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Nursing Ethical Principles II

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Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
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Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding

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Ethics Roundtable: Advance Directives, Autonomy, and Gastrostomy Placement.

Steven J Baumrucker¹, Gregg VandeKieft², Eddy R Smith³

¹Ballad Health System, Kingsport, TN, USA.

The American Journal of Hospice & Palliative Care

|November 14, 2022

Summary

This summary is machine-generated.

A 94-year-old male refused nutritional support but his family pursued percutaneous endoscopic gastrostomy (PEG) tube placement. An ethics consult was requested due to conflicting patient wishes and family demands.

Keywords:

advance care plan advance directive enteral feeding ethics living will surrogate decision-making

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Area of Science:

Geriatric Medicine
Bioethics
Palliative Care

Background:

A 94-year-old male with a history of stroke and frailty presented with new weakness and altered mental status.
The patient had previously and consistently refused nutritional support, expressing a desire to forgo life-sustaining treatment.

Observation:

Despite prior refusals, the patient's family, including his designated surrogate, requested a percutaneous endoscopic gastrostomy (PEG) tube.
The surgical team assessed the patient as lacking capacity and proceeded with scheduling the PEG tube placement.

Findings:

A conflict arose between the patient's stated wishes for end-of-life care and his family's request for aggressive medical intervention.
The medical team initiated an ethics consultation to navigate this complex ethical dilemma.

Implications:

This case highlights the challenges in respecting patient autonomy when capacity is diminished and family wishes diverge.
It underscores the importance of advance care planning and the role of ethics consultations in resolving conflicts at the end of life.