Reference no: EM133361932

Lesedi Abebe works in the pediatric intensive-care unit of a community hospital. The unit is now at maximum capacity, with three children: Sarah, a profoundly developmentally delayed three-month-old baby; John, a three-year-old trauma victim admitted the previous day; and Omar, a five-year-old who is post-surgery.

Sarah is awaiting transfer to a specialty hospital for cardiac surgery. John is on a ventilator, requiring constant care; he is not expected to survive. Omar is ready for the step-down unit as soon as a bed becomes available. He is extremely anxious about leaving the protective environment of the unit.

The unit is usually staffed by two nurses, but on one particular shift Lesedi's colleague has gone home ill, and no critical-care nurses are available for relief. Even with two nurses, it is a challenge to attend to the needs of these three children.

Left on her own, Lesedi anguishes over the question of how she should set priorities with her limited time. She is faced with the need for micro-allocation decision-making. Lesedi decides to use the distinct criteria of need, equality, likelihood of benefit, and urgency.

Questions:

1. What bearing, if any, might Sarah's condition have on the decision about how much care she should receive relative to the others? Consider your position in relation to relevant principles of justice.

2. Allocation decisions of the kind with which Lesedi is faced can be extremely painful, and are bound to be emotionally charged. To what extent is emotion an obstacle to such ethical decision-making? To what extent might it be a precondition for it? What is the role of these kinds of situations in nurses' experience of moral distress?