What is it about the prospect of renal dialysis that stimulates the raising of the treatment-redirection process?

Discuss some of the common pitfalls associated with the system acquisition process and how those issues can be avoided. Provide substantive responses to two of your classmates. Support your ideas with research from our course sources and/or outside, scholarly sources.

Composed of a minimum of two – three paragraphs – at least 500 words.

Use the following questions as guides in discussing the ethical implications of the preceding case.

 

• Does it make a difference which stakeholder raises the question about treatment redirection? What would have happened if Barney had raised objection to the course of treatment? The nurses, doctors, or Almeda herself?

 

• Does the absence of advance directives complicate or simplify the treatment redirection process?

 

• Is Barney an appropriate substitute/surrogate decision maker to consent to treatment redirection to palliative care?

 

• Should some “official” or “legal” action be taken in order to proceed with a treatment redirection process?

 

• What would Almeda prefer if she were able to contribute to the discussion?

 

• Is Barney’s statement of a goal for Almeda adequate to justify continuing aggressive curative treatment?

 

• Is there evidence from the case text that the attending physician has been active enough in trying to inform and persuade Barney to consent to treatment redirection?

 

• What should have been the point of view of the nursing staff if Almeda was slowly getting better? What if she were neither improving nor getting worse?

 

• What is it about the prospect of renal dialysis that stimulates the raising of the treatment-redirection process? Why not when the gastric tube was inserted? Or when the ventilator was started?

 

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