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Model Distress in Nursing in Response to Medical Futility

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Model Distress in Nursing in Response to Medical Futility
Moral Distress in Nursing in Response to Medical Futility in the Geriatric Population at the End of Life

Each day, in the life of a nurse, they deal with issues that address respect for life and doing what is ethically and morally right. Promoting the patient’s self esteem and personal independence, and doing what is right and preventing harm are nursing care’s utmost priorities. Since nursing is a centrally ethical profession, morals and values play an important role in making a nurse perceive that their work is more meaningful (Ferrell, 2006). In Jameton’s (1984) influential book, Nursing Practice the ethical issues, he differentiates ethics from morals by contrasting professional versus personal values. According to Jameton (1984) professional values are set of rules that publicly state a profession’s ethical beliefs, such as the Code for Nurses, while personal values are morals that a person strongly believes in. In short, ethics refers to the more professional and theoretical term, while morals are more personal and informal.
Mohammed and Peter (2009) defines medical futility as medical interventions and treatments that will unlikely result in any positive outcome and further divides it into two categories: physiologic and qualitative. Physiological futility involves interventions that are unlikely to produce a specific medical outcome that will resolve symptoms nor prolong the patient’s survival (Mohammed & Peter, 2009). An example of physiologic futility is performing Cardiopulmonary Resuscitation (CPR) on a patient with a ruptured dissecting aneurysm. Physiologic futility is often based on the clinician’s past experience, their colleague’s shared experience and based on statistical data that an intervention would have no desired effect (Mohammed & Peter, 2009). However, even with a given statistical data, collective analysis will not usually show that an intervention is 100% guaranteed ineffective, hence the issue of whether to terminate a



References: American Nurses Association. (2009). Code of ethics for nurses. Retrieved October 1, 2009, from http://www.nursingworld.org Badger, J.M. (2005). A descriptive study of coping strategies used by medical intensive care unit nurses during transitions from cure to comfort-oriented care Carpenito-Moyet, L. J. (2006). Nursing diagnosis application to clinical practice (11th ed.). Philadelphia: Lippincott Williams & Wilkins. Ferrell, B. R. (2006). Understanding the moral distress of nurses witnessing medically futile care Garity, J. (2009). Fostering nursing students’ use of ethical theory and decision-making models: teaching strategies Jameton, A. (1984). Nursing practice: The ethical issues. New Jersey: Prentice-Hall. McCarthy, J. & Deady, R. (2008). Moral distress reconsidered. Nursing Ethics, 15(2), 254-262. Mobley, M.J., Rady, M.Y., Verheijde, J.L., Patel, B. & Larson, J.S. (2007). The relationship between moral distress and perception of futile care in the critical care unit Mohammed, S. & Peter, E. (2009). Rituals, death and the moral practice of medical futility. Nursing Ethics, 16(3), 292-302. Morris, P. E. & Dracup, K. (2008). Time for a tool to measure moral distress? American Journal of Critical Care, 17(5), 398-401. Pendry, P. (2007). Moral distress: Recognizing it to retain nurses. Nursing Economics, 25(4), 217-221.

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