Ethical Issues in Adult and Older Adults with.pptx

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1. Ethical Issues in Adult and Older Adults with Acute and Critical Care

2. Learning Objectives Objective 1: Analyze concepts, theories, and factors affecting health conditions in adults and the elderly. Objective 2: Apply knowledge, evidence-based practice, and advanced nursing innovations for holistic, patient- and family-centered care. Objective 3: Evaluate ethical dilemmas in acute and critical care scenarios for both adults and elderly patients.

3. Introduction to Ethical Issues Definition: Ethics in nursing, particularly in high-stakes environments like ICU and emergency care. Relevance: Ethical considerations are critical when dealing with life-and-death situations in adult and elderly populations. Overview: Common ethical principles (autonomy, beneficence, non-maleficence, and justice) and their specific application in acute and critical care. References: Beauchamp, T.L., & Childress, J.F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press. American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements . Silver Spring, MD: ANA.

4. Ethical Frameworks in Nursing Deontological vs. Consequentialist Ethics: Introduction to different ethical theories. Application: How these theories guide decision-making in acute and critical care. Theories of Aging: Ethical considerations in the care of elderly patients, including respect for autonomy and dignity in the context of aging. References: Levett -Jones, T., et al. (2019). The Clinical Placement: An Essential Guide for Nursing Students (5th ed.). Elsevier. Johnson, K.S. (2013). "Ethical Issues in the Care of Geriatric Patients." The American Journal of Geriatric Pharmacotherapy , 11(6), 491-495.

5. Social Determinants of Health in Adults Factors: Income, education, and access to healthcare. Impact on Care: How these factors influence health outcomes in adults. Ethical Considerations: Addressing disparities in acute care settings, particularly in emergency situations. References: Marmot, M., & Wilkinson, R. (Eds.). (2006). Social Determinants of Health (2nd ed.). Oxford University Press. Braveman , P., & Gottlieb, L. (2014). "The Social Determinants of Health: It’s Time to Consider the Causes of the Causes." Public Health Reports , 129(1_suppl2), 19-31.

6. Social Determinants of Health in the Elderly Factors: Social isolation, poverty, and limited access to healthcare. Impact on Care: The heightened vulnerability of elderly patients in acute care. Ethical Considerations: Ensuring equity in care for the elderly, especially in resource-limited settings. References: National Institute on Aging. (2021). "Social Isolation, Loneliness in Older People Pose Health Risks." NIH. Link Fulmer, T., et al. (2020). "Elder Mistreatment as a Social Determinant of Health." American Journal of Public Health , 110(7), 1049-1051.

7. Ethical Dilemmas in Acute Care for Adults End-of-Life Care: Navigating decisions about DNR orders and life support. Informed Consent: Challenges in obtaining consent from adults with cognitive impairments. Resource Allocation: Ethical issues in prioritizing care for critically ill adults. References: Truog , R.D., et al. (2015). "The Problem With DNR Orders." JAMA , 313(7), 671-672. Wendler, D., & Rid, A. (2011). "Systematic Review: The Effect on Surrogates of Making Treatment Decisions for Others." Annals of Internal Medicine , 154(5), 336-346.

8. Ethical Dilemmas in Acute Care for the Elderly End-of-Life Care: Special considerations for elderly patients, including advance directives and palliative care options. Informed Consent: Challenges with elderly patients who may have dementia or other cognitive impairments. Resource Allocation: Ethical challenges in the allocation of scarce resources, particularly during pandemics or crises. References: Teno , J.M., et al. (2013). "Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life." JAMA , 309(5), 470-477. Karlawish , J. (2021). The Problem of Alzheimer’s: How Science, Culture, and Politics Turned a Rare Disease into a Crisis and What We Can Do About It . St. Martin's Press.

9. Case Study 1: End-of-Life Decision (Adult Patient) Scenario: An adult patient with a terminal illness faces decisions about life-sustaining treatments. Ethical Issues: Autonomy, beneficence, and the right to refuse treatment. Discussion: Students analyze the ethical implications and propose solutions. References: Quill, T.E., & Miller, F.G. (2014). "Palliative Care and Ethics: Common Ground or Common Disagreement?" JAMA Internal Medicine , 174(10), 1664-1665.

10. Case Study 1: Analysis (Adult Patient) Analysis: Ethical principles involved and their application. Frameworks: Application of ethical frameworks in decision-making. Conclusion: Key takeaways for handling similar situations in practice. References: Beauchamp, T.L., & Childress, J.F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.

11. Case Study 2: End-of-Life Decision (Elderly Patient) Scenario: An elderly patient with multiple comorbidities and a poor prognosis. Ethical Issues: Balancing autonomy with family wishes, the role of palliative care. Discussion: Ethical analysis and student responses. References: Mitchell, S.L., et al. (2012). "A National Study of Palliative Care for Advanced Dementia Patients." Journal of the American Geriatrics Society , 60(12), 2279-2285.

12. Case Study 2: Analysis (Elderly Patient) Analysis: Ethical principles specific to the elderly population. Frameworks: Application of ethical frameworks in elderly care. Conclusion: Key takeaways for ethical decision-making in the elderly population. References: Johnson, K.S. (2013). "Ethical Issues in the Care of Geriatric Patients." The American Journal of Geriatric Pharmacotherapy , 11(6), 491-495.

13. Informed Consent and Capacity (Adults) Definition: Informed consent and its importance in healthcare. Challenges: Assessing capacity in adults with acute conditions or cognitive impairments. Ethical Considerations: Ensuring that adults understand the implications of their choices. References: Appelbaum, P.S. (2007). "Assessment of Patients’ Competence to Consent to Treatment." The New England Journal of Medicine , 357, 1834-1840.

