggressive treatment would serve no therapeutic or palliative purpose, the recommended that Baby K be provided only with supportive care in the form of nutrition, hydration, and warmth. Physicians at the hospital also discussed with the mother the possibility of a Do Not Resuscitate (DNR) order that would provide for the withholding of life-saving measures in the future. The physicians and the mother failed to reach an agreement as to the appropriate level of care for Baby K. The mother insisted that the baby be provided mechanical ventilation whenever the infant developed difficulty breathing on her own, whereas the physicians maintained that such care was inappropriate. The mother appealed to her firm Christian faith that all life should be protected. She said she believed that God would work a miracle if that was his will. Otherwise she believed God, not other humans, should decide the moment of her daughter’s death. As a result of this impasse the hospital sought to transfer Baby K to another hospital. This attempt failed when all hospitals in the area with pediatric intensive care units declined to accept the infant. All parties agreed that cost of care was not the issue. The mother was a member of an HMO that agreed to pay for all treatment. The mother was not married to Baby K’s father. Since the birth the father had been only distantly involved in matters relating to the infant. Neither the hospital nor the mother ever sought the father’s opinion or consent regarding Baby K’s medical treatment. Because of the mother’s continued insistence that Baby K receive ventilator support, the baby’s physicians requested assistance from the hospitals ethics committee in overriding the mother’s wishes. A three-person ethics committee consisting of a family practitioner, a psychiatrist, and a minister met with the mother’s healthcare providers. The committee concluded that Baby K’s ventilator support should end because “such care is futile.” It recommended waiting a reasonable time for the family to adjust to the idea of terminating aggressive therapy. If the mother refused to follow this advice, the committee recommended that the hospital attempt to resolve the matter through the legal system. In the meantime, Baby K was stable most of the time, needing ventilator support only occasionally. She was transferred to a local nursing home with the understanding that she would be returned to the hospital’s emergency room in the event of a respiratory crisis. Mary Hudson was a per diem nurse who worked from time to time in the emergency room of the hospital. From her conversations with other nurses, she knew that the ER might have to provide emergency ventilator support to Baby K when needed. She had a distinct sense that providing this kind of treatment in cases like Baby K’s was not the real purpose of nursing, although she understood that even the physicians who objected to the treatment as futile had agreed to the emergency ventilator support while the case was being settled in the courts. That did not completely settle the matter for Mary. Because the hospital had adequate staffing, other patients would not be at risk by providing the emergency ventilation. Nevertheless, she had a lingering discomfort when she realized that if she accepted future assignments at the hospital, she could well be forced to participate in interventions she considered useless and outside her understanding of the purpose of emergency room nursing. She wondered if it would be ethical to object to participating in this intervention. When considering this case study, reflect upon the following questions: 1. Can nurses and other healthcare professionals appeal to their understanding of their profession in refusing to participate in interventions sought by surrogates of patients who are critically or terminally ill? 2. Was the ventilator intervention consistent with good health care? 3. Is the preservation of life, no matter how futile, a fundamental goal of healthcare? 4. Does the preservation of life serve a purpose when the disease cannot be cured? 5. Is there indignity to the critically ill person to continue to maintain life? It is not necessary to answer these questions in your paper. They are provided as a guide for reflection. Please review the grading rubric before writing the paper in order to earn the full points available. Helpful hints from the teacher: Writing a paper using the ethical argument comes with its own unique set of challenges. Instead of merely presenting an overview of an issue you will argue for a specific position. Presenting the ethical argument from your position necessitates presenting counterarguments and refuting them. To ensure that your position on the issue is valid and sound you must cite appropriate sources. Once you have identified your topic you will need to make a list of all of the ethical terms, principles, issues, concepts and theories that could be used to argue for or against positions surrounding the topic. For instance you might consider the ethical theory of utilitarianism when looking at the topic of violations of autonomy in cases of paternalism. Could using a paternalistic viewpoint could be supported with this theory? Or could the ethical theory of deontology support a viewpoint against the use of paternalism or vice versa? Consider what other ethical principles might be associated with a violation of autonomy. After you have made your list of all the specific items that could be used group them in some way. Usually this is done by grouping them in the “for” or “against” column. Next develop your main statement. This is the fundamental position you will be arguing. Making the proper central position statement is critical. For instance you might state “It is ethically wrong for health care providers to act paternalistically towards patients in violation of their autonomy.” Think about what this statement says. You must first identify what is meant by ethically wrong, paternalism and autonomy. To strengthen your position you will want to research the topic. For instance you might cite an ethicist who has made a statement supporting your topic. Pay attention to the quality of your ethical argument. Each conclusion that you draw must be supported by premises and cited by evidence. My Suggested websites that can be used A reference book used in class is the following: Ethics Issues in Contemporary Nursing, Fourth Edition, Burkhardt & Nathaniel Thank you!

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