1) The nurse responsible for Maria's care should find Maria's doctor and ask for another medication that does not make Maria act so delirious, but still provides adequate pain relief. 2) Yes the principle of self-determination applies to competent adults regardless of cultural context. Adults are competent enough to make their own decisions about health care. 3) Continuing to administer the same pain medication to Marie would entail a failure to respect the relgious beliefs expressed by Jean. A pain medication needs to be found that does not cause her to act in such a way.
Marie's nurse should follow the wishes that marie gave her. If she asked for the pain medication then she should have it. Sel-determination does apply to any competent adult. If Marie's nurse had these questions she should have asked Marie's brother if that was the case. She could inform him that she was in a tremendous amount of pain, and asked for the pain medication. Jean was the one who told her to cut off the pain medication, not Marie. I think the nurse should honor Marie's wishes and keep her on the pain medication.
1. The nurse should handle Marie's care according to what Marie expressed, meaning continued pain medication. She made the competent autonomous decision to take pain medication, therefore the nurse should follow this course of action. 2. Self-determination does apply to competent adults regardless of cultural context. I'm assuming the nurse/doctor explained the potential side effects of the pain medicine, meaning she was aware of the "evil spirits" that may appear, yet she chose the medicine anyway. This is her right. 3. Continuing the pain medication would not be a failure to ahere to Jean's religious beliefs. This is because Jean is not the patient. Marie explicitly requested the medication, knowing the potential side effects. Therefore the nurse is doing her job and doing right by the patient by following her wishes.
In this case I would back Marie off the medication and explain things to her, if she still wanted to continue the medication then she should be put back on it. It is important that Marie does not feel obligated to discontinue medication because she feels socially obligated by her family to quit. I do feel that self-determination does apply regardless of cultural bounds. If she does feel that she is bringing spirits to her family then she has a right to quit, but if she wants to continue medication then she should be allowed. I feel that they are removed from land of their culture so maria has the rights associated with our culture, but she can also follow her culture. I do not feel that continuing medication would disrespect Jean if Marie truly wanted it.
1) I think that the nurse should respect the autonomy of Marie and keep her on the pain medication. She made a conscious decision to be put on the medication to alleviate her pain. Regardless of the feelings of her brother, Marie's choice should be honored. 2)I believe the principle of self-determination does apply regardless of cultural context. The well-being of the patient is the most important issue when considering possible treatments. If the patient feels that they are capable of making their own decisions (and they are of a sane mind and are truly acting autonomously) they should be free to do so regardless of the constraints of their culture. I believe that the majority of the people who grew up in a culture where they were not free to make their own medical decisions would not feel comfortable making those decisions in a western culture. In this case, the decisions of the responsible party should indeed be taken into consideration. However, if the patient feels confident in choosing the path of their own medical treatment, those choices should be honored. 3) The failure to discontinue use of the medications may be slightly disrespectful to the religious beliefs of Jean in this case. However, because Jean is not the patient in question, his religious beliefs are secondary to the wishes of the patient. If the patient had said that she wanted her brother to make her medical decisions, the situation would be different. However, in this case, the wishes of the patient are more important than those of her family members.
If Marie gave specific instructions to be heavily sedated until death, the nurse should continue to keep her on medications. If this was not the case, I think Marie should be allowed to become conscious in order to understand what is happening. Then the decision is up to her. This might mean that Jean will tell her what to do, and she will accept that, or she might realize that the evil spirits are just side effects of the medicine and counter his opinion. Either way, her culture should be respected. While the principle of self-determination is applicable in our culture, in others it is not, and if Jean telling her not to take medications makes her feel as though she cannot do so because he has power over her, her self-determination is removed, even though she is physically in our culture.
1) The nurse is responsible for following Marie's wishes not Jean's, so she should keep administering the pain medications to Marie. 2) I don't think that cultural content should affect self-determination. Marie has the right to her autonomy and when she made the decision to accept the pain medications, she was of sound mind. In our health care system the patient has the right to self-determination and no one else has the right to interfere with that unless the patient is not of sound mind. 3 The continual admistering of pain meds to Marie would very likely offend Jean and his religious belief, but that makes no difference. Jean is not the patient and has no right to make medical decision for Marie. Marie was clear in what she wanted, so there should be no discussion about it, the nurses should continue to administer the pain meds.
