Ethics. Case study# 2. Patient Refuses Blood

Mrs. Jones has gangrene on her left leg. Her hemoglobin slips to 6.4. She has a major infection and is diabetic. She has no spouse and no living will. Mrs. Jones decides she does not want to be resuscitated if she goes into cardiopulmonary arrest. She needs surgery, which she has agreed to, but she refuses a blood transfusion even though she is not a Jehovah’s Witness. The surgeon will not perform the surgery, which is urgent, without Mrs. Jones agrees to a blood transfusion if it becomes necessary. The attending physician questions the patient’s capacity to make decisions. Mrs. Jones’s children have donated blood, and she says she is not afraid to die.

Which primary ethical principle is most evident in Mrs. Jones's case?

Mrs. Jones has gangrene on her left leg. Her hemoglobin slips to 6.4. She has a major infection and is diabetic. She has no spouse and no living will. Mrs. Jones decides she does not want to be resuscitated if she goes into cardiopulmonary arrest. She needs surgery, which she has agreed to, but she refuses a blood transfusion even though she is not a Jehovah’s Witness. The surgeon will not perform the surgery, which is urgent, without Mrs. Jones agrees to a blood transfusion if it becomes necessary. The attending physician questions the patient’s capacity to make decisions. Mrs. Jones’s children have donated blood, and she says she is not afraid to die.

To reach an ethical solution, which of the following questions need to be addressed?

Mrs. Jones has gangrene on her left leg. Her hemoglobin slips to 6.4. She has a major infection and is diabetic. She has no spouse and no living will. Mrs. Jones decides she does not want to be resuscitated if she goes into cardiopulmonary arrest. She needs surgery, which she has agreed to, but she refuses a blood transfusion even though she is not a Jehovah’s Witness. The surgeon will not perform the surgery, which is urgent, without Mrs. Jones agrees to a blood transfusion if it becomes necessary. The attending physician questions the patient’s capacity to make decisions. Mrs. Jones’s children have donated blood, and she says she is not afraid to die.

Is there an ethical dilemma present in Mrs. Jones's case?

Mrs. Jones has gangrene on her left leg. Her hemoglobin slips to 6.4. She has a major infection and is diabetic. She has no spouse and no living will. Mrs. Jones decides she does not want to be resuscitated if she goes into cardiopulmonary arrest. She needs surgery, which she has agreed to, but she refuses a blood transfusion even though she is not a Jehovah’s Witness. The surgeon will not perform the surgery, which is urgent, without Mrs. Jones agrees to a blood transfusion if it becomes necessary. The attending physician questions the patient’s capacity to make decisions. Mrs. Jones’s children have donated blood, and she says she is not afraid to die.

Should the family have the right to override Mrs. Jones's decision to refuse a blood transfusion?

Mrs. Jones has gangrene on her left leg. Her hemoglobin slips to 6.4. She has a major infection and is diabetic. She has no spouse and no living will. Mrs. Jones decides she does not want to be resuscitated if she goes into cardiopulmonary arrest. She needs surgery, which she has agreed to, but she refuses a blood transfusion even though she is not a Jehovah’s Witness. The surgeon will not perform the surgery, which is urgent, without Mrs. Jones agrees to a blood transfusion if it becomes necessary. The attending physician questions the patient’s capacity to make decisions. Mrs. Jones’s children have donated blood, and she says she is not afraid to die.

What is the primary role of a nurse in Mrs. Jones's situation?