General Instructions for Response Paper

The idea behind each Response Paper is for you to reflect on the case or article and to write a thoughtful, well-reasoned response to the situation or issue presented, incorporating any arguments or conclusions you may make in light of the other readings and presentations in the course. Your evaluation of the case should be based on the following questions: Do you agree with the ultimate outcome of the case or conclusion to the article? What would you have done differently? Are there any red flags that are raised in your mind? As a Christian, how should you respond to situations or arguments like these? The prompt for each Response Paper will present additional, specific questions for you to consider as you read the case. Each prompt will identify which questions you must address and which ones you may consider and optionally address in your response.

One thing to avoid is an emotional response. You may passionately disagree with the outcome or the views of the author(s) or judge(s); however, you must not turn your Response Paper into an emotional rant. Each paper must be a reflective, intellectual, academic response to the merits of the case or article.

700 words (about 3 pages) APA Style 

Response Paper 1: Case Study on Principles of Bioethics

Patient Choice vs. Patient Good

Mrs. Wright, a fifty-five year old woman with advanced multiple sclerosis, was admitted to the chronic care unit of a hospital. As part of the admission routine, a full diet was ordered. At lunch time, Nurse Klein observed that Mrs. Wright was eating very slowly and appeared to have difficulty swallowing some of the foods on her dinner tray. Mrs. Wright explained that she needed to chew the food well in order to avoid choking. After staying with her until she finished her meal, Nurse Klein told Mrs. Wright that she was going to fill out a special diet requisition for a soft diet.

At dinner time when her food tray was presented, Mrs. Wright became very angry and upset. “I won’t eat this slop!” she asserted. “Bring me some real food that I can get my teeth into.” Nurse Klein patiently explained to her why it was best that she eat a soft diet and informed her about the risks of choking and aspiration. She also pointed out that the nursing staff would have limited time to spend assisting her with meals. Even so, Mrs. Wright was adamant. “It’s my life and I will live it the way I want!” she insisted.

The next day arrangements were made for nursing staff to meet with Mrs. Wright and her husband. During the discussion, it became clear that Mr. Wright supported his wife, and that the couple had thoroughly explored the options and were prepared to accept the consequences of their decision. They had also discussed the implications their decision would have on family members. Having realized that the Wrights were not going to change their decision, the nursing staff approached Mrs. Wright’s physician and convinced him that it would be in her best interest to order her a soft diet. This only further angered Mrs. Wright.

(Michael Yeo, Concepts and Cases in Nursing Ethics [Lewistown, NY: Broadview Press, 1991], 68–69.)

Address the following questions:

1. Which 2 of the 4 principles do you think are in conflict in this case? Support your answer.

2. Which principle do you think should take precedence in this case? Support your answer.

Other questions to consider: 

1. In light of the couple’s statement that they had “thoroughly explored the options and were prepared to accept the consequences of their decision,” do you think that should have ended the discussion?

2. Do you think the nursing staff were justified in approaching the physician and convincing him to write an order for a soft diet?

3. Can you think of a creative alternative that might resolve the conflict between the couple and the staff?