14. Informed Consent and Capacity (Elderly) Challenges: Obtaining informed consent from elderly patients with dementia or cognitive decline. Role of Surrogates: Legal and ethical considerations in surrogate decision-making for the elderly. Best Practices: Strategies to ensure that elderly patients’ wishes are respected. References: Moye , J., et al. (2017). "Clinical Evidence in Assessing Older Adults’ Capacity for Medical Decision-Making." American Psychologist , 72(2), 114-127.

15. Case Study 3: Informed Consent (Adult Patient) Scenario: An adult patient with a traumatic brain injury and fluctuating capacity. Ethical Issues: Autonomy vs. protection, involving family in decision-making. Discussion: Students explore the ethical challenges and propose solutions. References: Appelbaum, P.S. (2007). "Assessment of Patients’ Competence to Consent to Treatment." The New England Journal of Medicine , 357, 1834-1840.

16. Case Study 3: Analysis (Adult Patient) Analysis: Ethical principles involved and application in real-world scenarios. Frameworks: Use of decision-making frameworks in practice. Conclusion: Key takeaways for handling informed consent with adult patients. References: Beauchamp, T.L., & Childress, J.F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.

17. Case Study 4: Informed Consent (Elderly Patient) Scenario: An elderly patient with Alzheimer’s disease requiring a high-risk procedure. Ethical Issues: Capacity, surrogate decision-making, and patient autonomy. Discussion: Students analyze the ethical challenges and propose solutions. References: Moye , J., et al. (2017). "Clinical Evidence in Assessing Older Adults’ Capacity for Medical Decision-Making." American Psychologist , 72(2), 114-127.

18. Case Study 4: Analysis (Elderly Patient) Analysis: Ethical principles specific to informed consent in elderly patients. Frameworks: Decision-making models that support ethical choices. Conclusion: Key takeaways for handling informed consent with elderly patients. References: Karlawish , J. (2021). The Problem of Alzheimer’s: How Science, Culture, and Politics Turned a Rare Disease into a Crisis and What We Can Do About It . St. Martin's Press.

19. Resource Allocation in Critical Care (Adults) Challenges: Ethical dilemmas in allocating limited resources such as ICU beds and ventilators. Principles: Justice, fairness, and prioritization of care. Examples: Real-world scenarios involving critically ill adult patients. References: Persad, G., Wertheimer, A., & Emanuel, E.J. (2009). "Principles for Allocation of Scarce Medical Interventions." The Lancet , 373(9661), 423-431.

20. Resource Allocation in Critical Care (Elderly) Challenges: Ethical issues in prioritizing care for elderly patients in resource-limited situations. Principles: Balancing fairness with quality of life considerations. Examples: Real-world scenarios involving critically ill elderly patients. References: White, D.B., Katz, M.H., Luce, J.M., & Lo, B. (2009). "Who Should Receive Life Support During a Public Health Emergency? Using Ethical Principles to Improve Allocation Decisions." Annals of Internal Medicine , 150(2), 132-138.

21. Interactive Discussion: Resource Allocation Scenario: Limited ventilators during a pandemic. Group Activity: Students discuss how to allocate resources fairly between adult and elderly patients. Debrief: Share group findings and discuss ethical implications. References: Emanuel, E.J., et al. (2020). "Fair Allocation of Scarce Medical Resources in the Time of Covid-19." The New England Journal of Medicine , 382, 2049-2055.

22. Evidence-Based Practice in Ethics (Adults) Definition: Role of evidence-based practice (EBP) in supporting ethical decision-making. Application: Integrating EBP into the care of critically ill adults. Innovations: Current innovations in acute care that enhance ethical practice. References: Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (4th ed.). Wolters Kluwer.

23. Evidence-Based Practice in Ethics (Elderly) Application: Importance of EBP in making ethical decisions for elderly patients. Innovations: Advances in geriatric care and their ethical implications. Challenges: Ensuring that evidence-based interventions respect the autonomy and dignity of elderly patients. References: Fulmer, T., et al. (2020). "Elder Mistreatment as a Social Determinant of Health." American Journal of Public Health , 110(7), 1049-1051.

24. Case Study 5: Evidence-Based Ethical Decision (Adult Patient) Scenario: An adult patient with a complex, life-threatening condition. Ethical Issues: Balancing evidence-based care with patient and family preferences. Discussion: Students analyze the case and propose evidence-based ethical solutions. References: Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (4th ed.). Wolters Kluwer.

25. Case Study 5: Analysis (Adult Patient) Analysis: Ethical principles and EBP application. Frameworks: Decision-making models in evidence-based ethical decisions. Conclusion: Key takeaways for integrating EBP in adult patient care. References: Beauchamp, T.L., & Childress, J.F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.

26. Holistic and Family-Centered Care (Adults) Holistic Care: Importance of considering the whole person in care, including mental, emotional, and social factors. Family Involvement: Ethical considerations in involving families in adult patient care. Strategies: Best practices for providing holistic, family-centered care to adults. References: Wright, L.M., & Leahey , M. (2012). Nurses and Families: A Guide to Family Assessment and Intervention (6th ed.). F.A. Davis.

27. Holistic and Family-Centered Care (Elderly) Holistic Care: Ethical considerations in caring for elderly patients, respecting their life experiences and values. Family Dynamics: Challenges in balancing patient autonomy with family wishes in elderly care. Strategies: Best practices for providing holistic, family-centered care to elderly patients. References: D’Onofrio, G., et al. (2019). "Family-Centered Care for Older Adults in the Emergency Department: A Systematic Review." Geriatric Nursing , 40(4), 379-384.

28. Reflective Practice in Ethical Nursing Importance: Reflecting on ethical experiences to enhance future practice. Techniques: Journaling, peer discussions, and continuing education.