Case 10: Pain Relief, Cultural Beliefs, and the Role of a
Family Member
Josh, Megan, and Eric
This case considers challenges that occur when an
individual’s request for medical treatment conflicts with her religious
beliefs. Marie F. is suffering from terminal lung cancer, and requested pain
medication, which made her delirious. She and her brother, Jean, are Haitian
immigrants, and her brother believes that her incoherence is due to evil
spirits brought on by the pain medication. He demands that the pain treatments
be stopped.
Facts to consider:
·
Marie was coherent when she originally requested
pain medication
·
Religious beliefs dictate that evil spirits be
exorcised; if Marie were aware of her current behavior, she might agree with
her brother’s demands
·
Their cultural beliefs may state that male
family members make decisions on behalf of females
Options:
·
The nurse could continue treating Marie’s pain
against Jean’s wishes
·
The nurse could discontinue Marie’s treatment
·
The nurse could come up with an alternative (and
possibly less-effective) method of pain relief that might have less extreme
side effects
Questions:
1.
Whose requests should the nurse follow?
2.
Would your response to Question 1 be different
if Marie had named Jean as the person responsible for her medical care and
end-of-life decisions, i.e. power of
attorney?
3.
If Jean did legally have power of attorney
status, should he be able to base his decisions about his sister’s care on
religious beliefs, rather than medical science? How much of a role should
religion have in influencing medical treatment?
4.
If the nurse chooses to obey Marie’s initial
request, how could she go about explaining her decision to Jean? Would
educating him on the known side effects of pain medication make a difference?
I think there is a way to attend to both the patient and her brother. There is not just one way to treat pain so I think that there could be other options that would return the patient back to her proper mental state. If those treatments aren't working and she desires to go back to the first one knowing the consequences then that would be her decision, not her brothers. As long as there is another way to control the pain in the time being, then there is no reason to go against her brother's wishes. All the case says is that it was her wish to be treated for her pain.
ReplyDeleteI think that the nurse should follow the patients request. The brother's thoughts should be considered and possibly an alternative should be done for the both of them. If the patient is still in pain the medicine should be given again. If Marie had Jean as her power of attorney than I think if he saw the pain she was in, he may change his mind once he takes her off the medicine. I think religion plays a large role in peoples' decisions and understand why some people might make drastic decisions because of this. I think if the nurse obeys Marie's request she can explain to Jean that his sister is having a large amount of problems and if he wants her to not suffer the rest of her treatment/ life than she needs this medication.
ReplyDeleteThe religious beliefs in this case makes it hard to say really what's the right thing to do and whats not. However, I think that in this given situation the nurse should see the pain that the patient is going through and her needs should trump that of her brothers. I think the brothers thoughts should really only be a consideration honestly I feel the brother shouldn't have a right in saying what is being done in the situation because hes not going through the pain and suffering. That may be a little harsh but I don't think its fair for her to suffer just so he will be happy.
ReplyDeleteThe nurse could try to teach the brother on what the drug is and does inside the body also reassuring there are no "evil spirits" in her body. In any rate the nurse only advocates for the best interests of the patient. The nurse should also let the patient know what she was doing while under the drug and ask if she wishes to continue even if Jean has the power of attorney. Religion should be noted in the medical field so they know how to work around their rules, but it should no way shape or form do additional harm to the patient.
ReplyDeleteThe nurses main job is to advocate for the patient, so trying to teach the family that these are normal reactions to the drugs and that the drugs are doing nothing but helping her should be the first step. Of course if the family is adimit about their decision then the nurse and hospital staff must follow what they say. The role of religion plays a major role in this case, because for some religion is a central part of their life. If they do not do right by their religion they may fear the after life and what will happen to them. We don't know if educating the patient will help or not but it is worht trying.
ReplyDeleteThe nurse in this situation should follow the patient's request and think of the patient's well being. If the patient is in so much pain then the medication or other pain medicatoin should be administered. The brother has a right to care for his sister but his concerns should also be for her welbeing and pain. He should consider her feelings and her wishes before she became delirious.
ReplyDeleteYou have to listen to what the patient saidbecause when it comes down to it nobody knows their own body as well as they do so for the brother to try to stop medication for her I think that is wrong. Honestly as soon as the brother started talking about evil spirits I would have just stop listening to him all together.
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