4. CASE: Expectations for Care

Ned is an elderly patient with relatively advanced dementia who is recovering from surgery to repair a hip fracture. He spends most of every 24-hour period screaming unless someone familiar sits with him. Staff members on the unit are becoming increasingly frustrated and stressed. The unit manager has received numerous complaints, verbal and written, from other patients on the unit and from some of their family members. She decides to call the ethics line.

  • What are the ethics issues?
  • What are the non-ethics issues?
  • What underlying values are at stake?
  • How would you respond to this call?

 Some Values and Ethics Issues to Consider

  • Moral distress among health care providers
  • Distributive justice
  • Resource allocation
  • Patient-centered care
  • Capacity
  • Empathy
  • Respect for human dignity
  • Quality of life

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