The exemplar that shall be discussed and analysed would be the empowerment exemplar. In order to analyse the ethical decisions made, it is important to assess the patient holistically. It is important to assess the impact that the symptoms may have on the patient’s quality of life. For instance, would amputating her leg immobilise her? Physically, if the patient is to remain not amputated would that increase the risk of infection or would the ulcers worsen?
The risk factors should also be assessed, for instance, would amputating impact her social well being by immobilising her. If this were to be the case it would have a direct impact on her emotional and economical wellbeing, because with her unable to mobilize she may have to spend money to pay for a support worker to do various errands for her i. e. shopping, additionally she may not be able to get employment. If that was to be the case it may cause social isolation which could lead to depression, stress and other mental illnesses.
However, if she were to not amputate then it may still have direct impacts on her social, emotional and economical needs. At the moment, her daughter is against the option of amputation but a thing to consider is the pain that this leg ulcer may be causing. If the pain she’s experiencing is chronic then mobilizing would be difficult anyway. Furthermore, research shows that leg ulcers usually give out an offensive odour (Ebbeskog, 2001), this could have a negative impact on her emotional well being.
The ethical theory to consider here is utilitarianism. Utilitariansim is an ethical theory developed by Jeremy Bentham and John Stuart Mills that is founded on moral judgements or policies that focuses on bringing forth the greatest satistfaction or happiness for the greatest number of people. It can be described as quantitative and reductionst approach to ethics and contrasts with the deontology theory which do not regard the consequences of an act as a way to determine its moral value.
Considering this dilemma, the Student nurse had to consider which act would bring forth the greatest good for the greatest number. One could argue, that the only person that mattered in this situation was the patient, since it was concerning her, however once may also argue that the decision she would make would have an impact on those around her and society around her in general. For instance, if she decides to amputate she wouldn’t come to hospital as often when it comes to er leg ulcers. This would result to empty beds meaning that someone who may need a bed for more dire reasons are more likely to have it. Furthermore, the costs taken from the NHS to treat her leg continually would decrease meaning that the chance of the government cutting down on other services would decrease. Also, she would not be in as much pain as she was in when she had the ulcerated leg.
If she gets a prosthetic leg her mobility would improve and she may be able to mobilize better than she did previously. Although these outcomes may not appear obvious but the impact is undeniable. However, one may also argue that if she doesn’t amputate her family and friends may be happier with the decision (considering that all her family members share the same opinion with her daughter). She may be happier as well considering she has been living with her leg for a long time.
The whole argument would result to determining whether her quality of life is better if she amputates or not. Maleficence: Define & Apply – Autonomy vs Maleficence -Rodwell, 1995 -Patient differentials – Quality of Life -Maslows Hierarchy of Needs: Define & Apply – Barriers of empowerments: Define & Apply – Systematic Review: Define & Apply – Internal & External Locus of control: Define & Apply -Patients & Public empowerment -Health & Social care bill (2011) -More Policy -Look at NICE guidelines