Mr X, an 89-year-old man, has been admitted in extreme pain with urinary retention. He has prostate cancer with multiple secondaries throughout his abdomen. He is middle European in origin and has limited English. His distraught wife and two sons are with him – both sons speak fluent English. Effective analgesia has been provided and he is sleeping when the surgeon arrives to see him. The surgeon speaks with the sons and explains that the situation is terminal and that only palliative surgical measures will be undertaken to relieve his symptoms. The sons request that their father not be given his diagnosis. They explain that culturally it is the role of the family to be the decision-makers during illness and that their father would not expect to be involved. Furthermore, they all believe it would be detrimental to their father’s wellbeing for him to be given a terminal diagnosis. The surgeon reluctantly agrees to this request because the sons are so adamant about their cultural practices. He tells Mr X that they will insert a suprapubic catheter later that day ‘to bypass your blockage and sort out your pain’. However, when you are caring for Mr X, during that day, he constantly asks you, in his limited English, whether or not he is dying. How would you deal with this situation? (Staunton & Chiarella, 2013, pp. 28-29)
Question 2: Describe the process of ethical decision-making. In your answer you must refer to the following as they relate to Mr X in the case study: Code of ethics (NMBA) Cultural diversity Informed decision-making and Consent Ethical concepts and principles in nursing Autonomy Beneficence Non-maleficence Confidentiality Justice Rights Veracity
Question 1: a) What is your understanding of the following terms?
Power of Attorney (POA) Enduring Power of Attorney (EPOA) Advanced Health Care Directive (AHCD) Guardianship