Palliative Care | Case Study

Running Head: Nursing
Palliative Care
Name of the Student
Name of the University
Authors Note

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Introduction
End of life care or palliative care contains different standards and ethical principles
to serve the critically ill patient .The assignment is focused on a 20 year old boy john, who is
suffered from renal disease and was in the last stage of that disease. The Aboriginal boy
wanted to withdraw all the treatment facility and return to the aboriginal village from the
hospice care. As a registered nurse, different ethical principles should be maintained during
the patient’s treatment. The responsibility of registered nurse to assist the interdisciplinary
team members during palliative care with upholding ethics and standards of the care. This
assignment will focus on ethical consideration during end of life care treatment of John.
Discussion
Collaborative ethical decision making with interdisciplinary team
The physicians informed John that without dialysis he could not survive more than
three months during treatment. He wanted to withdraw all the life support and did not want to
take any help of assistance. He wanted to return to his home in the remote indigenous
community for spending his last days with his family and community members. However,
there is ethical dilemma to the healthcare providers as quality care might not be delivered in
the remote community. Ethical principles such as Clinical integrity, Respect for persons,
Justice and Benefit to the person with self-determination, truth telling, confidentiality and
informed consent (www.pallcarevic.asn.au.,2020). Ethical guidance and decision-making for
the end-of-life care are based on different factors such as alternation of context in the
treatment, relation between the team and the patient, collaborative nature of the team,
consensus building model, accountability and importance of palliative care for the patient.
Standards of the palliative care should be considered during the care plan of the critically ill
patient (www1.health.nsw.gov.au. ,2020). The team must assess the needs, develop a care

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plan take care of caregivers, provide treatment , maintain transition within and between
service, provide grief support, maintain the service culture, improve the quality of care and
emphasizes on trainings and qualification of the staffs.
Here, John did not want to continue hospice care so the principle of palliative care is
to respect the patient’s autonomy is maintained but primary goal of the treatment to preserve
life has not been managed. “Right to know and chose” and “withdrawing life sustaining
support” are maintained (www1.health.nsw.gov.au. ,2020). However, in multidisciplinary
teams disagreement might occur on withdrawing life supports. A collaborative care plan for
the patient must be chalked out by the team for the patient with the help of his family and
community members. Advance care plan is needed for the situation as any circumstances can
arise during the last days of the patient. Therefore the health professionals must use
“Advance Care Directives (NSW)” to treat the patient (Nguyen et al., 2017). Nurses and the
clinicians must execute their respective duties regarding administering medication and
educating patient with his family by the help of different ethical guidelines.
Identification and explanation of ethical decision making of interdisciplinary
team
The inter disciplinary tem should assess the needs of the person and after that take decisions
according to the ethical principle of palliative care. As a registered nurse and active part of
the interdisciplinary team , I understood that two ethical principles should be maintained
during John’s treatment. Decisions should respect his will and beneficence of the patient
according to his needs. Some issues can evolve regarding respecting the patient in the last
phase of his life , the issues are involving the person in the medical decision making and
provide all information regarding the chronic illness to the patient (McCreary, 2019).
Respecting the wishes of the patient might put the medical professionals to the ethical
dilemma as John does not want to continue the treatment in hospice care. Therefore a careful