1. I think that the nurse should respect what the family is saying but because the pt. asked for the pain medication herself, then she needs to continue with the pt. wishes. 2. I think that self-determination applies to the pt. regardless of their cultural backgrounds. If the pt. is aware of what is going on and is in the state of mind to make decisions for themself, then they need to do so and the health care team and family need to respect that. 3. Continuing to give the pain medication would probably be considered a failure to respect her brothers beliefs in regards to their culture and religion, but then again she is there to care for the pt. not him. And by giving Marie the pain medication she is respecting her wishes. If Marie was concerned about her cultural background she would most likely have expressed that before or in the process of speaking with the nurse, especially before she was given any sort of treatment.
1. The nurse responsible for Maria's care should do a couple things. First she should find out whether or not the male relatives speak for the female ones in Maria's culutre. She should wait until the pain medication has worn off so that Maria can express her wishes without being under pain medication. The nurse should also speak with MAria's doctor about getting her medication changed to something that will not cause her to be delirious. 2. The principle of self-determination does apply however the patient may not be willing to go against his or her cultural beliefs in order to make their own decisions especially if it is a culture where the males make decisions for the females. 3. Failure to discontinue the pain medication would be disrespectful to Jean's beliefs and inorder to give the patinet proper care without offending the patient's family; the nruse must get the family members to talk to the family so that she can relay her wishes to her family.
1. I believe that the nurse should continue giving care to Marie in the manner that Marie requests. Any terminal condition usually involves pain management and since Marie has made that request as a competent adult, the nurse should respect her wishes. 2. I don't think that you can have self-determination without cultural context. Everyone has cultural influences even if you may think that they don't. When caring for competent adults, always consider the culture of the patient as it may determine the self-determination of the patient. 3. I think that continuing the pain meds for Mary could be viewed as being disrespectful to Jean, however it is Mary who is the patient and the nurse is treating Mary and her wishes, not Jean.
1) The nurse responsible for Maria's care should find Maria's doctor and ask for another medication that does not make Maria act so delirious, but still provides adequate pain relief.
ReplyDelete2) Yes the principle of self-determination applies to competent adults regardless of cultural context. Adults are competent enough to make their own decisions about health care.
3) Continuing to administer the same pain medication to Marie would entail a failure to respect the relgious beliefs expressed by Jean. A pain medication needs to be found that does not cause her to act in such a way.
Marie's nurse should follow the wishes that marie gave her. If she asked for the pain medication then she should have it.
ReplyDeleteSel-determination does apply to any competent adult. If Marie's nurse had these questions she should have asked Marie's brother if that was the case. She could inform him that she was in a tremendous amount of pain, and asked for the pain medication.
Jean was the one who told her to cut off the pain medication, not Marie. I think the nurse should honor Marie's wishes and keep her on the pain medication.
1. The nurse should handle Marie's care according to what Marie expressed, meaning continued pain medication. She made the competent autonomous decision to take pain medication, therefore the nurse should follow this course of action.
ReplyDelete2. Self-determination does apply to competent adults regardless of cultural context. I'm assuming the nurse/doctor explained the potential side effects of the pain medicine, meaning she was aware of the "evil spirits" that may appear, yet she chose the medicine anyway. This is her right.
3. Continuing the pain medication would not be a failure to ahere to Jean's religious beliefs. This is because Jean is not the patient. Marie explicitly requested the medication, knowing the potential side effects. Therefore the nurse is doing her job and doing right by the patient by following her wishes.
In this case I would back Marie off the medication and explain things to her, if she still wanted to continue the medication then she should be put back on it. It is important that Marie does not feel obligated to discontinue medication because she feels socially obligated by her family to quit. I do feel that self-determination does apply regardless of cultural bounds. If she does feel that she is bringing spirits to her family then she has a right to quit, but if she wants to continue medication then she should be allowed. I feel that they are removed from land of their culture so maria has the rights associated with our culture, but she can also follow her culture. I do not feel that continuing medication would disrespect Jean if Marie truly wanted it.
