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Ethical Issues in Adult and Older Adults with.pptx
- 1. Ethical Issues inAdult and Older Adults with Acute and Critical Care
- 2. • Slide 3:Learning Objectives • Objective 1: Analyze concepts, theories, and factors affecting health conditions in adults and the elderly. • Objective 2: Apply knowledge, evidence-based practice, and advanced nursing innovations for holistic, patient- and family- centered care. • Objective 3: Evaluate ethical dilemmas in acute and critical care scenarios for both adults and elderly patients.
- 3. • Slide 4:Introduction to Ethical Issues • Definition: Ethics in nursing, particularly in high-stakes environments like ICU and emergency care. • Relevance: Ethical considerations are critical when dealing with life-and-death situations in adult and elderly populations. • Overview: Common ethical principles (autonomy, beneficence, non-maleficence, and justice) and their specific application in acute and critical care. • References: • Beauchamp, T.L., & Childress, J.F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press. • American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. Silver Spring, MD: ANA.
- 4. • Slide 5:Ethical Frameworks in Nursing • Deontological vs. Consequentialist Ethics: Introduction to different ethical theories. • Application: How these theories guide decision-making in acute and critical care. • Theories of Aging: Ethical considerations in the care of elderly patients, including respect for autonomy and dignity in the context of aging. • References: • Levett-Jones, T., et al. (2019). The Clinical Placement: An Essential Guide for Nursing Students (5th ed.). Elsevier. • Johnson, K.S. (2013). "Ethical Issues in the Care of Geriatric Patients." The American Journal of Geriatric Pharmacotherapy, 11(6), 491-495.
- 5. • Slide 6:Social Determinants of Health in Adults • Factors: Income, education, and access to healthcare. • Impact on Care: How these factors influence health outcomes in adults. • Ethical Considerations: Addressing disparities in acute care settings, particularly in emergency situations. • References: • Marmot, M., & Wilkinson, R. (Eds.). (2006). Social Determinants of Health (2nd ed.). Oxford University Press. • Braveman, P., & Gottlieb, L. (2014). "The Social Determinants of Health: It’s Time to Consider the Causes of the Causes." Public Health Reports, 129(1_suppl2), 19-31.
- 6. • Slide 7:Social Determinants of Health in the Elderly • Factors: Social isolation, poverty, and limited access to healthcare. • Impact on Care: The heightened vulnerability of elderly patients in acute care. • Ethical Considerations: Ensuring equity in care for the elderly, especially in resource-limited settings. • References: • National Institute on Aging. (2021). "Social Isolation, Loneliness in Older People Pose Health Risks." NIH. Link • Fulmer, T., et al. (2020). "Elder Mistreatment as a Social Determinant of Health." American Journal of Public Health, 110(7), 1049-1051.
- 7. • Slide 8:Ethical Dilemmas in Acute Care for Adults • End-of-Life Care: Navigating decisions about DNR orders and life support. • Informed Consent: Challenges in obtaining consent from adults with cognitive impairments. • Resource Allocation: Ethical issues in prioritizing care for critically ill adults. • References: • Truog, R.D., et al. (2015). "The Problem With DNR Orders." JAMA, 313(7), 671-672. • Wendler, D., & Rid, A. (2011). "Systematic Review: The Effect on Surrogates of Making Treatment Decisions for Others." Annals of Internal Medicine, 154(5), 336-346.
- 8. • Slide 9:Ethical Dilemmas in Acute Care for the Elderly • End-of-Life Care: Special considerations for elderly patients, including advance directives and palliative care options. • Informed Consent: Challenges with elderly patients who may have dementia or other cognitive impairments. • Resource Allocation: Ethical challenges in the allocation of scarce resources, particularly during pandemics or crises. • References: • Teno, J.M., et al. (2013). "Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life." JAMA, 309(5), 470-477. • Karlawish, J. (2021). The Problem of Alzheimer’s: How Science, Culture, and Politics Turned a Rare Disease into a Crisis and What We Can Do About It. St. Martin's Press.
