Ethical dilemma - page 2

by tnguy31 | 1,938 Views | 17 Comments

Hi nurses, Please give me your thoughts and advices on this. An 80 yrs old female is admitted to hospice program with the diagnosis of end stage COPD. She was also prescribed hypertension medication, fosamax, kaxalate, colace,... Read More


  1. 0
    Thanks everyone. It's my lack of knowledge. Will learn it from now on.
  2. 1
    It is not a "lack of knowledge"......we just want to know what makes you think this is an ethical dilemma for you. What YOU think....so we can begin a discussion.
    poppycat likes this.
  3. 0
    Quote from tnguy31
    Hi nurses,

    Please give me your thoughts and advices on this. An 80 yrs old female is admitted to hospice program with the diagnosis of end stage COPD. She was also prescribed hypertension medication, fosamax, kaxalate, colace, etc.. She is allergic to Tylenol. Initially, the patient was prescribed 30mg of Cymbalta for depression ( I believe). After a month I'm been with her, the doctor changed to 60mg Cymbalta by mouth once daily with the rationale of " she is responding well to the medication." The patient is physically ok, walks with walker, regular diet, no complain of pain. She talks and smiles everytime I visited her. Patient watches animated movies in free time.

    Personally, I think she doesn't need 60mg of Cymbalta. I have a feeling that the doctor just wants to experiment medication treatment on her. What should I do? Please correct me if I understand the situation wrongly.

    Thank you all.

    I must be missing something, but I've had the flu lately and my brain's a little fuzzy. Where's the ethical dilemma here? "Ethical dilemma" doesn't mean "something I don't understand" or "something I don't agree with." If she's doing well on these doses, then what's the problem? Can you clarify?
  4. 0
    Asst. Admin,
    My thought was she doesn't need the medication, maybe. I spoke to caregiver, and he stated that she has never had depression; her other caregiver stated the patient is a cheerful person to begin with, patient has friends and family visited her often, and pt talks and have conversations with them.
    This pt also has a lots of medication, and she is a very petite and old lady. I just want to look at her medications and try to understand why she needs them, if she needs them or not?
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    No, it's not your brain or the flu lol. I didn't make it clear, i think. The problem is I think she doesn't need to be on this med at all.
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    It would've be good to have interviewed the patient and see what you could have gathered about her DX.

    She may have been depressed and not communicating her feelings to you.

    I might not have depression until I find out that i'm going to die. However Kubler ross may advocate to let the Pt go through the stages until they can come to terms with their DX.


    You can still ask her how she feels about being on the medication, and how she feels about the increase of dosage.
    Ultimately it is her choice to take the med or not.
  7. 3
    See your last few posts gives us a better understanding of your question. I must say, you need to research this medication AND find out why the pt is taking it. You "believe" it is for depression but cymbalta treats other things than just depression.
    KelRN215, GrnTea, and poppycat like this.
  8. 0
    Quote from tnguy31
    Asst. Admin,
    My thought was she doesn't need the medication, maybe. I spoke to caregiver, and he stated that she has never had depression; her other caregiver stated the patient is a cheerful person to begin with, patient has friends and family visited her often, and pt talks and have conversations with them.
    This pt also has a lots of medication, and she is a very petite and old lady. I just want to look at her medications and try to understand why she needs them, if she needs them or not?
    There are many reasons for different meds......look up the meds compare to the diagnosis and see what you come up with.

    What are the drugs you are questioning maybe we can help.


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