When a pregnant lady is brain dead, she cannot acknowledge the fetus. Therefore, the mother lacks the moral responsibility to keep the fetus alive (Akhyari, Lichtenberg & Boeken, 2019; Paternoster et al., 2017; Staff & Nash, 2017). Being uninsured and lacking an advance directive that states that the mother intends to be kept alive to save the unborn child, prolonging life is considered unethical. In the case of a 26-year-old woman who is 20 weeks pregnant, ethical and legal considerations are vital.

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The Hendricks/Smith Model posits that one needs to undertake various processes before making a decision. The very first undertaking would be to gather data or conduct an assessment on the patient (Fero, Herrick, 7 Hu, 2011). There are several relevant data concerning the patient such as lack of insurance, the position of the mother, the position of the fetus and the status of the mother. The case reveals that the patient is brain dead. Secondly, the model stipulates that one needs to make a diagnosis of the patient, in which case the patient is brain dead. Third, planning for the various outcomes need to occur. In the present case, there are two options: supporting the mother’s position which is to keep the lady alive until a Cesarean delivery is conducted or supporting the husband who wants it to be terminated in order for his wife to be relieved. Following the planning process, Hendricks/Smith model states that the case manager must now make a decision. According to Nishimura et al. (2016), the older the baby when its mother is confirmed brain-dead, the higher its chances of survival. In the present case, and given the information about the husband’s lack of support for the pregnancy, it would be prudent for the case manager to prioritize the life of the fetus by supporting the mother’s position. Therefore, the mother will be kept on the life support machine until such a time that the Cesarean delivery option will be implemented. Thereafter, the state of the woman will be evaluated to determine if she will continue using the life support or she will be terminated.

I agree with the analysis of my peers because based on the Herrick/Smith model, a baby born at 20 weeks will have a 20 to 30 percent survival chances and a 40 percent chance of seriously being disabled (Pikto-Pietkiewicz et al., 2019). The older the baby, the less the risk of severe disability. In the scenario, the best ethical outcome would be to maintain the pregnancy until such as time that a Cesarean is conducted. The absence of an advance directive from the pregnant woman makes this the best ethical decision. Adopting the African-American culture for the scenario does not alter the chosen option. In the African-American population, terminating the woman’s life would be tantamount to killing, which is not supported by the culture.

References

Akhyari, P., Lichtenberg, A., & Boeken, U. (2019). Successful transplantation of a heart donated 5 months after brain death of a pregnant young woman. The Journal of Heart and Lung Transplantation, 38(10), 1121.

Fero, L. J., Herrick, C. A., & Hu, J. (2011). Introduction to care coordination and nursing management. Sudbury, MA: Jones & Bartlett Learning.

Nishimura, T., Kohama, K., Osako, T., Yamada, T., Tanaka, H., Nakao, A., & Kotani, J. (2016). Case of 24-week fetus delivered from mother on life support with brain-death from suicide attempt: Ethical issues associated with severe complications. Acta Medica Okayama, 70(5), 389-392.

Paternoster, M., Saccone, G., Maruotti, G. M., Bianco, C., Casella, C., Buccelli, C., & Martinelli, P. (2017). Ethical challenges in pregnant women with brain injury. The Journal of Maternal-Fetal & Neonatal Medicine.

Pikto-Pietkiewicz, I., Okniński, A., Wójtowicz, R., & Wójtowicz, M. (2019). The Management of a Thirteen Weeks Pregnant Woman Rendered Brain-Dead Following a Ruptured Aneurysm. The Journal of Critical Care Medicine, 5(3), 111.

Staff, L., & Nash, M. (2017). Brain death during pregnancy and prolonged corporeal support of the body: A critical discussion. Women and Birth, 30(5), 354-360.

As referenced in Week 2, Discussion 2, nurses are perceived as having very high ethical standards (Gallup, 2013). Doctorally prepared nurses should be able to consider ethical issues from multiple viewpoints. In this week’s media presentation, the experts discuss ethical challenges encountered by nurses as they assume leadership positions and as they engage in research.

To prepare:

• Reflect on ethical challenges that you have encountered in your nursing practice.
• Think about the information the experts shared in this week’s media presentation, focusing on the ethical challenges they have encountered as nurse leaders or scientists, as well as information presented in other Learning Resources.
• With this information in mind, consider what new ethical challenges you may face once you obtain your doctoral degree.

By Day 3

Post a cohesive response that addresses the following:

• Describe two or more significant ethical issues relevant to the DNP- or PhD-prepared nurse.
• Explain how these issues might compare to the types of issues you have already encountered in your practice.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

• Ask a probing question, substantiated with additional background information, evidence, or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
• Validate an idea with your own experience and additional research.
• Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 5 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 5 Discussion