| Course | NU144 Medical-Surgical Nursing II |
|---|---|
| Unit | Unit 7 |
| Paper type | Ethics case analysis |
| Length | About 880 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BSN (prelicensure) |
| Updated | October 2026 |
Free sample paper for NU144 Unit 7
He Wants to Stop Dialysis and His Son Says It Is Depression: An Ethics Case Analysis of a Composite 78-Year-Old Man Four Years on Hemodialysis, Testing a Position Against Its Strongest Objection
[Student Name]
Purdue University Global
NU144: Medical-Surgical Nursing II
Unit 7 Ethics Case Analysis
[Instructor Name]
[Date]
The patient and family are composite; the analysis is educational, and decisions about capacity and treatment belong to the patient and his care team.
The Facts
[Mr. K.], composite, 78, has kidney failure from diabetes and has spent four years on hemodialysis, three sessions a week. He also has heart failure and had a below-knee amputation last year. He tells his nurse during a session that he is "done" and wants to stop dialysis. He has thought about it for months, he says, since his wife died, and he wants to spend his remaining time at home with hospice. His son, who lives nearby, says his father has been depressed since his mother's death and is not thinking clearly; he asks the team to refuse.
The Principles in Tension
Respect for autonomy supports honoring a capable adult's decision to stop a treatment, even one that sustains life. Beneficence and nonmaleficence ask whether stopping would harm him, and whether continuing would. Stopping dialysis usually leads to death within days to a couple of weeks, which can be peaceful with good symptom care such as treating breathlessness, itching and agitation (Harding et al., 2023). Continuing means more sessions he finds burdensome. The son's concern draws on beneficence: if depression is distorting his choice, honoring it could be a harm (Beauchamp & Childress, 2019).
The Central Question: Capacity
Whether to honor his request depends on whether he has decision-making capacity for this decision: he understands the information, appreciates how it applies to him, can reason about options and can express a consistent choice. Depression does not automatically remove capacity, but severe depression can distort appreciation of one's future. The request should be taken seriously and explored, not accepted or dismissed on first hearing.
A Position
If assessment shows he has capacity, and any treatable depression has been identified and offered treatment, his decision to stop dialysis should be honored, with hospice support and care for his son's grief.
The question is not whether his son is right that he is sad; it is whether his sadness has taken away his ability to decide.
The Strongest Objection
His son's objection is serious: grief and depression after a spouse's death are common, often treatable, and could make a person choose death when, with treatment, he would choose to live. Stopping dialysis is irreversible. If the decision is driven by a treatable illness, honoring it would be a grave harm.
How the Position Holds
The objection is answered not by dismissing it but by building it into the process. The team arranges a capacity assessment, screens for depression and offers treatment and counseling, and asks Mr. K. to describe his reasons in more than one conversation. His wish has been consistent for months, predates the worst of his grief, and is tied to specific burdens: exhausting sessions, his amputation and his heart failure. Withdrawing from dialysis is recognized as an ethically acceptable choice for a capable patient. If he remains capable and consistent after these steps, his choice stands. If capacity is lacking, decisions move to a surrogate using his known values.
A Second Objection
A different objection comes from within the team: some staff feel that stopping a treatment he could continue for years is too close to ending his life on purpose. The usual ethical answer distinguishes stopping a burdensome treatment, which allows the underlying disease to take its course, from acting to cause death. A capable patient may decline any treatment, including one started years ago, and the duty of the team shifts to relieving symptoms. Staff who remain uncomfortable can raise their concerns through the ethics service, and the plan should not depend on any one nurse acting against conscience, as long as his care continues without interruption.
The Family Meeting
The meeting included Mr. K., his son, the nephrologist, the social worker, a palliative care nurse and his dialysis nurse. Mr. K. explained his reasons in his own words. His son asked whether his father would suffer, and the palliative nurse described the symptoms that may occur and how they would be treated at home. The son asked for two weeks to say what he needed to say, and his father agreed to continue dialysis for that time while the assessments were done.
The Nurse's Role
The nurse listens without judgment, documents his words, reports the request to the team, advocates for a capacity and depression assessment, supports a family meeting and keeps caring for him whatever is decided. The nursing code of ethics places respect for a patient's own choices, and support for making them informed, at the center of the nurse's role (American Nurses Association, 2025). The nurse also attends to the son, whose fear of losing his father so soon after his mother is real.