- 9. • Slide 10:Case Study 1: End-of-Life Decision (Adult Patient) • Scenario: An adult patient with a terminal illness faces decisions about life-sustaining treatments. • Ethical Issues: Autonomy, beneficence, and the right to refuse treatment. • Discussion: Students analyze the ethical implications and propose solutions. • References: • Quill, T.E., & Miller, F.G. (2014). "Palliative Care and Ethics: Common Ground or Common Disagreement?" JAMA Internal Medicine, 174(10), 1664-1665.
- 10. • Slide 11:Case Study 1: Analysis (Adult Patient) • Analysis: Ethical principles involved and their application. • Frameworks: Application of ethical frameworks in decision-making. • Conclusion: Key takeaways for handling similar situations in practice. • References: • Beauchamp, T.L., & Childress, J.F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.
- 11. • Slide 12:Case Study 2: End-of-Life Decision (Elderly Patient) • Scenario: An elderly patient with multiple comorbidities and a poor prognosis. • Ethical Issues: Balancing autonomy with family wishes, the role of palliative care. • Discussion: Ethical analysis and student responses. • References: • Mitchell, S.L., et al. (2012). "A National Study of Palliative Care for Advanced Dementia Patients." Journal of the American Geriatrics Society, 60(12), 2279- 2285.
- 12. • Slide 13:Case Study 2: Analysis (Elderly Patient) • Analysis: Ethical principles specific to the elderly population. • Frameworks: Application of ethical frameworks in elderly care. • Conclusion: Key takeaways for ethical decision-making in the elderly population. • References: • Johnson, K.S. (2013). "Ethical Issues in the Care of Geriatric Patients." The American Journal of Geriatric Pharmacotherapy, 11(6), 491-495.
- 13. • Slide 14:Informed Consent and Capacity (Adults) • Definition: Informed consent and its importance in healthcare. • Challenges: Assessing capacity in adults with acute conditions or cognitive impairments. • Ethical Considerations: Ensuring that adults understand the implications of their choices. • References: • Appelbaum, P.S. (2007). "Assessment of Patients’ Competence to Consent to Treatment." The New England Journal of Medicine, 357, 1834-1840.
- 14. • Slide 15:Informed Consent and Capacity (Elderly) • Challenges: Obtaining informed consent from elderly patients with dementia or cognitive decline. • Role of Surrogates: Legal and ethical considerations in surrogate decision-making for the elderly. • Best Practices: Strategies to ensure that elderly patients’ wishes are respected. • References: • Moye, J., et al. (2017). "Clinical Evidence in Assessing Older Adults’ Capacity for Medical Decision-Making." American Psychologist, 72(2), 114-127.
- 15. • Slide 16:Case Study 3: Informed Consent (Adult Patient) • Scenario: An adult patient with a traumatic brain injury and fluctuating capacity. • Ethical Issues: Autonomy vs. protection, involving family in decision- making. • Discussion: Students explore the ethical challenges and propose solutions. • References: • Appelbaum, P.S. (2007). "Assessment of Patients’ Competence to Consent to Treatment." The New England Journal of Medicine, 357, 1834-1840.
- 16. • Slide 17:Case Study 3: Analysis (Adult Patient) • Analysis: Ethical principles involved and application in real-world scenarios. • Frameworks: Use of decision-making frameworks in practice. • Conclusion: Key takeaways for handling informed consent with adult patients. • References: • Beauchamp, T.L., & Childress, J.F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.
- 17. • Slide 18:Case Study 4: Informed Consent (Elderly Patient) • Scenario: An elderly patient with Alzheimer’s disease requiring a high- risk procedure. • Ethical Issues: Capacity, surrogate decision-making, and patient autonomy. • Discussion: Students analyze the ethical challenges and propose solutions. • References: • Moye, J., et al. (2017). "Clinical Evidence in Assessing Older Adults’ Capacity for Medical Decision-Making." American Psychologist, 72(2), 114-127.
- 18. • Slide 19:Case Study 4: Analysis (Elderly Patient) • Analysis: Ethical principles specific to informed consent in elderly patients. • Frameworks: Decision-making models that support ethical choices. • Conclusion: Key takeaways for handling informed consent with elderly patients. • References: • Karlawish, J. (2021). The Problem of Alzheimer’s: How Science, Culture, and Politics Turned a Rare Disease into a Crisis and What We Can Do About It. St. Martin's Press.
