Moral Status Fetal Abnormality Case Study

Based on \”Case Study: Fetal Abnormality\” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:

What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?
How does the theory determine or influence each of their recommendations for action?
What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?
Remember to support your responses with the topic study materials Moral Status Fetal Abnormality Case Study.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Case Study: Fetal Abnormality

Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.

Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears Moral Status Fetal Abnormality Case Study.

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother.

The Question of Moral Status: A Case of Fetal Abnormality and the Dilemma of Abortion versus Religious Beliefs

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Introduction

Moral status is the employment of ethical principles in the consideration of the importance of living things and their value, in as far as life is concerned (Gray, 2019). In an examination of the theories of moral status, some theorists clearly believe that life is equal regardless of the living thing under consideration, while others believe it is not. These theories have placed some sort of hierarchy or levels of consideration for moral standing. For example, Tauer (2001) quotes Warren in her1997 book Moral Status as considering all living things to be having the same moral standing (status). This is from human beings with complete full moral status (FMS) to the least significant single-celled organisms. This paper examines in this context the matter of a deformed fetus that is also likely to have cognitive deficiencies if carried to term.

The Christian View

The Christian view of the nature of human persons is that human beings right from conception are entitled to full moral status just by virtue of being a human being, all other considerations (like cognition status) notwithstanding (Gray, 2019; Studocu.com, n.d.). This view is compatible with the theory of moral status that is based on human properties (Studocu.com, n.d.). This is the religious or philosophical theory (Gray, 2019). The theory states that it is only human beings that possess moral status among all the other living things. All the others, including plants and animals, were created to serve the interests of the human being. It goes on to elaborate that the human person acquires this full moral status the moment that they are conceived in the womb. Thus according to this Christian and philosophical theory based on human properties, the status of a fetus and that of a grown complete human person with all cognitive functions intact is the same in as far as full moral status is concerned (Gray, 2019; Studocu.com, n.d.). This is related to the intrinsic human value and dignity in that the only characteristic for FMS is the fact of becoming a human being (at conception). What this implies is that this quality is innate or intrinsic, and human beings are conceived with it. In other words, human life is sacred right from conception Moral Status Fetal Abnormality Case Study.

The Theories Exhibited by Jessica, Marco, Maria, and Dr. Wilson in the Case Study

This case study involves a fetus that will not only be born with a deformity (lack of limbs), but also a 1 in 4 probability of having Down syndrome. This means that there is a high likelihood that the child will also be mentally challenged with cognitive (learning and thinking) deficiencies. From the case scenario, therefore, Jessica and Aunt Maria clearly subscribe to the religious/ philosophical theory of moral status based on human properties. As such, to them a human being possesses full moral status right from conception, regardless of their physical and mental deficiencies (Gray, 2019; Studocu.com, n.d.). Despite being concious of the reality of her precarious socio-economic status into which a mentally and physically challenged infant would impose further strain, Jessica still believes that “all life is sacred.” She therefore does not agree with Dr. Wilson’s view that aborting the baby is the best option. As for Aunt Maria, she is clearly religious and would not entertain any thought of terminating any life, whether already born or intra-uterine. She is clearly of the same theory as Jessica, which says that based on (intrinsic) human properties (of full moral status) all human life from conception is sacred. She characteristically therefore advises Jessica, despite the overwhelming medical evidence, to carry the pregnancy to term and play her role “as a mother.” Dr. Wilson on his part clearly subscribes to the moral status theory based on cognitive properties (Studocu.com, n.d.). Other authorities refer to this theory as the Kantian theory of moral status after Emmanuel Kant (Gray, 2019).  This particular theory of moral status holds that a living thing (human being) is only entitled to full moral status if they possess and can demonstrate “awareness, memory, understanding, and thinking.” This is capacity for cognition. Clearly, this being still a fetus it does not satisfy this criterion and hence it does not possess any moral status. But most importantly, the Kantian theory avers that this is essentially an “all-or-nothing position” (Gray, 2019). That is one either has cognitive ability or not, for possession of moral status. This fetus, from the medical tests, will certainly likely not have this cognitive capacity even if it s let to be born and grow (because of the possibility of Down syndrome). Dr. Wilson additionally belongs to the school of thought of the moral status theory based on relationships. He has a doctor-patient obligation which in this case does not confer moral status to Jessica’s unborn child (Studocu.com, n.d.). Finally, Marco – although apparently ambivalent – belongs also to the moral status theory of Kant that is based on cognitive properties. He “find[s] it difficult [that] the pregnancy and the … disabled child [will be] a burden and a barrier to their economic security and plans.” As such the fetus has no moral status because of the physical and possible cognitive disability.

