devry hsm542 week 2 Written Assignment latest 2016 may

devry hsm542 week 2 Written Assignment latest 2016 may

Just Turn This Thing Off!
A nursing assistant wheels Margie Whitson back to her room at
Golden Oaks Rehabilitation Center and helps her back into bed. Golden Oaks is
located on the grounds of Marion General Hospital, owned and operated by the
hospital board of directors.
It has been a very difficult day. Margie takes a deep sigh as she
leans back into bed and says, “I’ll get into night clothes in a few minutes if
that’s alright. I’d just like to sit here and think for a little while.” The
nursing assistant nods in agreement
Margie has just attended the funeral of her son William, who died
this week after several years of poor life quality in the same nursing
facility. William’s first stroke happened 3 years prior; two more strokes
followed, and he lingered in poor health at the center over the intervening
time. Margie is now 95 years of age, and William was 73 when he passed this
The last 5 years have simply been devastating for Margie. First her
husband Earl passed on at the age of 88. They had been married for 68 years,
most of them wonderful and successful years together, until the medical
problems began. They had one other son, Jacob, who died in a motor vehicle
accident in his 30s.
As Margie sits in the quiet of her nursing home room, she faces
the reality that she is utterly and completely alone in the world. She and Earl
had hoped for grandchildren, but that never happened, and Margie’s family is
simply all gone now. Margie’s own health is poor. A hip fracture 10 years ago
slowed her down significantly, and a heart attack 2 years ago nearly took her
life. But she survived due to good emergency medical care and quick placement
of an electronic pacemaker. Margie’s heart rhythm is now 100% paced, meaning
that her heart will not function effectively without the pacemaker; she is
completely dependent on the pacemaker for her survival.
Margie is a woman of great personal faith, raised that way, and
she raised her sons that way. She believes strongly that Earl, William, and
Jacob are waiting for her in heaven. And as she sits alone in her nursing home
room, the realization comes to her—the only thing keeping her from joining her
family in heaven is this pacemaker. And the pacemaker is nothing more than an
electrical device. It was turned on to save her life 2 years ago, and now it
can be turned off. She should have the right to turn it off! Margie presses the
nurse call button and says, “I need to see that lady who’s in charge of this
place, and right now please.”
When Nursing Home Administrator Cindy Mackin enters the room and
listens to Margie, she can hardly believe what she is hearing. “I’m telling you
I just want you to turn it off. I’ve had enough; there is nothing left for me
here on earth and I just need to go now and be with my family.” Cindy responds,
“Now, Margie, you’ve had a terrible time lately, and naturally you are grieving
the loss of your son right now. Things will look better tomorrow.” But Margie
does not think so. She says, “Call Dr. Vijay for me; he turned this thing on,
and he can turn it off. I insist.”
Cindy realizes that Margie does have a right to discuss this or
any other matter with her doctor, and she arranges a visit for the following
week. At the cardiology clinic, Margie is increasingly insistent about her
demand to deactivate the pacemaker. Dr. Vijay comments, “Margie, I’ve practiced
cardiology for nearly 20 years now, and frankly I have never had this request.
The pacemaker is keeping you alive, and that is of course what we do in
medicine—we save lives. I do not feel that I can ethically deactivate your
pacemaker. I know that you have had some very difficult experiences lately, and
perhaps you will feel differently with a little time passing.”
Returning to Golden Oaks, Margie is absolutely fuming, and now she
is determined. The same determination that carried her through life and made
her such a great wife and mother is now rising in her to make her own decision
about how and when to end her own life. She asks to see the Golden Oaks social
worker, and Jane Robison, MSW, is summoned. After more than an hour of
discussion and exploration of every option that Jane can imagine, Margie
persists in her request. “Well, Margie, we do actually have a process to help
in difficult situations like this, when patients, families, and doctors
disagree, through the hospital ethics committee, and I think that we should
take your case there for review. I happen to know that the ethics committee
meets next Friday, and the chairman is a colleague of mine who is our director
of social services.”
Your Assignment
You are David Jamison, MHA, ethics committee chairman at Marion
General Hospital. Coming before your committee today is the case of Margie
Whitson, age 95, who wishes to have her pacemaker deactivated. Her physician,
Dr. Rana Vijay, has declined to honor her request in this matter, citing
ethical concerns with such an action. It will be your job to thoroughly analyze
the issues in this case and to make a recommendation from the ethics committee.
Key Players

Margie Whitson

Patient, Female

Rana Vijay, MD

Cardiologist, Male

Jane Robison, MSW

Social Worker, Female

Cindy Mackin, CNHA

Rehabilitation Center Administrator,

David Jamison, MHA (This is your

Ethics Committee Chairman, Male

You Decide
or Assignment
Prepare a two–three page paper analyzing the key issues in this
case and stating a recommendation. Be sure to include the following steps in
your analysis.


Identify the dilemma. What
morals are involved? What morals are in conflict?


Get as much information as
possible about the dilemma. Often this step is taken too quickly, without
enough solid and detailed information, leading to bad decisions.


Talk with other healthcare
professionals on the case. Do they agree that there is a dilemma? Do they
concur with your understanding of the dilemma? Do you know everything that they
know about the case, and vice-versa?


When all the talking is
done, a choice needs to be made about what to do regarding the dilemma. A
choice must be made. Even choosing not to decide is a decision!
Your role here is to prepare a recommendation on behalf of the
ethics committee, with input from all participants, considering the best
outcome for the patient as the ultimate goal and highest priority.

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