Biomedical subjects
Publications and source records attributed to K A Singleton.
In Case 1, a nurse describes a scenario in which a patient's functional and legal families disagree about who has the right to make consent decisions. Case 2 reveals the situation's legal and ethical implications for nurses and how they can facilitate a resolution.
Issues surrounding patient autonomy frequently occur in the critical care setting. To deal effectively with the complex issues of autonomy, the critical care nurse needs to identify the threats to autonomy and respond as a patient advocate. The authors present a patient case that demonstrates the autonomy issues that confront many critical care patients.
Written, witnessed advance directives such as Durable Powers of Attorney and Living Wills communicate patients' care preferences. The critical care nurse must be knowledgeable about these legal documents to be able to effectively uphold the specific care requests. The authors define advance directives and outline the role of the nurse in execution of these directives.
The Safe Medical Device Act places a legal responsibility on health care practitioners to assess and report malfunctioning medical equipment. As a result of this law, the Food and Drug Administration (FDA) will for the first time have direct regulatory authority over hospitals. Today's complex and technological critical care setting requires that the nurse understand the legal and professional responsibilities imposed by this Act.
This article describes a case in which the health-care team initiated treatments assuming that the information provided by the patient was true. Following the onset of complications requiring additional consents and leading to a long-term relationship with family members, there was serious conflict between what was discovered to be a functional family unit and a legal family unit. The patient's wishes were uncertain and not legally supported. After being declared competent for consent, the patient still failed to clearly communicate his wishes to those affected. The case is followed by an ethical analysis.
A survey was conducted in the fall of 1989 to determine how hospitals handle the task of overreading of computer-generated electrocardiograms. All hospital-based members (1,451) of the American College of Physician Executives were sent questionnaires. Responses were received from 413 physician executives, a response rate of about 28 percent. The results of the survey are summarized in this article.
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