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  • The Case of Freda: Nursing Staff in Moral Distress When Patient’s Wishes Not Followed

    Freda is a thirty-two-year-old woman in an advanced fixed stage of multiple sclerosis. Freda’s inability to swallow has caused her to lose weight to the point that she is clinically malnourished. Freda’s mother insists on insertion of a gastric feeding tube, which puts the nursing staff in a high state of moral distress.

  • The Case of Claire Conroy

      Must Patients Always Be Given Food and Water? An eighty-four-year-old non-ambulatory nursing home patient was confined to semi-fetal condition with “severe organic brain syndrome.” She had necrotic gangrenous leg ulcers and no bowel control. The patient was not in a vegetative state; her life expectancy could not be predicted but it was thought to…

  • Case Study – My Patient’s Dying

    I had never seen it before. I had no experience on which to base my unsettling suspicions. Who is responsible for ensuring that Ms. P’s dying wishes are fulfilled to the degree possible?

  • Case Study – Mr. Jay’s Case

    Mr. Jay told his doctor he would prefer that resuscitation not even be attempted. Will paramedics know about Mr. Jay’s preference?

  • Case Study – Matter of Quinlan

    Evidence in the case included statements the patient made earlier referring to her “distaste for continuance of life by extraordinary medical procedures.” These statements were deemed by the court as remote, impersonal and lacking trial “probative weight.” The trial court refused the order to withdraw life-supporting apparatus. The father/guardian appealed.

  • Case Study – Managing Pain, A Family Affair

    Mrs. W is a sixty-year-old African American woman with a recent diagnosis of breast cancer with metastases to the bone and lung. Will she become addicted to the prescribed pain medication?

  • Case Study – “If you prick me, do I not bleed?”

    Elizabeth is over 100 years old, with little cognitive decline. Her blood-thinning medication requires monthly blood draws, which are painful and distressing to Elizabeth. Is continuing the monthly blood draws the right thing to do?

  • The Case of Grace: Why Are They Doing All This?

    Shortly after she retired, Grace, who has never married, sold her home and moved into Happy Valley Nursing Home where she has lived the past nine years and has now slipped into what the doctor agrees is Alzheimer’s disease. Grace started exhibiting signs of illness, which after blood tests, appears to be related to abnormal function of her spleen.

  • Case Study – Good Death or Assisted Suicide?

    “My body is all worn out. I’m worn out. Don’t want to do this anymore, Doc. Just stop that little gadget that shocks me and the part that keeps my heart going. I want them stopped. Yes, the pacemaker, too. A magnet will stop it, right? Just do it. Please.”

  • Case Study – What Should We Do? DNR for an Adult with Down Syndrome

    George is a twenty-three-year-old young man with Down’s syndrome, who lived independently in a group home. Unfortunately, an accident resulted in George suffering a severe brain injury, with no signs of consciousness after a year. He’s dependent upon a feeding tube.