Case Study I: Jules T.

Jules is a 36-year-old white male. He is married and the couple just had their first child, a baby girl. Six months ago, Jules was diagnosed with Lou Gehrigs disease, and has rapidly lost body function.

This disease is amyotrophic lateral sclerosis (a-my-o-TROE-fik LAT-ur-ul skluh-ROE-sis), or ALS, it is a progressive nervous system disease that affects nerve cells in the brain and spinal cord, causing loss of muscle control.

ALS is often called Lou Gehrig's disease, after the baseball player who was diagnosed with it. Doctors usually don't know why ALS occurs. Some cases are inherited.

ALS often begins with muscle twitching and weakness in a limb, or slurred speech. Eventually, ALS affects control of the muscles needed to move, speak, eat and breathe. There is no cure for this fatal disease.

The ethics problem is while Jules has received treatment at home to care for him as he progressively loses bodily function his main goal was to see his child born. Now that he has seen his daughter he wants to be allowed to die, to avoid the pain and suffering found with the end stage of this disease and to not be a burden on his wife.

The home care agency has a stated mission to help the ill and infirm to live a quality of life for as long as possible. The nurses assigned to oversee the case are concerned that this case borders on euthanasia and are seeking guidance from the Director of Nursing on how to deal with this request. The question is Can the agency ethically assist or continue to care for someone who is actively seeking to die? Prepare the response that the Director of Nursing will use to guide her staff.

Ethics Protocol In ethical decision making it is important to establish a protocol, a method for making ethic decisions. The ultimate outcome is to demonstrate an ethical decision making process by preparing a defensible persuasive response for administrative and biomedical issues, while considering the legal ramifications, the mission and values of the organization and reflecting a personal code of ethics. To facilitate this outcome consider using the analysis protocol identified below to form your opinion; 1. What action is in the best interest of the patient? 2. What action is in the best interest of the organization? Consider, if known, mission, vision, values. 3. What are the professional codes of ethics for your profession? Does this code impact upon the decision made? 4. Are there legal implications (laws which may be broken) which impact on this decision? (This may require research). 5. Using all of the above in decision making explain why you made the decision you did. The outcome of this protocol is to prepare a defensible position on ethical issues. The components of decision making above should help accomplish this