10 Sep 2022


Ethical Issues in Home Health Care

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Academic level: University

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Words: 1495

Pages: 5

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Summary / introduction 

Deep down Dark novel reflects the real stories of the 33 miners who were trapped in a mine for 69 days. The accident happened in Northern Chile on 5th August 2010. Hector Tobar narrates what the families when through while they waited for their loved ones for the sixty-nine long days, with the hope that they would see their loved ones alive fading daily. The book further reports on the success of the rescue, and how the 33 succeeded. The copper mine had been in existence for 100 years and although the miners knew its condition was risky, they continued working to raise money to support the women in their lives as Hector purports. Additionally, the book records that the minors had reported on the bad condition of the mine to the manager who took no action (Tobar, 2014). Additionally, Hector also narrates about the miners' personal lives like Yonni Barrios, who was married and yet had a mistress. He lived with the mistress whom he loved and not with the wife. However, it is also noted that Yonno later suffered posttraumatic stress disorder, and this is mainly attributed to the stories going public. 

The dominant theme in the work is the cases of faith crises as people wept and accepted the death of their loved ones, as they did not believe that they could survive after being underground for more than 2 months (Tobar, 2014). Hector recounts on the terror, which the miners underwent, especially when the rescue drill would go quite as they thought the rescuers had assumed they were all dead. Some encouraged the others on issues of faith while other miners wondered if they should pray or just give up and die. While they were there the in the mine, those in supervision gave up their roles while others who felt stronger took them. However, there was rising tension as people were frustrated, afraid, desperate, and sometimes the differences between them almost became violent. 

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In addition, the book highlights the bad conditions that exist in mines with one miner among the 33 having so far lived through five accidents. They all claim they mines have no basic safety features and so the lives of the miners are jeopardized on a daily basis. The author shows that even in the countries that are categorized as developed, the situation is still the same. On a no accident day, which they define as a good day, miners go through an ordeal of injuries, death traps, and even bad crashes as the rocks around them crumbled. They also vomit a lot owing to intense heat and humidity, not to mention the air that is filled with dust. In days when miners are trapped in mines they starvation, total darkness spells and periods of paranoia. Consequently, they are most times angry. 

In conclusion. Tobar tells of how experienced rescue teams came from all over the world, drilling holes to the exact position of the miners. It takes 16 days from the time they are found to the day they are rescued, but food and medicine arrived at them through the life-saving holes that had been drilled. Media access was also availed to them, and the men even begin signing contracts that would ensure that some of them do not benefit from the story at the expense of others. To them, the story was precious and they wanted to share all the benefits drawn from it as a group. The author states that the miners' families complained that the survivors of the accident were different from the men they were before the ordeal. One would term it as posttraumatic stress disorder. 

Concepts of Ethical, Legal, and Spiritual Insight of Patients and Healthcare 

The thirty-three men have just outlived a very horrible and traumatizing experience in which most of them stared death in the face. Right from the beginning, there is much torture distress, pain, hunger, and even emotional turmoil as one thinks of their families whom they do not know whether they will ever see again. According to them, each passing day makes the hope fade. Some do not even know whether to pray or resign to death. A picture of one who cannot even stand or walk after the ordeal is also shown, showing that beyond the emotional turmoil, they were also sickly and needed medical attention. 

As a nurse, in this case, there are ethical, legal, and spiritual standards that need to be observed in taking care of the patients. For some of the men, they lived private lives, whereby nobody in the public knew their details. However, upon surviving the mine accident, their stories, even the dirty linen, had all been aired in the public. Some were angry and afraid to face the world while others did not know how to handle the sudden fame. 

