A 72-year-old Catholic grandmother, Mama Rhunong,has been in the coronary care unit (CCU) for 4 weeks following a large

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A 72-year-old Catholic grandmother, Mama Rhunong,has been in the
coronary care unit (CCU) for 4 weeks following a large
anterolateral MI. She has suffered from CHF, pulmonary edema and
hypertension, andnow has developed ARDS. Her family is very
supportive and visit veryoften. The physicians have communicated
with the family, and, because the patient does not have an advance
directive, the family has entrusted the physicians with making the
“right decisions.”
Currently, Mama Rhunongrequires maximal ventilator support to
maintain adequate oxygenation. Her CO and BP are maintained at an
adequate level with IV vasopressors and inotropic agents. Attempts
to keep her pain-free are sometime thwarted by a drop in her BP
when she receives morphine and other medications. The nurses
involved in her care believe that it is inappropriate to continue
treating her aggressively and that the patient does not want such
extensive treatment. They believe that she is able to make
decisions regarding her life, even though she cannot speak. She is
observed to make appropriate gestures to the nurse and maintain eye
contact when the nurse talks to her. She is weak and her writing is
often difficult to read.
Today, when Nurse Betty asked Dr. Galing, the physician, to
please ask Mama Rhunongwhat she wants before they begin new
treatments, Dr. Galingresponded that the patient is “not competent
because of her illness and her prolonged stay in the CCU.”Dr.
Galing stated that the family told him to “make the right
decisions” and that gives him the authority to decide what is best
for Mama Rhunong.
1. Do you agree with Dr. Galing’s medical decisions for the
patient? Why or why not? (Include in your discussion the basis /
bases of your answer and cite them accordingly.)
2. Discuss the bioethical principles involved in the case
scenario and rationalize how they are observed or violated by the
healthcare team members. Cite the basis/bases of your answer.
3. From the above situation, develop a plan of care utilizing
and applying the Process of Ethical Analysis.