My Position

I take the view that moral status in this case should be decided solely based on the theory of Kant or cognitive properties. The fetus either has cognitive potential (now) or cognitive ability (later) or not. This is what will confer moral status on it. I take this position as it will be in the best interest of the child to be aborted as a fetus rather than being born only to suffer the rest of their life. In fact, the moral status theory of sentience is in support of this (pain and suffering should not be caused to a living thing) (Studocu.com, n.d.). As the case study presents, however, the fetus has a significant likelihood of being born with Down syndrome-induced cognitive deficiency which they’ll carry for life. My theory position will thus influence recommendation for action in that letting the fetus live will be tantamount to condemning it to a lifetime of misery and suffering because of its physical and cognitive deficiencies Moral Status Fetal Abnormality Case Study.

Brian Foster Chest Pain Shadow Health Assessment

Introduction and Pre-brief

This assignment provides the opportunity to conduct a focused exam on Brian Foster, who presents with recent episodes of chest pain in a non-emergency setting. Interview Mr. Foster and be sure to thoroughly assess the cardiovascular system as well as related body systems in order to compile a list of differential diagnoses. This case study offers you the opportunity to evaluate Mr. Foster’s personal and family history with heart disease and identify lifestyle risk factors. During the physical examination, thoroughly examine the cardiovascular system and carefully evaluate and document the patient’s heart sounds.

Tips and Tricks

The sounds in the Shadow Health Concept Labs and Physical Assessment Assignments are medically accurate.

Distinguishing normal from abnormal heart sounds requires practice and carefully listening for sometimes subtle and easily missed sounds. Be sure to take advantage of the Cardiovascular Concept Lab to sharpen your skills prior to beginning this assignment. Brian Foster Chest Pain Shadow Health Assessment

Optimize your listening experience by using headphones with your computer and listen to both normal and abnormal sounds multiple times to improve your proficiency with recognizing subtle differences.

Often patients present with a specific complaint or problem. However, during the history and physical examination, a new problem may be discovered that takes precedence during the visit. Be alert to such a situation with this case study assignment Brian Foster Chest Pain Shadow Health Assessment

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The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge.  Brian Foster Chest Pain Shadow Health Assessment.

Subjective Data Collection: 30 of 30 (100.0%)

Objective Data Collection: 30 of 33 (90.91%)

Professionalism and Social Media Essay Sample

Social media plays a significant role in the lives of nurses in both their professional and personal lives. Additionally, social media is now considered a mainstream part of the process for recruiting and hiring candidates. Inappropriate or unethical conduct on social media can create legal problems for nurses as well as the field of nursing.

Login to all social media sites in which you engage. Review your profile, pictures and posts. Based on the professional standards of nursing, identify items that would be considered unprofessional and potentially detrimental to your career and that negatively impact the reputation of the nursing field Professionalism and Social Media Essay Sample.

In 500-750 words, summarize the findings of your review. Include the following:

Describe the posts or conversations in which you have engaged that might be considered inappropriate based on the professional standards of nursing.

