Mr. Cisneros is a 38 year old Latino male patient, admitted to athe nursing unit after sustaining a spinal injury in a fall. He hasundergone an Anterior Cervical Fusion and Discectomy of C4-5 andhas continued to complain of in “both legs below the thigh”. Hishistory included years of “living on the street” and activeintravenous drug abuse at the time of admission. He is currentlyincarcerated in the area prison.
Assessment reveals:
The patient is very anxious, focused on his legs and “I’mhungry”. (No orders have been placed for a diet). He has beenpulling on his SCD connections, to “make sure they are working” andcomplaining of pain “nine-to-ten” on a scale of one-to-ten, withintensity focused in the area of his surgical wounds. A sheriff’sdeputy is sitting at the bedside at all times.
He can have Morphine for pain but states “ I don’t call outcause I know they just think I’m trying to get the drugs.”
When the unit charge nurse and the attending physician respondto being called for pain management options, they describe thepatient’s condition as “probably related to being a druggie” andthat his pain is mostly “drug seeking” in nature, as evidenced byhis “calling for more medication a few times a shift,” and that heseems to “watch the clock.” They also note that this patient is a“prisoner” who “ did this to himself”
- What are the ethical issues related to this case?
