RES 410: Module 2–Discussion REPLY
Classmate’s Post:Patient’s Rights
In healthcare, we face ethical dilemmas with patients’ rights. It is important to respect the patient’s wishes and choices. “Human dignity is the recognition that human beings possess a special value intrinsic to their humanity and as such are worthy of respect simply because they are human beings.” ( The Center for Bioethics & Human Dignity, 2022) I have taken care of many obesity hypoventilation syndrome patients and faced the choice of pushing the patient to wear NPPV. I had OHS patients come in the emergency room obtunded because their CO2 is elevated. Typically, I would have the nurse help sit the patient up and place them on NIV until they turn around and become alert. After the patient is admitted, we try to educate how important it is to wear NIV at night. I would explain to my patients the benefits and try to wear the machine. We all have faced the challenge of patients refusing NIV because it is not comfortable, even as a respiratory therapist you have tried everything, and the patient continues to refuse.
I had a patient that was never diagnosed with OHS, and that patient would not keep the BiPAP on, so we had to intubate the patient. The patient was a difficult wean and therefore was trach. I remember the patient’s family member had to make the decision for the patient to get the trach, but this was the only option. The patient did make it off the ventilator and was upset with the trach. The patient stated that this would have been the last thing they would have ever wanted but the patient could not make that choice at the time.
Another ethical issue I had with OHS patients is when they are in the hospital and wear BiPAP at night and are very compliant with it. When it comes to discharging and the patient does not have insurance to buy a machine.
Is it ethical or safe for that patient? No, it is not, but what do you do in a situation like this? We can not buy every OHS patient a machine to go home with, especially when the hospital struggles financially.
