[Verified Answer]: Case Study: Ethical Decision Making at the…

Case Study: Ethical Decision Making at the End of Life An 87-year-old female resident has lived in your nursing home for three years. She was initially placed there by Adult Protective Services after her two daughters were determined to be stealing her medicines. She has end-stage Alaheimer’s disease, is noncommunicative, and requires total feeding assistance. Alving will is on file, indicating the resident’s wish for no artificial means of prolonging her life, and she is also under the care of a local hospice agency. One of her daughters now has power of attorney. The daughter approaches you with a copy of her mother’s membership certificate in the Hemlock Society, which advocates assisted suicide. (Assisted suicide is not legal in your state.) She also brings you a book published by the Hemlock Society. She claims that total feeding assistance is an artificial means of prolonging life and violates hel mother’s wishes. She asks that you stop the feeding and allow nature to take its course. The nursing staff reports that the resident eats relatively well. Her weight is stable, although she is assessed as being at high risk for pressure ulcers and weight loss. CNAs can tell you her favorite foods, based on facial expressions. She seems to especially like strawberry milkshakes; she smiles, smacks her lips, and sucks on the straw vigorously to the last drop. The nursing home’s ethics committee will be meeting with the daughters, hospice agency representatives, and the nursing home’s attorney. Case Study Questions What competing values should be considered in making your decision? What role could the long-term care ombudsman play in this situation? Both the decision and the process by which the decision is made should be considered highly ethical. What is the role of the health care ethics committee in this process? What preventive steps could you put into place in order to avoid similar situations in the future?