Ethics in Emergent Situations

Ethics in Emergent Situations

A well-known cardiothoracic surgeon, Dr. Wilbanks, and his wife present to the women’s center at your rural facility. You have placed them in observation and are awaiting a few tests.

The wife, Sarah, has been placed on monitors and is determined to be in active labor. All attempts to stop labor have failed. Ultrasound shows the fetus measuring at 23 weeks and 0 days gestation, weighing approximately 475 grams. The fetus is also found to be male. You are unable to ship her to another location due to the progression of her labor.

You, the sole provider on the unit, know that delivery is imminent and discuss this with Dr. Wilbanks and Sarah. You go over the complications that may occur at the edge of viability and discuss resuscitation options. Sarah looks to her husband for answers and states she trusts his judgment.

Ethics in Emergent Situations

As she is being rushed back for an emergency Cesarean section, Dr. Wilbanks states:

“I do not want any resuscitation efforts performed. The baby is too early and would only have a multitude of issues. Raising a child like that would be too much of a burden on my wife and I. We can always try again. I’ve performed surgeries on these types various times, and they never turn out normal.”

Check tips on how to do your DNP Project Writing Assignments.

Briefly describe the scenario:

1. What ethical principles support the parents’ wishes?
2. Do ethical standards dictate that Sarah should also be questioned?
3. How does the emergent nature of this scenario affect the ethics surrounding the case?
4. Do your personal convictions as a provider play a part here?
5. You are present at delivery to care for the infant. While the hospital does have a small Neonatal Intensive Care unit, they are only prepared to care for 32 weeks and above infants. The neonatologist is busy with another emergency and cannot attend the delivery. At delivery, the 23- week gestation male makes an effort to cry.
6. Do you perform resuscitation at this me? Why or why not?
7. Based on the reflective equilibrium model in chapter 2 p. 53–54, what ethical theory and principles are leading you in the 15 seconds you have to make a decision?
8. How does the Belmont Report (PDF) support your decision?
9. What ethical principles now apply to this baby, who is no longer a fetus, but an infant?

Provide at least two critically reviewed references to support your assertions.