ReplyDelete1) I think that the nurse should respect the autonomy of Marie and keep her on the pain medication. She made a conscious decision to be put on the medication to alleviate her pain. Regardless of the feelings of her brother, Marie's choice should be honored.
ReplyDelete2)I believe the principle of self-determination does apply regardless of cultural context. The well-being of the patient is the most important issue when considering possible treatments. If the patient feels that they are capable of making their own decisions (and they are of a sane mind and are truly acting autonomously) they should be free to do so regardless of the constraints of their culture. I believe that the majority of the people who grew up in a culture where they were not free to make their own medical decisions would not feel comfortable making those decisions in a western culture. In this case, the decisions of the responsible party should indeed be taken into consideration. However, if the patient feels confident in choosing the path of their own medical treatment, those choices should be honored.
3) The failure to discontinue use of the medications may be slightly disrespectful to the religious beliefs of Jean in this case. However, because Jean is not the patient in question, his religious beliefs are secondary to the wishes of the patient. If the patient had said that she wanted her brother to make her medical decisions, the situation would be different. However, in this case, the wishes of the patient are more important than those of her family members.
If Marie gave specific instructions to be heavily sedated until death, the nurse should continue to keep her on medications. If this was not the case, I think Marie should be allowed to become conscious in order to understand what is happening. Then the decision is up to her. This might mean that Jean will tell her what to do, and she will accept that, or she might realize that the evil spirits are just side effects of the medicine and counter his opinion. Either way, her culture should be respected. While the principle of self-determination is applicable in our culture, in others it is not, and if Jean telling her not to take medications makes her feel as though she cannot do so because he has power over her, her self-determination is removed, even though she is physically in our culture.
ReplyDelete1) The nurse is responsible for following Marie's wishes not Jean's, so she should keep administering the pain medications to Marie.
ReplyDelete2) I don't think that cultural content should affect self-determination. Marie has the right to her autonomy and when she made the decision to accept the pain medications, she was of sound mind. In our health care system the patient has the right to self-determination and no one else has the right to interfere with that unless the patient is not of sound mind.
3 The continual admistering of pain meds to Marie would very likely offend Jean and his religious belief, but that makes no difference. Jean is not the patient and has no right to make medical decision for Marie. Marie was clear in what she wanted, so there should be no discussion about it, the nurses should continue to administer the pain meds.
1. I think that the nurse should respect what the family is saying but because the pt. asked for the pain medication herself, then she needs to continue with the pt. wishes.
ReplyDelete2. I think that self-determination applies to the pt. regardless of their cultural backgrounds. If the pt. is aware of what is going on and is in the state of mind to make decisions for themself, then they need to do so and the health care team and family need to respect that.
3. Continuing to give the pain medication would probably be considered a failure to respect her brothers beliefs in regards to their culture and religion, but then again she is there to care for the pt. not him. And by giving Marie the pain medication she is respecting her wishes. If Marie was concerned about her cultural background she would most likely have expressed that before or in the process of speaking with the nurse, especially before she was given any sort of treatment.
1. The nurse responsible for Maria's care should do a couple things. First she should find out whether or not the male relatives speak for the female ones in Maria's culutre. She should wait until the pain medication has worn off so that Maria can express her wishes without being under pain medication. The nurse should also speak with MAria's doctor about getting her medication changed to something that will not cause her to be delirious.
ReplyDelete2. The principle of self-determination does apply however the patient may not be willing to go against his or her cultural beliefs in order to make their own decisions especially if it is a culture where the males make decisions for the females.
3. Failure to discontinue the pain medication would be disrespectful to Jean's beliefs and inorder to give the patinet proper care without offending the patient's family; the nruse must get the family members to talk to the family so that she can relay her wishes to her family.
1. I believe that the nurse should continue giving care to Marie in the manner that Marie requests. Any terminal condition usually involves pain management and since Marie has made that request as a competent adult, the nurse should respect her wishes.
ReplyDelete2. I don't think that you can have self-determination without cultural context. Everyone has cultural influences even if you may think that they don't. When caring for competent adults, always consider the culture of the patient as it may determine the self-determination of the patient.
3. I think that continuing the pain meds for Mary could be viewed as being disrespectful to Jean, however it is Mary who is the patient and the nurse is treating Mary and her wishes, not Jean.