Problem
Case Scenario:
This case study focuses on a 32-year-old woman, with no significant past medical history, who presents to the emergency department with several days of worsening confusion. The complete blood count shows a hemoglobin concentration of 9.8 g/dL and a platelet count of 34 x 109/L. Creatinine is 3.1 mg/dL and the LDH is 448 IU/L. A review of the peripheral blood smear shows numerous schistocytes. ADAMTS13 level is measured and found to be 68 percent without evidence of a detectable inhibitor. The patient is diagnosed with atypical hemolytic-uremic syndrome and eculizumab is started. Advance Directives of the patient stated to do possible things to keep her alive when the time comes that she is in a critical condition and cannot consciously decide.
One morning, the client's condition worsen. Her family members immediately went to the hospital to check on her. She was unconscious with a deteriorating condition. The attending physician explained that an immediate blood transfusion is needed due to the abrupt decline of her CBC values. But the family refused because of their strict religious practice.
Task
a) What is the ethical issue involved in this case?
b) As a nurse, what are you going to do? Explain and justify your thoughts.