Nursing Ethics: Analysis of End-of-Life Issues and Codes

This nursing ethics assignment analyzes end-of-life issues in healthcare, focusing on a case study involving a patient with irreversible brain damage. The paper explores ethical principles such as autonomy, beneficence, justice, and non-maleficence, discussing their relevance to decisions about life support and futile therapy. It argues for removing life support based on the principle of justice and considers the hospital's mission to provide affordable healthcare. The assignment also examines the most important aspects of the nursing code of ethics, emphasizing beneficence and justice, and identifies areas needing further clarification, particularly regarding patient autonomy in end-of-life situations. Furthermore, it differentiates between legal and ethical considerations, highlighting the alignment between the code of ethics and the hospital's mission and values, emphasizing quality and affordable care.

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Nursing Ethics
Name
Institutional Affiliation
Date

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Relevant End-of-Life Issues in Health Care Ethics relating to the Case Study
Several end-of-life issues relate to Tony’s case. For instance, autonomy, where the client
has the freedom to make decisions about his or her health (Bossaert et al., 2015). However, if the
individual is incapable, a surrogate makes decisions for the patient. In this case, Tony has
suffered brain damage and cannot decisions. The family has the right to make decisions for the
patient. Another issue is the restriction of care and futile therapy. Expensive modern treatment
such as ventilation may be futile in some case leading to increased healthcare costs (Bossaert et
al., 2015). There is a need for shared decision-making in case treatment is ineffective during end-
of-life to reduce healthcare costs.
Termination of Life Support
The hospital should remove life support because the patient suffered brain death which
cannot be reversed. The most appropriate principle of ethics, in this case, is justice. It would be
unfair to provide life support to the dying patient, Tony whose brain damage cannot be reversed.
Instead, the therapy should be provided to other patients in the facility, mainly because there are
limited resources (McDermott-Levy, Leffers & Mayaka, 2018). Furthermore, futile therapies
increase healthcare costs. However, the hospital should explain to the family and make a shared
decision.
My view is not supported by our professional code of ethics which, in this case, is the
nursing principle of ethics. Non-maleficence states that nurses should not perform interventions
that would harm the patient. In this case, removal of life support is against non-maleficence
because the family will consider it as harmful to the patient.
My view is consistent with the mission of the local hospital. To illustrate this, the
hospital’s mission is to provide quality healthcare to the community at affordable prices

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(McDermott-Levy, Leffers & Mayaka, 2018). In this case, stopping the end of life support would
reduce the cost for Tony’s family. An accrediting body would support my choice because they
will also base their decisions on the fact that the patient’s condition is irreversible, and further
treatment would be increasing costs without positive outcomes.
The Most Important Item in the Ethical Code
The principles of beneficence and justice are the most important principles among the
nurses’ code of ethics. The reason is beneficence ensures nurses’ interventions are beneficial to
the patient (Preshaw et al., 2016). Also, patients will be guaranteed for quality healthcare. Justice
ensures all patient are treated equitably without discrimination. Hence patients from various
background will receive healthcare from the hospital fairly without discrimination from the
healthcare providers.
Parts of the Code that need to be addressed
I would like to see the principle of autonomy addressed in more depth. Patients have the
right to make decisions about their health. However, I would like the issue of decision-making
during the end, or life is addressed more in-depth because there are cases patients may make
decisions to receive interventions that would prolong despite the fact their conditions may be
irreversible (Romo et al., 2017). In such cases, healthcare providers should explain to the patient
and their families about irreversible conditions and the benefits of terminating care.
Distinction between what is Legal and what is Ethical
The code of ethics does not make a clear distinction between what is legal and what is
ethical. For instance, the law would protect healthcare providers who terminate life support
interventions due to futility. Besides, termination of treatment after receiving patient consent is
legal (Sinuff et al., 2015). However, non-maleficence requires that the interventions that nurses

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take should not harm the patient. Hence, stopping the treatment of a patient at the local hospital
would be considered illegal because it is unethical (Sinuff et al., 2015). Adherence to non-
maleficence will require nurses not to stop treatment as it would harm the patient.
The Code of Ethics and how it align with the Mission and Values Statement of the Hospital
The mission of the hospital is the delivery of quality and affordable care to enhance the
health of patients and the community at large. The value statement of the hospital is facilitating
collaboration with individuals to assist them to live a healthy life and develop societies that are
among healthiest in the country. The code of ethics aligns with the mission and values of the
hospital. To illustrate this, one of the principles is beneficence which states that nurses should
perform interventions that are beneficial to the patients (Vryonides et al., 2017). This includes
delivery of quality healthcare which is as per the mission of the hospital. The nurses at the
facility ensure patient safety is guaranteed, which form part of quality healthcare. For instance,
nurses provide appropriate treatment to the patient and on time. Also, the principle of justice
aligns with the value statement of the healthcare facility. To illustrate, adherence to the principle
of justice ensure nurses provide equitable care to patients without discrimination. This ensures
the hospital collaborates with all patients and other members of the community without
discrimination to assist them in living a healthy life.

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References
Bossaert, L. L., Perkins, G. D., Askitopoulou, H., Raffay, V. I., Greif, R., Haywood, K. L., ... &
Xanthos, T. T. (2015). European Resuscitation Council Guidelines for Resuscitation 2015
Section 11. The ethics of resuscitation and end-of-life decisions. Resuscitation.-Limerick,
1972, currens, 95, 302-311.
McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of
global health nursing practice. Nursing outlook, 66(5), 473-481.
Preshaw, D. H., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by
healthcare workers in nursing homes: literature review. Nursing ethics, 23(5), 490-506.
Romo, R. D., Allison, T. A., Smith, A. K., & Wallhagen, M. I. (2017). Sense of control in end‐
of‐life decision‐making. Journal of the American Geriatrics Society, 65(3), e70-e75.
Sinuff, T., Dodek, P., You, J. J., Barwich, D., Tayler, C., Downar, J., ... & Heyland, D. K.
(2015). Improving end-of-life communication and decision making: the development of a
conceptual framework and quality indicators. Journal of pain and symptom
management, 49(6), 1070-1080.
Vryonides, S., Merkouris, A., Charalambous, A., Eleftheriou, C., Andreou, P., & Papastavrou, E.
(2017). The types of ethical climate as related to missed nursing care in cancer care units.
12th World Conference on Bioethics, Medical Ethics & Health Law.