I believe that the Nurse should continue to respect Marie's wishes and give her the pain medication. The principle of self-determination is a right that every competent adult has regardless of cultural context. Marie was in a lot of pain. If the nurse would educate Jean on the side effects of heavy doses of pain medication maybe he would see that what he truly is seeing are in fact side effects and not evil spirits. Although it is important to respect religious beliefs, it is also important to respect Marie's wish to die without pain. If the nurse was to lower the dose of the pain medication Jean would see how much Marie is suffering. If he was present for that suffering maybe he would change his mind on lower the dose of the drug. I think that sometimes being uneducated on what is happening can cause misunderstandings. It would be best for both Jean and Marie if the nurse sat Jean down and discussed what was going on in a respectful manner.
I think the nurse should continue to care for Marie's wishes until told by Marie herself otherwise. Even in difficult situations, a nurse's job is to care for the patient first, and the family if needed second. She may (HIPPA allowing) discuss Marie's situation with her brother and go into detail the significance of her need for pain medication. She should also explain side effects of pain medication and the effects of withdrawaling the pain medication from her relating to the amount of pain she would be suffering. In the end of a life situation, a person may wish to neglect their initial wishes when presented with a great deal of pain. Withdrawaling treatment because of a demand of a family member is not an adequate form of treatment. The issue of self determination revolves around every competent patient regardless of their ethicity, culture, race, religion, social factors. The nurse must first treat her patient to the best of her knowledge and then worry about offending her family. Even though it is hard, this is another example of how a patient's wishes, goals, and treatment must come first.
I agree with Lindsay and Christy. The nurse should respect Marie's wishes if she stated them before. I would have a hard time as a nurse standing up to the family of a ill patient even when it is in the patient's best intrest. I know it might not be helpful but maybe the nurse could try to talk to Jean about the medication and see if he could talk rationally and ask any questions. I believe the principal of self-determination does apply to adults regardless of cultural influences. I think by still giving Marie the medicine, it may offend her family but it would be in her best intrest. I would want to follow the patient's wishes.
I agree with the 3 girls above me, the nurse should respect what the patient wants. If the family wants something else then it should be talked about with the patient then the patient should tell the dr. and nurse what exactly she wants. The family cannot tell the nurses and doctors things for the patient if the patient wants something. So as a nurse, they should always check with the patient. I agree with Jenna in saying that i would also have a hard time standing up to the family of a patient when they want something different than the patient themself. I would still continue to give the patient the medication because that is what the patient wants, and i don't really care what the family says.
I like the others agree that the nurse should respect Marie’s wishes for pain medication to manage the pain she was experiencing related to her terminal lung cancer. The nurse should educate Marie’s brother Jean on the side effects of pain medication in heavier doses used to manage end of life pain and as Lindsay described the nurse should explain Jean’s sister’s condition best she can without violating the regulations of HIPPA so that he understands the pain associated with terminal cancer. I feel that in this case the issue of self-determination applies to Marie’s wishes and the nurse should do her best to uphold those wishes regardless of cultural context because Marie was a competent adult at the time of her decision. If Jean still disagreed with the medications administration after the nurse’s explanation of it then yes, the nurse might be failing to respect Jean’s beliefs in order to respect Marie’s wishes. However, like Christy said I think open and honest communication is the best way to approach the situation.
I believe like the others that the nurse should respect Marie's wishes for pain medication. At the time she was competent to make the decision to request pain medication. As Melissa said, the brother should be adequately informed of the side effects of the medication, in order to minimize his anxiety. Due to the competency of Marie decision, I believe the principle of self-determination does apply in this case. I believe the medication should continue to be administered to Marie, overall we have the patient's best interest at heart, and at times the family's values conflict with our values as health care professionals, and this leads to huge controversy. However in the long run the patient's wishes need to be respected, and the family's values need to be taken into consideration, but you can't always have it both ways, and sometimes you just have to choose what will be the most beneficial for the greater number.
I agree that the nurse should continue to care for Marie's wishes. Given this consideration, it is extremely important for the nurse to explain to Jean the need for the medicaton, the side effects of the medication that had been administered, and the problems or issues related to not giving the medication. In this way, it would not be disregarding their cultural or spiritual beliefs; it would be taking action according to nursing priorities. In this case, I believe that Marie's pain takes priority, but the nurse should still be sensitive to the cultural influences on Marie's care.
