Mr. B., a community health nurse, must decide whether to refer his patient, 77-year-old Mr. W., for consideration for conservatorship and guardianship. Mr. W. has no living relatives and lives alone in a one-room apartment furnished with a bed, refrigerator, table & chair, lamp and small sink. Because he does not have a stove, two meals per day are supplied by the landlord. With the support of his Social Security check and food stamps, he has adequate money for his needs and has lived for over 10 years with these arrangements. He is in good physical health. Mr. B. has made 3 home visits to Mr. W. to check vital signs and the effects of medications ordered after a recent hospitalization for pneumonia (which resolved) where it was found that Mr. W. has hypertension. Although Mr. W, has made excellent progress and visits from the community health nurse are no longer warranted, the landlord and other tenants of the apartment are asking the nurse to “do something” about Mr. W. Admittedly, Mr. W. has a strong odor from the long-term accumulation of dust, dirt, and mold in the apartment. Cockroaches have been seen in the apartment and spoiled food is found in the refrigerator. Mr. W. is often found wearing soiled clothes and it is obvious that Mr. W. does not bathe himself routinely. His hair is obviously dirty and a strong body odor is present. His toenails are so long that they have perforated the canvas tennis shoes he wears. Mr. W. is comfortable with his lifestyle and does not want to change living arrangements. He has refused offers of homemaker services and home health aide services even though these services could be provided at a minimal cost to Mr. W. Should the community health nurse, Mr. B., make an arrangement in which Mr. W. would lose the right to control his person, his financial resources, and his environment? Can an individual in the community be forced to be clean and to live in a clean environment? How far should the nurse go in providing “good” for a patient and who determines what is “good” for Mr. W.? What is the appropriate legal and ethical action in this case? Please use an ethical decision making framework (page 167 of textbook) rather than just your opinion.
Margaret A. Burkhardt and 1 more Ethics and Issues in Contemporary Nursing 4th Edition
