Patients with Do-Not-Resuscitate Orders Undergoing Surgery - Article Example

Do Not ResuscitateI agree with Student K. The nurse is primarily accountable to her patient, not to the patient’s family. Since the patient was requesting for medical care, that care had to be delivered. The DNR order at this point is already revoked because the patient asked the nurse to do everything she could to save her life and to not let her die (Blankenship, 2008). Clearly, the patient has expressed her will and her desire to live, and she should therefore be given a chance to live.

Moreover, the care to be administered to the patient at that point was not for cardiac resuscitation, but it was to ease her breathing. It was not a life-saving technique. DNR orders are interventions which are meant to extend the life of the patient; these are not interventions which are meant to lend her comfort from her symptoms (Blankenship, 2008). The patient’s words also indicate that she is allowing other interventions which are meant to save her life. At this point, the DNR is revoked (Schwab and Gelfman, 2005).

The daughter cannot expect the DNR order or the living will to be applied anymore because the patient herself is still mentally competent enough to revoke it. The daughter is also not the legally authorized proxy who can make the decisions for the patient. Proxies are usually assigned where patients are unconscious or mentally incapacitated to make sound decisions about their health (Schwab and Gelfman, 2005). In this case, the patient is conscious and is able to express her wishes coherently, logically, and with sound mind.

The patient has the right to authorize a DNR order and also to revoke it. Under these conditions, such right cannot be transferred to the family members, in this case, her daughter. The nurse must therefore follow the patient’s orders (Newkirk, 2009). The nurse and the physician must also honor the patient’s right to self-determination by upholding the DNR order unless and until the patient revokes it. The patient still has the proper faculties to make decisions regarding her care. Nevertheless, it is still part of the nurse’s duty to clarify the patient’s request, discussing what she wants done and mentioning if she means to revoke her previous DNR orders (Newkirk, 2009).

Whatever measures which the patient has chosen must then be respected and implemented. Under acute conditions, other health professionals would be in the room to assist in the patient’s care and they can also support the fact that the patient has revoked her previous DNR order. Health professionals would also have to document the incident in detail in order to specify the interventions carried out, and the exact statements of the patient effectively revoking her previous DNR order. These measures will support the actions of the nurse and other health professionals, especially following the patient’s revocation of the DNR order (Devettere, 2009).

There does not seem to be an ethical dilemma for me because the situation is very clear. The DNR order has been revoked by the patient and now I have to honor the patient’s most current wishes. She is of sound mind and is still physically and clearly able to express her wishes and directions on her care. Ethical dilemmas arise where an act would present two options on an equal plane (Newkirk, 2009). Ethical credit to both arguments has to be more or less balanced. In this case, the will of the patient clearly overrules the will of the daughter.

Moreover, the previous DNR order is not an irrevocable act or decision on the patient’s part. It is an order which is subject to the patient’s choices (Newkirk, 2009). Granting that the patient is no longer conscious or is no longer of sound mind to make logical choices on her care, the daughter, as a medical proxy can make the choice for the patient. Otherwise, the patient’s will and right to self-determination has to be upheld. ReferencesBernat, J. (2008). Ethical issues in neurology.

Philadelphia: Lippincott Williams & Wilkins. Blankenship, M. (2008). Patients with Do-Not-Resuscitate orders undergoing surgery. New York: ProQuest. Devettere, R. (2009). Practical decision making in health care ethics: Cases and concepts. Washington: Georgetown University Press. Newkirk, C. (2009). Do Not Resuscitate in the critical care unit. Kentucky: Northern Kentucky University. Schwab, N. and Gelfman, M. (2005). Legal issues in school health services: A resource for school administrators, school attorneys, school nurses.

California: Universe.