If I was the nurse, I would respect Marie’s wishes regardless of the cultural context and give her the pain medication as needed. Marie was an adult when she made her decision, but I would also consult to her brother. I would also inform her brother of her wants’ and let him know everything that he needs to know about different side effects from the medication. As a nurse I would be sure to help Jean understand anything he didn’t and try to answer questions he may have about his terminal sister. This case is hard because you wouldn’t want to see a family member suffer ever but you would also want the best for them when it’s their time. I would be just as worried as jean if it was my sister and be wanting to do anything for her, even if it is giving her some extra pain medication to ease her pain at the end of her life.
It seems that I am not in the minority here that I believe that the pain medication should be continued to be given unless Marie specified otherwise. Although her brothers subscribe to these religious beliefs, we do not know if Marie herself does, and without that knowledge, we need to continue to act on the assumption that she would want her treatment to continue as she specified previously. As someone mentioned above though, it is important to make sure that the family understands as much about her treatment as possible in order to be sure to get as much consent as possible. It is also necessary to be sure to explain to the family why it is that their wishes for the removal of pain medication are not being honored.
Brittany Buechel: I, as everyone else, believe that Marie's pain relief treatment should be continued. If i were the nurse, I would explain Marie's situation, listen to the brothers concerns, and talk to marie about her brothers concerns. Even though her brother believes that she is has evil spirits in her, he is not experiencing the pain that Marie is. Perhaps if Marie can, at some point, explain to her brother how she is feeling and how much pain she is in, then the brother might understand. I believe all cultural contexts should be taken into consideration when taking care of patients of different culture backgrounds, but communication and education can do alot for those types of patients. If they know the side effects as well as benefits of all treatments, they are more likely to do what is best for their family. Since Marie was competent when she agreed to pain medication, then she should be granted her requests no matter what. The nurse is not failing to respect the religious beliefs of the brother, the nurse is just putting the patient first, which is what should happen. Marie obviously knows what she wants, the nurse should continue to do what was discussed.
I think the pain medication should be continued to be administered. Marie was competent in her decisions when she asked for the medication. As Marion said, we do not know if she follows those beliefs, but we also don't know if she decided in her mind to give that belief up because she was in so much pain. Jean may not know this either. Jean may not understand the pain that Marie was in. Like others said, he may not realize that these are simply side effects of the medication and that she will suffer greatly if not given the right amount of medication. Jean may only need to be educated about these things. I do think that continuing the administration of the pain medication is fails to respect these beliefs, but as I said before, Marie may have waived her beliefs when making her competent decision to have the pain medication. Jean is the only one asking for it to be reduced and I believe that it is Marie's right to decide what she gets and how much. I don't think her family should be able to do so since she was competent to decide on her own.
I think the nurse should continue administering the pain medication especially with Marie being competent in making the decision. I think the nurse should discuss the situation with Marie and with the brother also. This may also get Marie and her brother talking and then maybe Marie could explain about the pain to her brother. I do not think that continuing to administer the pain medication would be a failure to respect religious beliefs especially if the brother becomes educated on the pain and pain medication.
i believe the pain medication should continue to be administered because Marie was competent in her decisions when aking for the pain medication. Nobody knows if Marie followed the same beliefs as her brother or if she did if she still continues to follw them. Like Matt said, Jean may not understand the pain that Marie was in and he may not realize that these are simply side effects of the medication. i believe that the nurse should educate Jean about these side effects and try to explain that it is only side effects of the medication. i agree with Danielle that if the administration of the pain medication is continued it would not fail to respect these belief. However, We do not know the patients beliefs and should ask the patient of their beliefs before continuing further treatment. I believe Marie has the right to decide whether she wants the medication for pain or not because she was competent. If any person is to have an opinion to be considered it should be the parents or guardians after the patients own wishes.
I believe, as everyone else, that the nurse should continue to give Marie pain medication. She is competent and can decide what she wants for herself. It never says that Marie follows the same beliefs as her brother, so she should be treated as an individual. I also think the family should learn as much as they can about what Marie is going through so they can understand the reasoning for her continuation of pain medication.
