Ethical decision making

Read the following case and then answer the questions related to the case. 
Geraldine (Gerri) Bowen is a 74 year old woman living with dementia. Her husband passed away one year ago. He was her primary care giver, although he had contracted for a daily caregiver to help Monday through Friday with Gerri’s activities of daily living and also so that he could run errands such as banking, grocery shopping, etc. Since his death, the family (three sons and their wives) set up 24 hour care giving because Gerri wants to live at home and not in an extended care facility. Recently, Gerri had complained of abdominal discomfort and has frequent diarrhea. After some diagnostic tests (a lower GI, a CT and abdominal MRI) she was diagnosed with Stage 3 (late stage 3) colon cancer. In addition, Gerri has a right lower lobe lung lesion. The surgeon feels that it is most likely not metastasis, but a second primary cancer. The surgeon recommends palliative surgery, since Gerri will not benefit from radiation or chemotherapy. 
You are the nurse caring for Gerri after her colon resection and over hear the family discussing what they should be telling their mother. Gerri asks you, “no one is telling me what is going on. It’s not right. I don’t want to stay here (the hospital) I just want to be at home. I don’t like all these people around me.” 
You tell the oldest son that Gerri has asked questions about her condition on several occasions. He tells you that he and his brothers cannot agree whether or not Gerri should be told about her condition (the cancer). He advises you to tell Gerri that nothing is wrong. While two of the sons want their mother told, the third son feels it would be cruel to tell her because she isn’t completely “there”. Gerri recognizes her family and recalls the past all of the time. She often has difficulty expressing her feelings and recalling the immediate past. But it is your opinion that she does understand some things. 

What is the dilemma in this case? 

What are the relevant facts in the case?

List two (2) questions you would ask to gain more information about the case. Explain why you chose these two questions and how this information will help you to make a decision. 

Identify the sections of the ANA Code of Ethics for Nurses that apply (Include BOTH the provision and section). Justify your choice(s).

Who are the key participants/stakeholders? Why are they “key” to this case?

Identify three (3) potential strategies to address this case. (Note: the strategies must be separate and different from one another.)

Which ethical principle(s) are pertinent to this case? Justify your choice(s).

What should be done? Does Gerri have a right to know that she has stage 3 colon cancer? Why or why not? Support your answer.


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