The Case of Casey: Casey’s Last Inning
Casey, a forty-seven year old woman, umpired little league baseball games until she apparently suffered a cardiac arrest six months ago. She suffered anoxic brain damage and is now in a persistent vegetative state. Her mother, who lived with Casey until her illness, insists on aggressive treatment despite the poor prognosis. The nursing home staff has reluctantly agreed to CPR.
About midnight, staff discover Casey to be without pulse or respiration. Medics are called (911) and the rescue squad arrives within six minutes. During this time the nursing staff initiate CPR. After twenty minutes of unsuccessful resuscitation, Casey's physician is called for instructions. The doctor orders that the resuscitation efforts be continued, and that Casey be transported to a nearby emergency room. The nursing staff is reluctant to carry out this order. The rescue squad is willing to proceed. The physician is not willing to come to the nursing home to supervise the resuscitation attempt.
Reflecting on Cases involving Moral Distress
Each case should be analyzed according to its particular merits and context. The following questions, however, will help individuals or ethics committees clarify the nature of the conflict, the impasse, and the sort of moral distress that characterizes each situation.
The following questions test whether adequate attempts have been made to deal with the moral distress created by the conflicting goods:
These questions are important elements in all ethical deliberation.