I as a nurse would tell Jean that Marie, competant, requested pain medication and I was abiding by her wishes. If he disagrees then I would restrict pain medication until Marie was competant again and have her sign a consent as to what she wanted and if she becomes incompetant again who should make decisions for her. In the healthcare system the patient has the right to decide their own care if competant, not the family. Getting a consent from Marie would eliminate further issues with the family. Furthermore to be more respectful of the culture I would investigate the aspects of her and her family's culture to better provide care for Marie.
I believe that the nurse should continue to give the medication. It is NOT the result of voodoo, so why does it matter what the brother *thinks* is true. It indeed is a false assumption. You have to respect the religious rights of a patient. the patient wants the medication, therefore I think it should be given. If SHE did not want it for religious reasons, then that is a different situation.
I personally believe that Marie's brother cultural expression is going way too far and hard on her sister! The pain medication should be continued since 'lung cancer' is a serious disease and I can imagine how painful it must have been. I think the nurse should calm down Jean and talk him about the implications and benefits of the pain killers (that were requested by his consented sister). I also think that Jean was not reacting in a realistic manner since if he strongly believed in the voodoo then I suppose he couldn't have allowed his sister to be hospitalized. The principle of self-determination does apply to competent adults reagrdless of cultural context to a certain limit(when the decision the adult makes does not end up harming the majority but for the greatness of a majority). In most religions and other cultural beliefs it is always faith that matters alot. One might have the medication but it is believed that you receive the healing process by faith. Faith is a vital virtue that helps connect Science and Medicine with Religious and Cultural beliefs. Therefore, I disagree that continuing the pain medication to Marie entail a failure to respect the religious beliefs expressed by Jean. I know besides the cultural beliefs, Jean also wanted his sister to have a better health and safety. Even though sometimes traditions and beliefs do play a major role in the medication administration among the individuals, it is also important that they take Medicine into account.
Seeing as Marie was competent when she made the decision to request pain management, I believe this treatment should be continued despite her family's protests. The nurse should, in my opinion, attempt to explain to Jean that Marie's actions are a common side effect of pain management, and assure him that despite the seemingly traumatic situation, she is being kept relatively comfortable as a result of medication.
I believe that the Nurse should continue to respect Marie's wishes and give her the pain medication. The principle of self-determination is a right that every competent adult has regardless of cultural context. Marie was in a lot of pain. If the nurse would educate Jean on the side effects of heavy doses of pain medication maybe he would see that what he truly is seeing are in fact side effects and not evil spirits. Although it is important to respect religious beliefs, it is also important to respect Marie's wish to die without pain. If the nurse was to lower the dose of the pain medication Jean would see how much Marie is suffering. If he was present for that suffering maybe he would change his mind on lower the dose of the drug. I think that sometimes being uneducated on what is happening can cause misunderstandings. It would be best for both Jean and Marie if the nurse sat Jean down and discussed what was going on in a respectful manner.
ReplyDeleteI think the nurse should continue to care for Marie's wishes until told by Marie herself otherwise. Even in difficult situations, a nurse's job is to care for the patient first, and the family if needed second. She may (HIPPA allowing) discuss Marie's situation with her brother and go into detail the significance of her need for pain medication. She should also explain side effects of pain medication and the effects of withdrawaling the pain medication from her relating to the amount of pain she would be suffering. In the end of a life situation, a person may wish to neglect their initial wishes when presented with a great deal of pain. Withdrawaling treatment because of a demand of a family member is not an adequate form of treatment. The issue of self determination revolves around every competent patient regardless of their ethicity, culture, race, religion, social factors. The nurse must first treat her patient to the best of her knowledge and then worry about offending her family. Even though it is hard, this is another example of how a patient's wishes, goals, and treatment must come first.
ReplyDeleteI agree with Lindsay and Christy. The nurse should respect Marie's wishes if she stated them before. I would have a hard time as a nurse standing up to the family of a ill patient even when it is in the patient's best intrest. I know it might not be helpful but maybe the nurse could try to talk to Jean about the medication and see if he could talk rationally and ask any questions. I believe the principal of self-determination does apply to adults regardless of cultural influences. I think by still giving Marie the medicine, it may offend her family but it would be in her best intrest. I would want to follow the patient's wishes.
ReplyDeleteI agree with the 3 girls above me, the nurse should respect what the patient wants. If the family wants something else then it should be talked about with the patient then the patient should tell the dr. and nurse what exactly she wants. The family cannot tell the nurses and doctors things for the patient if the patient wants something. So as a nurse, they should always check with the patient. I agree with Jenna in saying that i would also have a hard time standing up to the family of a patient when they want something different than the patient themself. I would still continue to give the patient the medication because that is what the patient wants, and i don't really care what the family says.
