The contentious issue is whether to put Jennie on a feeding machine or not. Jennie is a 76-year-old patient with hypertension, diabetes, and stroke. She is a mother to Mary. Jennie is incapable of caring for herself because of her health status. Mary took her to St Francis nursing center for specialized care when it became apparent that she could not meet it. Before this, Jennie had stated in her directive will that she does not want to be put on a life support machine. However, Mary and the director of St Francis nursing home think that a feeding machine is suitable for meeting Jennie’s nutritional needs because of the long time it takes to feed her. The director of St Francis nursing home has noted that feeding Jennie consumes a lot of time at the expense of other patients in the home care. From the information given in the case study, it takes three to six hours for a nurse to feed Jennie. This time duration has been noted to increase with the passage of time. The director of the nursing home does not see the need of spending a lot of time feeding Jennie at the expense of other patients. Jennie is not seriously ill when compared to other patients in the nursing home. However, she needs special nursing care because of her advanced age and psychological complications. She suffered multiple strokes before she was taken to St Francis nursing home. Putting Jennie on a feeding machine would mean making her immobile for some time and according to the facts on her file, she is yet to reach that stage (Kearney-Nunnery, 2012).
The use of a feeding tube is against Jennie’s wishes as seen from the directive file signed by Mary when admitting her to the nursing home. The information in the will shows that Jennie had not initialed surgery, heart-lung resuscitation, antibiotics, dialysis, mechanical ventilator, or tube feeding. Considering her health status, Jennie might not have a full understanding of the implications of her will. However, the fact that she mentioned to a friend of hers who came to visit that she did not want to be kept alive by a life support machine makes it clear that she was conscious of her decisions when she made them. Therefore, it is unethical for St Francis’s nursing home to dishonor her will (Kearney-Nunnery, 2012). Ethical practices in human health require medical practitioners to obtain the consent of the patients before any surgical operation or installment of life support machines is initiated. In view of this, it is unethical for Mary and the director of St Francis nursing home to put Jennie on a feeding machine without her consent. Putting Jennie on a feeding tube is a violation of her will to live without a life support machine (Kearney-Nunnery, 2012).
Despite the fact that Jennie may not be seriously ill currently, the need for specialist nursing support is justified by her advanced age coupled with hypertensive and diabetic conditions. Diseases like diabetes and hypertension need constant care, monitoring, and treatment. Jennie’s previous record of stroke underscores that she is incapable of caring for herself. Mary tried to provide her with homecare but felt she was not competent enough to provide it. This background information justifies the need for a trained nurse to provide specialized care for Jennie. That is the reason why Mary took her mother to St Francis nursing center (Kearney-Nunnery, 2012).
It is justifiable for Mary and the director of St Francis nursing home to consider putting Jennie in a feeding machine. This is because feeding her is time-consuming. The nursing home is running under strained human resources against an increasing number of patients. Besides Jennie, the nurses need to attend to other patients in the nursing home. However, Jennie needs to give consent to the decision before it is executed. In view of this, Mary should explain the decision to put Jennie on the feeding machine before it is implemented. In the event of any difficulties in obtaining Jennie’s consent, the nursing home should provide the needed care to Jennie according to her will as long as her family is capable of paying for it. Mary is currently paying the nursing care bill. Therefore, St Francis nursing home is not suffering any financial loss. The nursing home is thus obliged to honor Jennie’s will of living without a life support machine as long as Mary is capable of meeting the cost. However, since Mary has considered the option of a feeding tube and is willing to pay for its cost, it is good that she explains to her mother the decision to put her on a feeding tube and obtain her consent for the process (Kearney-Nunnery, 2012).
According to the requirements of the ethical code of practice in human medicine, the person in charge of the patient’s treatment should collaborate with the patient in all decision-making processes. Mary is not a patient hence the director of St Francis nursing home should not consult her in decision-making. The ultimate consent of the decision regarding the feeding tube lies with Jennie. St Francis nursing home is obliged to respect Jennie’s will as long as she does not consent to a life support machine.
Reference
Kearney-Nunnery, R. (2012). Advancing your career: concepts of professional nursing. 5th ed. Philadelphia: F.A Davis Company.