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Problem
Patient Refuses Blood:
Mrs. Jones has gangrene of her left leg. Her hemoglobin slips to 6.4. She has an 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 agreeing to a blood transfusion if it becomes necessary. The attending physician questions the patient's capacity to make decisions. Mrs. Jone's children have donated blood and she says she is not afraid to die.
Respond to all of the following questions:
A. Which ethical issues and principles are involved in this case?B. Generate questions that need to be answered to reach an ethical solution in this case.C. Is an ethical dilemma involved in this case? Explain.D. Should the physician refuse to treat this patient? Support your answer.E. Should the family have the right to override the patient's decision to refuse blood? Support your answer.F. What is the role of the nurse practitioner in this case?
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