ReplyDeleteI like the others agree that the nurse should respect Marie’s wishes for pain medication to manage the pain she was experiencing related to her terminal lung cancer. The nurse should educate Marie’s brother Jean on the side effects of pain medication in heavier doses used to manage end of life pain and as Lindsay described the nurse should explain Jean’s sister’s condition best she can without violating the regulations of HIPPA so that he understands the pain associated with terminal cancer. I feel that in this case the issue of self-determination applies to Marie’s wishes and the nurse should do her best to uphold those wishes regardless of cultural context because Marie was a competent adult at the time of her decision. If Jean still disagreed with the medications administration after the nurse’s explanation of it then yes, the nurse might be failing to respect Jean’s beliefs in order to respect Marie’s wishes. However, like Christy said I think open and honest communication is the best way to approach the situation.
ReplyDeleteI believe like the others that the nurse should respect Marie's wishes for pain medication. At the time she was competent to make the decision to request pain medication. As Melissa said, the brother should be adequately informed of the side effects of the medication, in order to minimize his anxiety. Due to the competency of Marie decision, I believe the principle of self-determination does apply in this case. I believe the medication should continue to be administered to Marie, overall we have the patient's best interest at heart, and at times the family's values conflict with our values as health care professionals, and this leads to huge controversy. However in the long run the patient's wishes need to be respected, and the family's values need to be taken into consideration, but you can't always have it both ways, and sometimes you just have to choose what will be the most beneficial for the greater number.
ReplyDeleteI agree that the nurse should continue to care for Marie's wishes. Given this consideration, it is extremely important for the nurse to explain to Jean the need for the medicaton, the side effects of the medication that had been administered, and the problems or issues related to not giving the medication. In this way, it would not be disregarding their cultural or spiritual beliefs; it would be taking action according to nursing priorities. In this case, I believe that Marie's pain takes priority, but the nurse should still be sensitive to the cultural influences on Marie's care.
ReplyDeleteIf I was the nurse, I would respect Marie’s wishes regardless of the cultural context and give her the pain medication as needed. Marie was an adult when she made her decision, but I would also consult to her brother. I would also inform her brother of her wants’ and let him know everything that he needs to know about different side effects from the medication. As a nurse I would be sure to help Jean understand anything he didn’t and try to answer questions he may have about his terminal sister. This case is hard because you wouldn’t want to see a family member suffer ever but you would also want the best for them when it’s their time. I would be just as worried as jean if it was my sister and be wanting to do anything for her, even if it is giving her some extra pain medication to ease her pain at the end of her life.
ReplyDeleteIt seems that I am not in the minority here that I believe that the pain medication should be continued to be given unless Marie specified otherwise. Although her brothers subscribe to these religious beliefs, we do not know if Marie herself does, and without that knowledge, we need to continue to act on the assumption that she would want her treatment to continue as she specified previously.
ReplyDeleteAs someone mentioned above though, it is important to make sure that the family understands as much about her treatment as possible in order to be sure to get as much consent as possible. It is also necessary to be sure to explain to the family why it is that their wishes for the removal of pain medication are not being honored.
Brittany Buechel: I, as everyone else, believe that Marie's pain relief treatment should be continued. If i were the nurse, I would explain Marie's situation, listen to the brothers concerns, and talk to marie about her brothers concerns. Even though her brother believes that she is has evil spirits in her, he is not experiencing the pain that Marie is. Perhaps if Marie can, at some point, explain to her brother how she is feeling and how much pain she is in, then the brother might understand. I believe all cultural contexts should be taken into consideration when taking care of patients of different culture backgrounds, but communication and education can do alot for those types of patients. If they know the side effects as well as benefits of all treatments, they are more likely to do what is best for their family. Since Marie was competent when she agreed to pain medication, then she should be granted her requests no matter what. The nurse is not failing to respect the religious beliefs of the brother, the nurse is just putting the patient first, which is what should happen. Marie obviously knows what she wants, the nurse should continue to do what was discussed.