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Discuss why nurses have a responsibility to uphold a standard of conduct consistent with the standards governing the profession of nursing at work and in their personal lives. Include discussion of how personal conduct can violate HIPAA or be considered unethical or unprofessional. Provide an example of each to support your answer.
Based on the analysis of your social media, discuss what areas of your social media activity reflect Christian values as they relate to respecting human value and dignity for all individuals. Describe areas of your social media activity that could be improved.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion Professionalism and Social Media Essay Sample.

Patient’s Spiritual Needs: Case Analysis Essay

In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about \”Case Study: Healing and Autonomy\” as the basis for your responses in this assignment.

Answer the following questions about a patient\’s spiritual needs in light of the Christian worldview.

In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient\’s autonomy? Explain your rationale.
In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James\’s care? Patient’s Spiritual Needs: Case Analysis Essay

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In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?
Remember to support your responses with the topic study materials.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion Patient’s Spiritual Needs: Case Analysis Essay.

Week 2 Practicum Journal: Safe Prescribing
There is probably no greater responsibility that the psychiatric mental health nurse practitioner assumes than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications.
In this Practicum Journal Assignment, you will explore the legalities associated with prescribing controlled substances, as well as what a DEA number is, how to obtain one, and, most importantly, how to prescribe controlled substances in your state.
Learning Objectives
Students will:
• Analyze roles of the Drug Enforcement Administration
• Analyze PMHNP responsibilities when issued a DEA number
• Analyze DEA number application procedures
• Analyze state requirements for safe prescribing and prescription monitoring
• Analyze PMHNP responsibilities for safe prescribing and prescription monitoring
• Analyze Schedule II-V drug levels
** Assigned in Week 2 and submitted in Week 4.
To prepare for this Practicum Journal:
• Review the Learning Resources.
In 2-3 pages:
• Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP.
• Explain your responsibilities when having a DEA number.
• Explain how you apply for a DEA number.
• Explain your state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements.
• Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

Every patient has a right to be prescribed the right medication upon visiting a healthcare facility. Getting the correct medication not only ensures that a patient’s chances of better outcomes are increased but it also minimizes the chances of medication errors and adverse effects (Gorgich, Barfrohan, Ghoreshi, et al., 2016). It is, therefore, important that a PMHNP is well versed with the state and federal legislation that guides the use and prescription of controlled drugs. This paper will discuss the role that DEA plays, responsibilities of a person in possession of a DEA number, application of DEA, requirements for the safe prescription of controlled drugs and the role of PMHNP, and lastly some examples of schedule II-Vdrugs will be discussed.

The Role of DEA

Kanouse & Compton (2015) point out that the main responsibility of the DEA is to ensure that the circulation of illegal narcotics is controlled. The Department of Justice oversees the activities of the DEA. The DoJ makes sure the federal laws that touch on the manufacturing, sale, use as well as the distribution of controlled drugs adherence. As regards the PMHNP, the role of the DEA is in ensuring that drugs are controlled and that the prescription and supply are done by licensed persons who possess a DEA number (Kanouse & Compton, 2015). This prevents the misuse and abuse of controlled drugs.

Responsibilities of Possessing a DEA Number

When a professional possess a DEA number it shows one’s competency in the controlled drugs prescription. A DEA provisional number ought to be given to a person that is licensed prior to attaining the number. Hence, a person is tasked by federal legislation adherence as pertaining to the drug prescription, manufacturing and distribution (Caulkins &Reuter, 2017)

Application of DEA Number

The acquisition of a DEA number is necessary for the legalization of controlled drugs prescribed to patients. One has to visit the DEA website to create an order form. Alternatively, a person can visit a DEA field where one gets a form that will fill to acquire the number. After filling out the form and submitting it, one should note the ID number with which a person can check the progress status. After a three day waiting period, a person can contact the DEA to find out if the registration is approved or is yet pending. Additionally, one can make any necessary changes, on the application form. A person needs to first hold a license for practice as well as a permit for controlled substance distribution prior to being issued with a DEA number.

