Conflict Resolution & End of Life

L. Elliott MSN, RN

Define and demonstrate ethics in nursing.
Discuss the five-step process to resolving an ethical conflict (ethical decision making).
Analyze ethical dilemma scenarios.

Assess the Situation
- Evaluate the context in which the conflict arises.
- Gather all relevant information related to the ethical issue.
Identify the Problem
- Clearly articulate the ethical dilemma at hand.
- Understand the implications of the ethical conflict on patient care and outcomes.
Identify and Explore Alternatives (Prioritization)
- Consider possible actions to take and their potential impact.
- Prioritize alternatives based on ethical principles and patient wishes.
Implement Your Decision (Action)
- Put the chosen alternative into action.
- Ensure the decision aligns with ethical standards and patient needs.
Evaluate (Reassess) the Outcomes
- Assess the effectiveness and impact of the action taken.
- Re-evaluate the situation to determine if further action or adjustments are necessary.

Living Will: A document that outlines the medical treatment preferences of a patient in the event they become unable to communicate their wishes.
Medical Power of Attorney: A legal document that designates an individual to make medical decisions on behalf of a patient if they are unable to do so themselves.

Definition: POLST is a set of portable medical orders, executed by an adult patient (or legal surrogate) and the patient's medical provider, to guide medical treatment based on the patient's current medical condition and goals.
Usage: POLST is usually for persons with serious illness or frailty. The rule of thumb is to recommend POLST for patients if their provider would not be surprised if they die within a year.
POLST vs MOLST:
- MOLST: Stands for Medical Orders for Life-Sustaining Treatment. It is used in specific states such as New York, Connecticut, Massachusetts, Rhode Island, Ohio, and Maryland.
- POLST and MOLST are virtually identical documents that translate a patient's wishes about life-sustaining treatments into portable medical orders. The main difference between the two is that MOLST is can be used only in certain states, while POLST is the national standard adopted in most other states.