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Ethical Dilemmas

Mrs. Duncan is a 75-year-old woman with a diagnosis of Stage IV breast cancer with metastasis to the lungs. Although Mrs. Duncan spoke with the nurse and conveyed her wishes for no life-saving measures, she does not have an Advanced Directive in place. Mrs. Duncan has experienced a significant decline in cognitive function and is presently unable to make decisions for her care. Her children cannot agree on what treatment or life-saving measures are appropriate.

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 Mr. Jameson is in end-stage renal failure. Despite efforts to help manage the disease, including dialysis three times weekly, his condition has worsened. Mr. Jameson’s physician has noted the decline in his status and has informed the family that Mr. Jameson may have only a few weeks to live. Mr. Jameson’s children and family are skeptical about telling Mr. Morris how bad his condition is, and the physician has made no effort to talk to the patient about it. After his family left the hospital for the evening, Mr. Jameson called for the nurse and asked her to tell him what the doctor said, stating he felt like he was not getting the whole story.

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