Care and Cure
The terms cure and care are both used in administering wellness to an individual whether emotionally or physically. However, there exists a slight difference in the two terms in two major ways. Cure is meant for illnesses and injuries in the sense that its main objective is to suppress observed symptoms (Youtube, 2018). Therefore, where cure is involved, there must be accurate observation of signs and symptoms experienced by the patient, accurate diagnosis and testing, and proper medication thereafter to suppress the effects of the symptoms. On the other hand, care is focused on conditions that are not curable by definition but only experienced by the individual in need. These experiences as explained in the youtube video mostly tend to affect the emotional stability of the patients. Since there is no need to choose treatment options, diagnosis is less important during care (Youtube, 2018). Instead, the patient is monitored from a biopsychosocial perspective: their emotions, psychology, and spirituality are assessed to determine the disabilities and strengths after which support is given to promote their strengths while accommodating disabilities identified.
The outcome from cure can be physically felt and is always visible whereas the outcome of care is not always visible. For instance, administering cure to a broken limb will result to a healed limb which can be seen physically when the patient walks (Youtube, 2018). However, for dementia, improvement in the mental and emotional wellness of the patient cannot be seen after care; the same way there does not exist emotional meters to measure the amount of care given.
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Basic Care
Human beings are morally obliged to basic care which encompasses aspects such as nutrition, hydration, shelter, and human interaction. The human body is engineered in such a way that all parts are interdependent: the brain needs the heart for blood, and the heart needs the brain to discharge its function properly which is pumping blood (Youtube, 2018). Therefore, in the same way, basic needs are complimentary of each other whereby lack of one lead to breaking down of a few parts of the human body which ultimately affects the wellness of the whole body (Youtube, 2018). For instance, an individual leaving in a nice shelter but suffering from malnutrition is likely to die from the condition if it is not treated. We are therefore morally obliged to basic care as evidenced by the aforementioned reasons.
Swallow Test
A Swallow test refers to a medical procedure conducted to detect any abnormalities that exist within the gastrointestinal tract, from the esophagus to the stomach. The procedure is mostly done using X-rays and Barium sulfate solution (Youtube, 2018). The patient is required to drink a solution containing barium sulfate, whose movement can then be tacked using X-rays through the digestive system (Hill, 2018). The test is conducted to determine the cause of painful swallowing, abdominal pains, difficulties in swallowing, among other symptoms associated with the digestive tract (Youtube, 2018). Therefore, medical conditions such as Schatzki’s ring, dysphagia, Hiatal hernia, varices, polyps, ulcers, and GERD are detected using a swallow test.
Medically-assisted Nutrition Health
Nutrition health is in most cases the responsibility of every human being: every person has a personal responsibility to ensure they stay hydrated, eat a balanced diet, and exercise. However, some situations might need artificial nutrition health where food is administered to the patient in liquid form or tablet form to support the already existing nutrition plan (Youtube, 2018). Medically assisted nutrition is done through either enteral nutrition or parenteral nutrition. This type of nutrition health is indicated when an individual has difficulties intaking food orally, lacks critical nutrients in the body, or is critically ill.
Enteral Nutrition (EN)
Enteral nutrition refers to a medically assisted nutrition health procedure where food is administered to an individual through a tube placed in the nose, stomach, or the small intestines. There exist different tubes that are used to administer this type of nutrition, depending on the whether the tube is placed in the nose, the stomach, or the small intestines: nasogastric tubes, gastrostomy tubes, and jejunostomy tubes respectively (Youtube, 2018). However, in most cases, these tubes run from the nose to the stomach through the esophagus, or further to the small intestines from the stomach in which case they are categorized as Nasogastric tubes and Nasojejunal tubes respectively.
Nasogastric tubes are used for patients with neck or facial injuries and surgeries, blockages in the intestines, comatose, and patients who need mechanical ventilation to breathe. Nasojejunal tube on the other hand used pumps to give feedings to the patient and no bolus feeding is allowed (Youtube, 2018). In cases where NJ and NG tubes are not used, either gastrostomy or jejunostomy tubes are inserted into the digestive tract using a procedure called Percutaneous Endoscopic Gastrostomy (PEG) (Youtube, 2018). The PEG procedure involves a surgical incision on the skin around the stomach area that directs into the stomach and insertion of an endoscope through the mouth to guide and hold in place the gastrostomy tube inserted through the incision (Blaser et al., 2017). Lidocaine is used as an anesthesia during the procedure and no surgery is performed on the abdomen whatsoever.
Parenteral Nutrition
Parenteral nutrition involves intravenous administration of nutrition to a patient who cannot feed through enteral nutrition nor orally. The patient is given a sterile liquid containing a chemical formula for either proteins, carbohydrates, fat, minerals, vitamins, electrolytes, or all through an Intravenous catheter needle in the veins (Youtube, 2018). Parenteral nutrition is most common with GI fistula patients, bowel obstruction, and patients with acute pancreatitis. PN exists in two form: Total Parenteral Nutrition and Partial Parenteral Nutrition. TPN supplies the patient with all daily nutritional requirements while PPN supplies only some essential nutrients to supplement other means of nutrition such as ingestion orally (Sobotka & Forbes, 2019). However, since TPN solutions are highly concentrated than PPN, a central venous catheter is used instead to avoid side effects such as thrombosis of the peripheral veins.
Bioethical Analysis of Nutrition Health
Nutrition Health is guided by principles which act as frameworks for ethical actions for both the medical practitioner and the patient. The ethical principles include autonomy, beneficence, non-maleficence, and justice (Chadwick & Gallagher, 2016). The basic principle is beneficence, where the healthcare professional should always act in the best interests of the patient while administering nutrition and hydration. However, as much as the objective is to prevent further suffering of the patient, there are two exceptions to the principle (Youtube, 2018). If there is a reasonable expectation of equated benefits, or the benefits of the procedure administered outweigh the risks involved, then the nutrition health professional is permitted to perform the involved procedure.
Terry Schiavo Case Study
Terry Schiavo’s case contains a few events where ethical practices were observed by both the physicians, the guardian, the patient, and other third parties. However, there also exist events where ethical principles were violated. When a PEG is first performed on Terry, the physicians do that because it was in the best interests of the patient since she could not feed through the mouth after the neurosurgery. The principle of beneficence was observed. Some physicians violate the principles of non-maleficence and beneficence by performing procedures that risk the life of Ms. Schiavo, and the courts restore justice by fining the physicians $250,000 in May 28, 1992 and $350,000 and $700,000 in November 28, 1992. Terry Schiavo informs Michael that she does not wish to be kept alive in a PSV; Michael acts by requesting for removal of the PEG which is granted by the court under Judge Greer, hence upholding the principle of autonomy. However, after petitions by Terry’s family, the PEG is reinstated hence violating autonomy, and this is done several times until the death of Terry.
References
Blaser, A. R., Starkopf, J., Alhazzani, W., Berger, M. M., Casaer, M. P., Deane, A. M., & Loudet, C. I. (2017). Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive care medicine 43(3), 380-398
Chadwick, R., & Gallagher, A. (2016). Ethics and nursing practice. Macmillan International Higher Education.
Hill, I. (2018). It’s hard to swallow- which test is best? The Journal of Pediatrics, 201, 1-2
Sobotka, L., & Forbes, A. (2019). Basics in clinical nutrition (Vol. 1, No. 5 th ). Galen
Youtube (2018). BIO 603 3 24 18, ALFRED CIOFFI , https://youtu.be/8yxIRjW9x7w