Spiritual assistance other medical assistance is vital as it may help them overcome the turmoil that they underwent. Research shows that some patients undergo religious struggles as they may blame God for what they just faced. Others may wonder where God was as they passed through the turmoil, albeit they came out. Besides that, some, whose stories are now in the public may still blame God and feel unloved and unwanted in his care. As a nurse, it is vital to refer them to the appropriate clergy and even help them overcome the negative emotions that may crowd their minds on the occurrences. The nurse needs to collect the psychosocial history of the patients. Consequently, for the patients who agree to open up on the issues of their religiosity may benefit more from the therapy. Using spirituality helps the patients to cope more easily than they would ordinarily. 

Ethically the health care professionals ought to have respect for the persons or patients despite the publicity that the issue has drawn. By this, the nurses should keep confidentiality between the issues that the patients reveal to them without sharing with any third party. It is clear that the 33 are now famous and journalists and other media personalities may seek clarification from all that are around the 33, including their doctors and nurses. However, it is important for the nurses to keep the information as discreet as possible not to breach the privacy rights to privileged information. 

The health care practitioner must also carefully scrutinize the issue so that the spiritual care must not include malpractice, as the practitioner must not force their beliefs on the patients. Consequently, it is ethical to ensure that the boundaries of care are not crossed and these include physical care as well as guarding the private rights of a patient. Legally, the healthcare practitioner must ensure that the medical information used such as intuition cannot be categorized potentially as manipulative, fraudulent, or misleading by the patient, as this can attract lawsuits. Moreover, they must avoid cases of misrepresentation and breach. They should as well see to it that they define the line between working within the spiritual framework of the patient that would enhance care and coercing them. The practices used for care must also be acceptable. 

Ethical Duties of the Registered Nurse 

Nurses have the ethical duty of providing compassionate, safe, ethical, and competent care to the patients. They are also entrusted with the duty of promoting the wellbeing and health of their patients (Smith, Ladd & Pasquerella, 2008). Additionally, a nurse has the ethical duty of promoting informed decision making where their patients are concerned and respecting those decisions too. In this regard, the patient must be given all the necessary information concerning their situations. They must also preserve the dignity of their patients and avoid situations where the dignity is abused. Lastly, a nurse has the ethical duty of being accountable and promoting justice where the patients are concerned (Pera & Van, 2005). . 


When I was in my late twenties, my father passed away. In the last five years of his life, drove an 18-wheeler truck because he enjoyed the country. While driving cargo he had a massive heart attack and another truck driver spotted him slumped over the wheel over his truck. It took a lot of time to recover from this and my mother lost her hair due to the shock. These 33 men banded together and rationed whatever food was available for survival. Similarly, after the passing of my father my five brothers and I banded together to support each other and my mother. 

So far, I have worked as a hospice nurse for three years. I have encountered patients at the worst and final stages of their life. Patients have told their life stories and expressed the joy their children and family members have been supportive. In all of the years working as a hospice nurse I never once encountered a negative response from family. The hospice nurse serves as the source of hope that their loved one will be pain-free and comfortable in the last stages of life. There is a powerful source when families band together. The 33 men banded together, encouraged each other, and prayed for each other to help them survive an unexpected tragedy of the collapse of the mine. 


In conclusion, it was a harrowing experience for each of the 33 men who were caught up in the hole for 69 days. Although they almost despaired, it was clear that their unity helped them through so that none of them died before the rescue. Moreover, their ability to share their stories could have lessened the pain and burden, albeit they often got into disagreements due to the mounting pressure. Health care practitioners must offer them due to care while protecting the men's dignity. They must also help them recover using different strategies with the spiritual aspect of care being fundamental. Ethical and legal aspects of care must be observed. 


Pera, S. A., & Van, T. S. (2005).  Ethics in health care . Lansdowne, South Africa: Juta. 

Smith, S., Ladd, R. E., & Pasquerella, L. (2008).  Ethical issues in home health care . Springfield: Charles C Thomas Publisher, LTD. 

Tobar, H. (2014).  Deep down dark: The untold stories of 33 men buried in a Chilean mine, and the miracle that set them free  (First edition.). New York: Farrar, Straus, and Giroux. 

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