ReplyDeleteI think the pain medication should be continued to be administered. Marie was competent in her decisions when she asked for the medication. As Marion said, we do not know if she follows those beliefs, but we also don't know if she decided in her mind to give that belief up because she was in so much pain. Jean may not know this either. Jean may not understand the pain that Marie was in. Like others said, he may not realize that these are simply side effects of the medication and that she will suffer greatly if not given the right amount of medication. Jean may only need to be educated about these things. I do think that continuing the administration of the pain medication is fails to respect these beliefs, but as I said before, Marie may have waived her beliefs when making her competent decision to have the pain medication. Jean is the only one asking for it to be reduced and I believe that it is Marie's right to decide what she gets and how much. I don't think her family should be able to do so since she was competent to decide on her own.
ReplyDeleteI think the nurse should continue administering the pain medication especially with Marie being competent in making the decision. I think the nurse should discuss the situation with Marie and with the brother also. This may also get Marie and her brother talking and then maybe Marie could explain about the pain to her brother. I do not think that continuing to administer the pain medication would be a failure to respect religious beliefs especially if the brother becomes educated on the pain and pain medication.
ReplyDeletei believe the pain medication should continue to be administered because Marie was competent in her decisions when aking for the pain medication. Nobody knows if Marie followed the same beliefs as her brother or if she did if she still continues to follw them. Like Matt said, Jean may not understand the pain that Marie was in and he may not realize that these are simply side effects of the medication. i believe that the nurse should educate Jean about these side effects and try to explain that it is only side effects of the medication.
ReplyDeletei agree with Danielle that if the administration of the pain medication is continued it would not fail to respect these belief. However, We do not know the patients beliefs and should ask the patient of their beliefs before continuing further treatment.
I believe Marie has the right to decide whether she wants the medication for pain or not because she was competent. If any person is to have an opinion to be considered it should be the parents or guardians after the patients own wishes.
I believe, as everyone else, that the nurse should continue to give Marie pain medication. She is competent and can decide what she wants for herself. It never says that Marie follows the same beliefs as her brother, so she should be treated as an individual. I also think the family should learn as much as they can about what Marie is going through so they can understand the reasoning for her continuation of pain medication.
ReplyDeleteI as a nurse would tell Jean that Marie, competant, requested pain medication and I was abiding by her wishes. If he disagrees then I would restrict pain medication until Marie was competant again and have her sign a consent as to what she wanted and if she becomes incompetant again who should make decisions for her. In the healthcare system the patient has the right to decide their own care if competant, not the family. Getting a consent from Marie would eliminate further issues with the family. Furthermore to be more respectful of the culture I would investigate the aspects of her and her family's culture to better provide care for Marie.
ReplyDeleteI believe that the nurse should continue to give the medication. It is NOT the result of voodoo, so why does it matter what the brother *thinks* is true. It indeed is a false assumption. You have to respect the religious rights of a patient. the patient wants the medication, therefore I think it should be given. If SHE did not want it for religious reasons, then that is a different situation.
ReplyDeleteI personally believe that Marie's brother cultural expression is going way too far and hard on her sister! The pain medication should be continued since 'lung cancer' is a serious disease and I can imagine how painful it must have been. I think the nurse should calm down Jean and talk him about the implications and benefits of the pain killers (that were requested by his consented sister). I also think that Jean was not reacting in a realistic manner since if he strongly believed in the voodoo then I suppose he couldn't have allowed his sister to be hospitalized. The principle of self-determination does apply to competent adults reagrdless of cultural context to a certain limit(when the decision the adult makes does not end up harming the majority but for the greatness of a majority). In most religions and other cultural beliefs it is always faith that matters alot. One might have the medication but it is believed that you receive the healing process by faith. Faith is a vital virtue that helps connect Science and Medicine with Religious and Cultural beliefs. Therefore, I disagree that continuing the pain medication to Marie entail a failure to respect the religious beliefs expressed by Jean. I know besides the cultural beliefs, Jean also wanted his sister to have a better health and safety. Even though sometimes traditions and beliefs do play a major role in the medication administration among the individuals, it is also important that they take Medicine into account.
ReplyDeleteSeeing as Marie was competent when she made the decision to request pain management, I believe this treatment should be continued despite her family's protests. The nurse should, in my opinion, attempt to explain to Jean that Marie's actions are a common side effect of pain management, and assure him that despite the seemingly traumatic situation, she is being kept relatively comfortable as a result of medication.
ReplyDelete