Outcome
After two weeks, a psychiatric assessment found grief without major depression and full capacity. Mr. K. stopped dialysis and died at home with hospice nine days later, with his son present.
References
American Nurses Association. (2025). Code of ethics for nurses. https://codeofethics.ana.org/
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C. (2023). Lewis's medical-surgical nursing: Assessment and management of clinical problems (12th ed.). Elsevier.
The Purdue Global NU144 Unit 7 instructions
Unit 7 commonly asks for an ethics case analysis using a structured approach: the facts, the stakeholders, the ethical principles in conflict, a position, an objection and a response. Students are expected to identify which principles apply and why they pull in different directions. Many prompts ask what the nurse should do, with reference to the professional code of ethics. Instructors look for a clear position rather than a summary of both sides, and for an objection stated fairly enough that the response is meaningful. Capacity, surrogate decision making and the role of the family often arise. Papers usually run four to five pages with an ethics text and the nursing code cited in APA 7.
Inside the NU144 Unit 7 example
The analysis begins with the facts of Mr. K.'s illness, his request and his son's view. The principles section sets autonomy against beneficence and nonmaleficence, citing the Beauchamp and Childress text. A section names capacity as the central question and defines its four parts. The position follows in two sentences, then a highlighted line on sadness versus the ability to decide. The strongest objection is stated, and the response builds it into the process, with two margin notes explaining why. A second objection from staff is answered by the difference between stopping treatment and causing death. The family meeting, the nurse's role and the outcome complete the paper.
NU144 Unit 7 rubric: what earns full points
Ethics rubrics in NU 144 usually distribute points across identifying the dilemma, applying ethical principles, taking and defending a position, considering objections, the nurse's role and APA writing. Dilemma points depend on stating the conflict clearly in one or two sentences. Principle points reward explaining how each applies to these facts rather than defining them. Position points require a clear stance. Objection points are earned only when the objection is presented at its strongest and then answered. The nurse's role is graded on concrete actions and a link to the professional code. Writing points include organization and citations. Addressing capacity directly usually earns full credit in the reasoning category.
NU144 Unit 7 help: mistakes that cost points
Ethics papers commonly lose points by describing both sides without ever choosing one. Another frequent mistake is presenting a weak objection that is easy to dismiss, which earns little credit for critical thinking. Some students treat depression as automatically removing capacity, or treat a patient's wish as automatically final, skipping the assessment that decides between them. Others forget the nurse's practical role. Lay out the facts, name the principles in conflict, take a position, state the strongest objection fairly, answer it and describe what the nurse does whatever the decision. Cite the current code of ethics. Close with the family, since their grief is part of the case.
Get an NU144 Unit 7 example written to your instructions
Ethics cases in Unit 7 turn on different refusals: a transfusion declined, a feeding tube, a family demanding treatment the team calls futile. Name the refusal in the posted case and the framework the course teaches, attach its rubric, and a defensible position is worked out through that framework. First custom sample free; 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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NU144 Unit 7 questions, answered
Where can I find a free NU144 Unit 7 sample paper?
The full NU144 Unit 7 ethics case analysis appears on this page, covering a composite man's request to stop dialysis, his son's objection, capacity, two objections answered, the nurse's role and four sources. If your dilemma differs, we can work through it with you.
What is decision-making capacity?
The ability to understand information about a decision, appreciate how it applies to oneself, reason about the options and express a consistent choice. It is judged decision by decision.
Does depression mean a patient lacks capacity?
Not automatically. Severe depression can distort how a person sees the future, so it is assessed and treated, but many people with depression keep the capacity to make decisions.
Is stopping dialysis ethically acceptable in NU144 Unit 7?
Yes, for a patient with capacity. Declining a burdensome treatment allows the disease to take its course, and the team's duty shifts to managing symptoms and supporting the family.
What is the nurse's role when a patient asks to stop treatment?
Listen, document the patient's words, report the request, advocate for capacity and depression assessment, support a family meeting and continue caring for the patient whatever is decided.