|Type of paper:||Essay|
|Categories:||Violence Medicine Gun violence Ethical dilemma|
A thirty-four-year-old is taken to a Las Vegas emergency unit of an educational health center after being wounded by a bullet in the stomach. A triage nurse classified the man as a victim of violence (VOV) and put him on care constraints as read out by the hospital's policies. He is found to be the sole caregiver of his mother, who is almost dying. He is also left with ten centimeters of the small bowel and has a severe short gut syndrome. After three weeks, he is transferred to a regular hospital ward wherein he requests to contact his family, and a new surgeon lifts the protective status against the hospital policy. However, he has a past of bad behavior, so his demand is denied, where he threatens to leave contrary to medical advice (AMA) (Rodriguez et al., 2018). He is depressed, incapable of upholding sufficient hydration without total parenteral nutrition (TPN).
Ethical and Legal Issues of the Case
Based on his history of a misdemeanor and the fact that he is the caregiver of his mother, should his wishes be respected and permit the patient to leave the hospital contrary to medical advice without situations for follow up? Also, can it be workable for the hospital to facilitate TPN for discharge to allow him to leave temporarily with the condition of returning after his mother's burial? The committee's decision to uphold the VOV status may be sustained. Alternatively, can his communication devices returned so that he can be returned and keep him as an inpatient.
My Position On This Case
The best thing to do is to keep the patient inside the facility until his health improves. Also, he can be allowed to contact his family (Saad & Jackson, 2018). After the Las Vegas mass shooting incident of 2017, the scale of the gun violence disaster in the United States was published (Rodriguez et al., 2018). The VOV status is meant to safeguard him, the establishment, workers, and clients from harm. Notably, he has been admitted with gun wounds that are linked with violence, and the specifics of the confrontation are undependable at the moment. Before it is specified whether he was only an innocent bystander or a gang-member, he must be retained within the hospital.
The patient must be made aware and advised of the underlying assumptions in the combination of losses from various kinds of disability with the damages that may come if he is unable to return to his initial condition. However, risk management may be used to ask whether the patient is still at risk. At the same time, risk management may be aligned with the hospital policies, which should be reassessed to conclude if they are achieving the health objectives intended.
Upholding the hospital's decision to maintain the VOV status is a very viable option to improve the health of the patient. I believe the patient had already took on a consent to be attended at the facility. Since it's not legally binding, he is at the liberty of withdrawing consent when he chooses. Respecting his wishes and allowing him to leave will prioritize his autonomy, which is okay but is an imperfect process. Even though the patient is to relate the dangers connected with abandoning AMA, there are no criteria for determining whether his interpretations are an accurate reflection of his understanding. Numerous factors are involved in the complex interaction of what should be done, and among the concern as to whether he may rightly make an informed consent without adequate health knowledge.
Rodriguez, J. G. Z., Yu, J., Kodner, I. J., Brown, D., & Punch, L. J. Victims of violence: An ethical conflict between patient rights and institutional policy. Retrieved from http://bulletin.facs.org/2018/10/victims-of-violence-an-ethical-conflict-between-patient-rights-and-institutional-policy/. 24th Sept. 2019.
Saad, T., & Jackson, G. (2018). Testing conscientious objection by the norm of medicine. Clinical Ethics, 13(1), 9-16. doi: 10.1177/1477750917749952
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