Requirements for Safe Prescription, PMHNP Responsibility, and Cleveland’s Program on Prescription Monitoring

The process of manufacturing, distribution, and prescription of controlled substances in Cleveland is governed by several guidance rules. These guidelines aim at eradicating or at least minimizing incidences of drug abuse. A practitioner first has to register with the regional DEA office that heads the drug monitoring program. Once successfully registered, a physician is licensed to prescribe controlled drugs to a patient in need of the same in their treatment process. However, Bao, Pan, Taylor et al., (2016) point out that a physician is required to first consult with the PDMP of a patient before prescribing a controlled drug. Further, upon dispensing a controlled drug, a report should be filed on the same for accountability purposes.

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As a PMHNP, I am expected to prescribed controlled drugs to patients residing in the area in which I practice my profession. I should not for any reason, self-prescribe. Regarding schedule narcotics, I should first check the ILPMP before initial first time prescription of the said drugs. This action ensures that controlled substances are not misused or abused and also medical errors are averted.

Schedule II-V Drug Examples

Controlled drugs are classified into schedules in order of their severity in the possibility of abuse and causing harm. They are also categorized based on their usefulness and possibility of dependence. The top of this list is the schedule II drugs. These drugs are likely to cause severe dependence both psychologically and physically with equally high abuse potential. Fentanyl is a schedule II drug that can be prescribed for patients with chronic pain and who have already developed a tolerance for other opioids (Ramos & Lope, 2019). Schedule III drugs have physical reliance that is low while psychological reliance is high. Pentobarbital is an example of a schedule III drug that can be prescribed for treating insomnia (Johnson & Sadiq, 2019). The schedule IV drugs have a lesser chance of abuse compared to the previous two schedules. Benzphetamine is one such drug in the schedule IV list. This drug is an appetite suppressant used in the treatment of obesity and overweight patients (Plodkowski, McGaeve, Reisinger et al., 2016). Schedule V drugs are moderately mild and Lomotil is one such example. Lomotil is used in the treatment of diarrhea (Khan, Asghar, Kanwal, et al, 2019).

Conclusion

Controlled drugs need to be administered by licensed professionals. Abuse and misuse of these drugs can cause a lifetime of dependence and in some cases, death. Physicians and NPs that are licensed to prescribe controlled drugs need to be vigilant and perform their due diligence before prescribing the drugs to a first-time patient. Additionally, a PHMNP should be knowledgeable on the correct dosage and prescription and always stay informed on any changes affecting the drugs the one prescribes.

References

Bao, Y., Pan, Y., Taylor, A., Radakrishnan, S., Luo, F., Pincus, H. A., & Schackman, B. R. (2016). Prescription drug monitoring programs are associated with sustained reductions in opioid prescribing by physicians. Health Affairs, 35(6), 1045-1051.

Caulkins, J. P., & Reuter, P. (2017). Dealing more effectively and humanely with illegal drugs. Crime and justice, 46(1), 95-158.

Gorgich, E. A. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. Global journal of health science, 8(8), 220.

Johnson, A. B., & Sadiq, N. M. (2019). Pentobarbital. In StatPearls [Internet]. StatPearls Publishing.

Kanouse, A. B., & Compton, P. (2015). The epidemic of prescription opioid abuse, the subsequent rising prevalence of heroin use, and the federal response. Journal of pain & palliative care pharmacotherapy, 29(2), 102-114.

Khan, H. R., Asghar, S. A., Kanwal, S., Qadar, L. T., & Qadri, K. H. (2019). Diphenoxylate-atropine (Lomotil) Toxicity in Infantile Diarrhea: A Case Report of Therapeutic Failure. Cureus, 11(10).

Plodkowski, R. A., McGarvey, M. E., Reisinger-Kindle, K., Kramer, B., Nelson, E., Lee, J., & Nguyen, Q. T. (2016). Obesity Management: Clinical Review and Update of the Pharmacologic Treatment Options. Federal Practitioner, 33(1), 6.

Ramos-Matos, C. F., & Lopez-Ojeda, W. (2019). Fentanyl. In StatPearls [Internet]. StatPearls Publishing.