Showing posts with label ethics. Show all posts
Showing posts with label ethics. Show all posts

Saturday, April 4, 2009

The Trick of Humanity

I spent the first day of pediatric clinicals in the intensive care unit. My patient was very young, under one year, born with congenital anomalies that included a heart defect, this one specifically, choledochal cysts and biliary atresia, meaning that she needed both open heart surgery and a liver transplant. She received both, preceded by a miriad of other surgies. When I cared for her, she was nine days post-op. I counted eight IV lines going into her body, exclusive of her pacer wires, NG tube, Jackson-Pratt drain, CPAP and ventilator.

I didn't mind the PICU so much as I expected. In fact, pediatrics seems like a place I would be excited to work, a great surprise to me. Maybe it's the timing. The most significant obstacle would be coming to terms with advanced technology out-sizing the patient. Following yesterday's rotation I felt like this was a huge moral dilemma, so I sought out reserach on the subject and found an interesting article that takes on the distress that PICU nurses face in the wake of modern technology that outpaces moral questions about life at any cost. The authors ask how medical and "life-saving technologies are outstripping our human abilities to comprehend and live with the consequences". Certainly a very worthy ethical question and definitley one that represents what I find the most difficult aspect of peds: what it means to be humane. To me, it looks like humanity tricking us again.

Saturday, February 7, 2009

Substituted Judgment

An interesting article, provided me by The Partner, describes the application of suspended judgment among first-year medical students, wherein patient self-determination is preserved in the face of loss of ability in autonomous decision making via appropriate, designated surrogate. The results are very interesting and an important consideration for all health care providers. It's the conundrum of best interest of the patient, medical judgment or family wishes placed against patient self-determination. As a nurse and 'patient advocate', you think you know what you would do, don't you? It's worth rethinking because it's a very tricky ethical dilemma.