Need help with a Medical Ethics Paper.?

Question

I need to write a 5 page paper analyzing a case study. In a quick summary the case study is this: A patient wants pain medication, but is a recovered drug addict. He only recovered with the help of a church. He rates his leg pain as a "10" and wants pain meds, but the doctor won't give them to him b/c he was an addict. The nurse has to follow doctor's orders and not give him the meds and cant tell him why. They give him a placebo treatment, and still the patient is a "10" for pain.
What is the moral obligation of the nurse? (Tell the patient whats going on? etc.)

I need ethical justifications for my answer. like autonomy is being violated, ect. any help is appreciated!!!

Answer 1

What's the real reason for not giving the pain medicine? Is the pain medicine the same he was addicted to? What is the injury? Is it because the doctor thinks he is lying? Even if the pain isn't a ten, that doesn't mean he should suffer.

Patients should get pain relief when needed. The doctor and nurse should be honest to the patient.

The patient has a right to know. The patient has a right to be a participant in his own treatment and to decide on it. The pros and cons should be carefully explained to the patient, including any addiction risks. The choice should be his. He is not being treated as a person in this scenario. You may be surprised to find out he may not want the risk or some other drug can be substitued.

The moral obligation of the nurse is to do what she thinks is the right thing and stand up to the doctor if need be.

Answer 2

Great question.

What is the nurse's obligation? First, what's going on? Technically she follows the doctor's orders. But the Patient has a right to know how he is being treated. He has a right to consent to that treatment. I'm sure the doctor is not keeping the Patient informed to avoid the potential emotional blowup with the Patient. Beside, most pain meds are controlled meds. He has to do prescriptions in triplicate. The meds can only be signed off in limited amounts, etc. Additionally, the trend is to provide more pain meds to provide relief for suffering.

Lot'sa stuff to balance.

The nurse has a duty to both follow the direction of the treating physician and to provide appropriate care, which includes the duty to keep the patient fully informed.

I'd say that the Nurse should first say to the Patient, "I am going to have to talk to the doctor about your continued pain." She then needs to inform the doctor that the patient continues have problems AND she is concerned that the patient has not been informed and therefore cannot consent to the current treatment.

Basically the nurse needs to push the doctor intoscussing the treatment with the patient. If the doctor does not, she should either call a medical ethics hot line, if they have one, to get their opinion. Next step would be to tell the patient that he should see another physician if he continues to be in pain. If that is infeasible, last resort is to tell the patient what is going on.

Answer 3

Nurses are not mindless drones who follow physicians orders without question. They have their own standards of care to follow and expectations to the level of care they will give.

Given the situation you have stated the first thing I would do would be to contact the physician and state that the patient is continuing to have pain and needs a pain medication order. If he still refused I would contact the nursing supervisor, and the director of medicine for the department. Every person has a boss - and that includes doctors. If the need be I would contact the ethics committee, risk management and any other person who will listen.
A patient has a right to have their pain managed - research patient bill of rights. Nurses cannot sit idolly by and allow the patient to be abused! Not medicating pain is abuse.

Just because a person was an addict does not mean they should be allowed to writhe in pain - and administering a placebo and telling the patient it's a pain medication is not only unethical, but illegal because they are not being informed of their care.

Answer 4

I would say that she will call the doctor and see if he will order anything.... It is not the nurses job to tell a patient why he or she is not recieving pain meds in this case. She should tell the patient that he needs to talk to the doctor about it. and i think leave it at that.....
She could try other methods that could try to help pain. The again maybe there is something going on that the doctor isn't thinking about that is causing the patient's pain.

I saw this on one of those TV shows like documentary ones... where the patient was having severe pain in the ER, and the wife wanted them to give him pain meds, and listed a few, and when the doctors and interns left the room to talk about the case.... one was like he is just a drug addicted wanted meds.... well it turned out that the patient had something that they never thought about as a diagnosis.


You didn't say what is the cause of the patient's leg pain.... is there anything non-medical they can do to try to help it, like heat or massage or anything like that???