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Lorraine Bayless died! Was the Nurses’ Inaction Ethical?

Lorraine Bayless died!  A nurse observing her gasping for breath called 911 but took no direct action.  The nurse said it was against company policy.  The question I have to ask as an ethics speaker is – was the nurses’ action or inaction ethical?

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I remember so vividly years ago in my college biology class, the quote from my professor which at that moment I took as a grain of salt. At his age of 68, he pretentiously quipped, “Life is one of the profound possessions that we take most for granted until it is on the verge of being taken from us.”

“The clock never stops ticking,” he continued, “and nor should our zeal to relish every moment.”

Though science and technology has seen fit to supplement our lives with extended years, the anticipated expectancy has all too often been cut short. From that biology class many years ago to the present, violence, negligence, politics, and lack of moral ethics have all but obscured the opportunity to enjoy these ever evolving times.

There is no doubt that Lorraine Bayless had this same zeal to relish and enjoy every single moment of her remaining years. At her ripe old age of 87, Lorraine surely had hopes of enjoying her tenure with new found friends and a surfeit of activities at the senior living facility in Bakersfield, California. But on March 3rd, the policies and procedures that were unambiguously and emphatically set in place ultimately decided her fate and marked the end of her life’s journey.

The CPR that could have possibly saved her life was obviously against company policy. After all, this wasn’t a hospital, a convalescent home, or a rehab center; it was a senior living facility that Lorraine, through sound decision, had chosen to become a residence. For the nurse on duty, company policy always takes precedence over ethical policy. Saving a life by performing a task she was trained to do was not worth losing her job violating company policies. There was just too much to risk when the fine print in the employment contract clearly states…”Heroes Not Welcome!”

Per a spokesman at Glenwood Gardens Senior Living Facility, the nurse on duty was not obligated to give CPR and had done everything she was legally required to do according to company protocol. Though no one really wants to comment on the moral and ethical choices of a company or an individual, one cannot help but to wonder in which direction our standards are focused in any situation such as this. We are a society that sends the entire fire department to retrieve a kitten out of a tree or a dog out of an abandoned well, but yet we are legally bound to forfeit a life that is just steps from our reach.

But let’s understand the concern for those entities and individuals whose focus is more so on the legal aspects rather than the ethical. Though CPR has progressed into state-of-the-art techniques, we admit that it still remains a dangerous and risky process for an 87 year old. Understandably it raises many legal concerns for any nurse or healthcare personnel who have placed their signatures on clearly defined employee guidelines and policies. In some cases there is a possibility of fractured ribs, punctured lungs, and sternum damage. In addition, since it does very little good in restoring adequate blood flow, it has become questionable whether CPR works on the elderly at all.

Even so, hasn’t scientific and technological development made us morally and ethically obligated to do our part in maintaining the well-being and quality of life? If nothing more, nurses and other health professionals have an ethical code of conduct that they have “promised” to adhere to, sworn to uphold, promote, take responsibility for, and maintain for the duration of their lives. A nurse’s oath, for example, is not administered behind closed doors or cloaked in the darkness of night. Rather, it is a publically documented promise maintained by all healthcare professionals.

The oath, ethics, and code of conduct for all nurses and nursing professionals are elucidated in the following excerpt taken directly from their “Code of Conduct” handbook. It is clear and needs no interpretation or philosophical illumination in terms of meaning. The important findings that Lorraine Bayless would have appreciated are included in the following.

*“In the Code for Nurses with Interpretive Statements (Code for Nurses) explicates the goals, values and ethical precepts that direct the profession of nursing. The ANA believes the Code for Nurses is nonnegotiable and that each nurse has an obligation to uphold and adhere to the code of ethics.

Health care ethics is concerned with the rights, responsibilities, and obligations of health care professionals, institutions of care, and clients. Upon entering the profession of nursing, nurses accept the responsibilities and trust that have accrued to nursing over the years and also the obligation to adhere to the professions’ code for ethics. The Code for Nurses, published by the American Nurses Association, is the standard by which ethical conduct is guided and evaluated by the profession. It provides a framework within which nurses can make ethical decisions and discharge their professional responsibilities to the public, to other members of the health team, and to the profession.

The Code for Nurses is not open to negotiation in employment settings, nor is it permissible for individuals, groups of nurses, or interested parties to adapt or change the language of this code. The Code for Nurses encompasses all nursing activities and may supersede specific policies of institutions, of employers, or of practices. Therefore, the content of the Code for Nurses with Interpretive Statements is nonnegotiable.”

*http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/NursingStandards

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