The Pharmacology of Morphine

Discuss about the Case Study Of Tom that Suffering From A Life-Limiting Disease.

Tom is an Aboriginal whose living conditions have worsened lately. The family takes him to the hospital where the nurse checks his status. Tom is not open to the nurse since she is a native Australian and not an Aboriginal. The nurse invites an Aboriginal specialist who Tom tells his view about his health conditions. At first, Tom refuses to get a life-ending morphine injection. His conditions worsen by the day. The family takes him back home where he spends time with family members, friends, and the traditional healer. Tom’s situation reaches a critical state where the family makes him to the hospital to receive the terminal health care. Tom and the wife agree, but the daughter declines to the life-ending morphine injection. This paper looks at the pharmacology of morphine and legal and ethical principles in clinical decision making. Furthermore, the article explores the essence of shared decision and the factors impacting the issuance of palliative care for the Aboriginals.

Tom is suffering from a life-limiting disease. The disease limits the life of an individual. People who have epilepsy are likely to die. The nurse at the hospital suggests that Tom is injected with morphine to reduce his pains. Tom declines and later agrees. Morphine is an opioid which induces analgesic conditions in the patients (Tapp et al., 2017).  Morphine is one of the most effective painkillers in the medical world. Health practitioners recommend it to patients suffering from hypertension. The drug also reduces pain in road carnage patients (Tapp et al., 2017). Furthermore, the drug relieves cancer patients of depression.

Legal and ethical principles conflict when Tom decides to seek for the end of life care. Tom’s wife, who is the enduring Guardian, respects the patient to request for a morphine injection. On the other hand, the daughter, who is the attorney, objects the decision of the father. Tom passed all the requirements of looking for Morphine injection. Tom’s decision was an informed one. He accepted the consequences of termination of life. Tom knew that the care involved an infusion of morphine. Additionally, he knew about the harms involved in his decision.

The legal requirement for such a weighty decision requires the following steps. Firstly, the doctor and the patient must meet to discuss the consequences of the termination of life care (Tapp et al., 2017). Secondly, the patient signs an agreement affidavit to reaffirm the choice (Singh et al., 2017). Several ethical issues influence the patient’s decision-making process. Firstly, the act of the physicians and relatives to allow the patient to make a decision respects the principles of Autonomy (Greenfield and Jensen, 2016). However, clinicians must exercise caution not to harm the patients. Hence, the physician obeys the law of non-maleficence (Bossaert et al., 2015). Furthermore, the doctor should administer treatment that primarily benefits the patient. The other ethical principle in decision making is the self-motivation and determination (Friedman et al., 2015). The policy complements the principle of Autonomy. However, the system of inbuilt motivation is closer to the act of allowing the patient to make their own decisions.

Legal and Ethical Principles in Clinical Decision Making

Shared Decision making refers to the recognition of the patient’s rights (Fassbender, 2018). The nurses should educate the patient on the available medical solutions. Furthermore, the health practitioners should be at liberty to choose the best mode of treatment that suits their interests. The insightful opinions by the physicians about the various treatment options are very essential. The physician should be frank and inform the patient of the uncertainty in the results of the treatment options. Shared decision making is critical in two key categories. Firstly, is when a range of treatment options are plenty for a given disease (Giesbrecht et al., 2016). Secondly, is whereby, the result of the treatment is not apparent (Giesbrecht et al., 2016). Tom decides to accept the morphine injection.

The nurse must explain the consequences of that particular decision. The wife is the guardian while the daughter is the attorney. The art of shared decision making improves the interactive relationship between the patients and health practitioners (Greenfield and Jensen, 2016). The clinician should fully clarify the treatment options to the patients. However, the health professional should not treat the patient out of their own treatment choices. The combination of the two points enables a smooth process of decision making.

Shared decision making relies on ethics to urge doctors to properly teach patients on the available modes of health care options. The decision making is an essential aspect of medical attention since both patients and clinicians take part in the conversations. In the process of decision making, patients and nurses have different roles. Nurses, such as Sarah, in Tom’s case, have the duty to diagnose the patient and offer medical attention. On the other hand, needs to choose the suitable mode of treatment. The patient needs to consider issues such as medical history and their own choices before making any health conditions.

Before a patient can make an informed decision, the health practitioners need to enlighten them on various aspects of treatment models. The physicians should guide the patient in acquiring the knowledge of the aftermath of a medical decision (Koski et al., 2017). Additionally, the clinicians should tell the patients about the consequences of the decisions that they decide to take (Laidsaar-Powell, Butow, Boyle and Juraskova, 2018). After the patient has made the all-important decision, the clinician gives them the shared decision form to fill (Laidsaar-Powell et al., 2018). Afterward, the physician can now go ahead to conduct treatment on the patient.

Shared Decision-making

The nurse must ensure that the patient has fully understood the types of treatments, their positive and negative sides. Additionally, the patient must genuinely look at the procedure of the treatment that they have chosen (LoBiondo-Wood and Haber, 2017). A patient that is at a critical condition loses the ability to make a well-thought-out decision (Rogers and Student, 2017). As such, the enduring guardian assists in the decision making (Rogers and Student, 2017). In the rare occasion, the Attorney helps in the decision-making process.

