Monash bioethics review
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Monash bioethics review · Jun 2009
Ethical decision-making in an emergency department: findings on nursing advocacy.
The purpose of this article is to share with the reader the specific findings on the role of nurse as consumer advocate from a study on ethical decision-making in an emergency department (ED). Qualitative interviews were conducted with 11 health professionals (doctors and nurses) working in the ED of a hospital. The interviews were audio-recorded, transcribed verbatim and thematically analysed. ⋯ It is noted that seeing the need for advocacy does not necessarily translate into effective action, as management support is essential for productive advocacy. A phenomenon of the desire not to rock the boat was reported. The findings indicate that the support of other nurses is essential for advocacy and affirm the importance of focusing on the ethical nature of the organisation as opposed to an exclusive focus on the individual.
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Monash bioethics review · Jun 2009
A case for increased caution in end of life decisions for disorders of consciousness.
Disorders of consciousness include coma, the vegetative state and the minimally conscious state. Such patients are often regarded as unconscious. This has consequences for end of life decisions for these patients: it is much easier to justify withdrawing life support for unconscious than conscious patients. ⋯ Additionally, we argue that if their lives are to be ended, then increased caution should be exercised to avoid undue suffering. As a consequence, the already difficult ethical and clinical questions surrounding these patients are made even more difficult with regard to making and acting on end of life decisions, as well as with regard to quality of life prognoses. The best we can hope for is that research both on disorders of consciousness and on the neural correlates of consciousness will progress more and make these kinds of questions easier to address in the future.