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

Case Study – The Case of Freda

Freda is a thirty-two-year-old woman in an advanced fixed stage of multiple sclerosis. She is no longer able to move independently or feed herself. She is able to speak with great difficulty. Her decisional capacity is intact. Freda’s inability to swallow has caused her to lose weight to the point that she is clinically malnourished.

In conversation with long-term care nursing staff, social workers, and her attending physician, she has made it clear that she does not want a gastric feeding tube. However, Freda’s mother insists on insertion of a gastric feeding tube, which puts the nursing staff in a high state of moral distress.

Have the healthcare providers clearly identified the right and good and wise action that ought to be taken for the patient?

Are there barriers to taking the right, good and wise action?