- 19. • Slide 20:Resource Allocation in Critical Care (Adults) • Challenges: Ethical dilemmas in allocating limited resources such as ICU beds and ventilators. • Principles: Justice, fairness, and prioritization of care. • Examples: Real-world scenarios involving critically ill adult patients. • References: • Persad, G., Wertheimer, A., & Emanuel, E.J. (2009). "Principles for Allocation of Scarce Medical Interventions." The Lancet, 373(9661), 423-431.
- 20. • Slide 21:Resource Allocation in Critical Care (Elderly) • Challenges: Ethical issues in prioritizing care for elderly patients in resource-limited situations. • Principles: Balancing fairness with quality of life considerations. • Examples: Real-world scenarios involving critically ill elderly patients. • References: • White, D.B., Katz, M.H., Luce, J.M., & Lo, B. (2009). "Who Should Receive Life Support During a Public Health Emergency? Using Ethical Principles to Improve Allocation Decisions." Annals of Internal Medicine, 150(2), 132-138.
- 21. • Slide 22:Interactive Discussion: Resource Allocation • Scenario: Limited ventilators during a pandemic. • Group Activity: Students discuss how to allocate resources fairly between adult and elderly patients. • Debrief: Share group findings and discuss ethical implications. • References: • Emanuel, E.J., et al. (2020). "Fair Allocation of Scarce Medical Resources in the Time of Covid-19." The New England Journal of Medicine, 382, 2049-2055.
- 22. • Slide 23:Evidence-Based Practice in Ethics (Adults) • Definition: Role of evidence-based practice (EBP) in supporting ethical decision-making. • Application: Integrating EBP into the care of critically ill adults. • Innovations: Current innovations in acute care that enhance ethical practice. • References: • Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (4th ed.). Wolters Kluwer.
- 23. • Slide 24:Evidence-Based Practice in Ethics (Elderly) • Application: Importance of EBP in making ethical decisions for elderly patients. • Innovations: Advances in geriatric care and their ethical implications. • Challenges: Ensuring that evidence-based interventions respect the autonomy and dignity of elderly patients. • References: • Fulmer, T., et al. (2020). "Elder Mistreatment as a Social Determinant of Health." American Journal of Public Health, 110(7), 1049-1051.
- 24. • Slide 25:Case Study 5: Evidence-Based Ethical Decision (Adult Patient) • Scenario: An adult patient with a complex, life-threatening condition. • Ethical Issues: Balancing evidence-based care with patient and family preferences. • Discussion: Students analyze the case and propose evidence-based ethical solutions. • References: • Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (4th ed.). Wolters Kluwer.
- 25. • Slide 26:Case Study 5: Analysis (Adult Patient) • Analysis: Ethical principles and EBP application. • Frameworks: Decision-making models in evidence-based ethical decisions. • Conclusion: Key takeaways for integrating EBP in adult patient care. • References: • Beauchamp, T.L., & Childress, J.F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.
- 26. • Slide 27:Holistic and Family-Centered Care (Adults) • Holistic Care: Importance of considering the whole person in care, including mental, emotional, and social factors. • Family Involvement: Ethical considerations in involving families in adult patient care. • Strategies: Best practices for providing holistic, family-centered care to adults. • References: • Wright, L.M., & Leahey, M. (2012). Nurses and Families: A Guide to Family Assessment and Intervention (6th ed.). F.A. Davis.
- 27. • Slide 28:Holistic and Family-Centered Care (Elderly) • Holistic Care: Ethical considerations in caring for elderly patients, respecting their life experiences and values. • Family Dynamics: Challenges in balancing patient autonomy with family wishes in elderly care. • Strategies: Best practices for providing holistic, family-centered care to elderly patients. • References: • D’Onofrio, G., et al. (2019). "Family-Centered Care for Older Adults in the Emergency Department: A Systematic Review." Geriatric Nursing, 40(4), 379-384.
- 28. • Slide 29:Reflective Practice in Ethical Nursing • Importance: Reflecting on ethical experiences to enhance future practice. • Techniques: Journaling, peer discussions, and continuing education.