Palliative Care is the kind of attention aimed at patients that decide to undergo termination care (Singh et al., 2017). A majority of patients take the responsibility to eliminate suffering before death. Tom suffers a lot of health difficulties and decides to seek for Palliative Care. Australian health department provides the care when the patient requests for it. Additionally, the family members must consent to the decision by the patient. In Tom’s case, the wife, who is also the enduring guardian, accepts the conclusion of the husband to terminate the life after Palliative care.

Aboriginals and other native Australians enjoy Palliative care when they are at last stages of their lives. The care assists in social and cultural support of the patient (Singh et al., 2017). Furthermore, the Palliative Care supports the patient to overcome both emotional and behavioral weaknesses (Scholl et al., 2018).  The care unit enables the patient to live in a society or to go back to their original home. The palliative care assists the mobs, friends, relatives and traditional healers to look after the patient (Scholl et al., 2018). In the case of Tom, the palliative care enables the family to take him back to the country. Tom gets the opportunity to interact with mobs before returning to the hospital. He later asks for termination of life care. Furthermore, Palliative care enables someone to lead a fulfilling life until they die.

When an individual is on the homestretch of their lives, they need to accomplish various projects. Some bedridden people always want to go back to the family members and share the last moments. The aboriginals may long for their countries of origins (Rogers and Student, 2017). Before termination of life, one needs to discuss all the plans in mind with the family (Fassbender, 2018). Additionally, one needs to return to the country of origin to bid farewell to the kin.

Palliative Care

The Palliative team assists the Aboriginals to understand their orientation of culture. Additionally, the dying person is curious to understand what the family members think of them. The aboriginal needs to follow the norms of death. The Palliative ensures that all these concerns get attention from the government (Fassbender, 2018). The care team caters to the fare charges that the relatives require going to the hospital to bid bye to the individual in the sick bed. The team also looks for rental spaces for the married people. The virtues of the care group include comfort, dignity, and morals (Fassbender, 2018). Furthermore, the care unit helps the relatives and friends of the patient to fill the emotional gap that death brings.

Conclusion

Morphine is a painkiller that most health specialists recommend to Aboriginals suffering from life-limiting conditions.The legal and ethical aspects are critical in any form of healthcare delivery. Additionally, the art of shared decision making enables conclusive medical attention. Palliative care is essential for the Aboriginals seeking for an ultimate end of life care. The nurses should follow legal guidelines when treating patients. Additionally, the ethical principles of Autonomy, beneficence, and non-maleficence are essential in the treatment field. Shared decision making enables both patient and doctor to agree to come up with a health care decision. Palliative Care is necessary since it allows for the relatives of the patient to know how to handle the sick person.

References

Bossaert, L.L., Perkins, G.D., Askitopoulou, H., Raffay, V.I., Greif, R., Haywood, K.L., Mentzelopoulos, S.D., Nolan, J.P., Van de Voorde, P., Xanthos, T.T. and Georgiou, M., 2015. European Resuscitation Council Guidelines for Resuscitation 2015: Section 11. The ethics of resuscitation and end-of-life decisions. Resuscitation, 95, pp.302-311.

Fassbender, K., 2018. Consensus Development Conference: Promoting Access to Quality Palliative Care in Canada. Journal of palliative medicine, 21(S1), pp.S-1.

Friedman, L.M., Furberg, C., DeMets, D.L., Reboussin, D. and Granger, C.B., 2015. Fundamentals of clinical trials. Springer-Verlag.

Giesbrecht, M., Crooks, V.A., Castleden, H., Schuurman, N., Skinner, M. and Williams, A., 2016. Palliating inside the lines: The effects of borders and boundaries on palliative care in rural Canada. Social Science & Medicine, 168, pp.273-282.

Greenfield, B.H., and Jensen, G.M., 2016. Understanding the lived experiences of patients: Application of a phenomenological approach to ethics. Physical Therapy, 90(8), pp.1185-1197.

Koski, J., Kelley, M.L., Nadin, S., Crow, M., Prince, H., Wiersma, E.C. and Mushquash, C.J., 2017. An Analysis of Journey Mapping to Create a Palliative Care Pathway in a Canadian First Nations Community: Implications for Service Integration and Policy Development. Palliative Care: Research and Treatment, 10, p.1178224217719441.

Laidsaar-Powell, R., Butow, P., Boyle, F., and Juraskova, I., 2018. Facilitating collaborative and effective family involvement in the cancer setting: Guidelines for clinicians (TRIO Guidelines-1). Patient education and counseling.

LoBiondo-Wood, G. and Haber, J., 2017. Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.

Rogers, A. and Student, M.N., 2017. A Cultural Safety Perspective on Palliative Care for Indigenous Peoples.

Scholl, I., Hahlweg, P., Lindig, A., Bokemeyer, C., Coym, A., Hanken, H., Müller, V., Smeets, R., Witzel, I., Kriston, L. and Härter, M., 2018. Evaluation of a program for routine implementation of shared decision-making in cancer care: study protocol of a stepped wedge cluster randomized trial. Implementation Science, 13(1), p.51.

Singh, N., Hess, E., Guo, G., Sharp, A., Huang, B., Breslin, M. and Melnick, E., 2017. Tablet-based patient-centered decision support for minor head injury in the emergency department: pilot study. JMIR mHealth and uHealth, 5(9).

Tapp, H., Derkowski, D., Calvert, M., Welch, M. and Spencer, S., 2017. Patient perspectives on engagement in shared decision-making for asthma care. Family practice Nursing, 34(3), pp.353-357.