Mr. Bowen is 74 years old. He

Mr. Bowen is 74 years old. He has been very healthy and active, working as a farmer. He had a right-sided cerebrovascular accident 14 days ago and currently has moderate leg weakness, significant arm weakness, slurred speech, and mild difficulty swallowing. He is expected to recover the ability to ambulate with a cane, though return of arm function is guarded. His ability to speak and swallow will likely improve, but he may require a special diet to prevent aspiration. Mr. Bowen has decided to stop eating, stating that he does not want to live as an invalid. His family is very distressed and wants the nursing staff to force him to eat. He has been evaluated for depression and an antidepressant has been ordered, which he refuses to take. Mr. Bowen is oriented to time, place, and person. Prior refusing to eat, Mr Bowen’s decision-making capacity had never been questioned. 1.What ethical dilemma(s) exist in this situation? 2.What ethical principles apply in this case study? 3.Does Mr. Bowen have the right to refuse to eat and take medications when he clearly is not in an end-of-life situation? 4.As the nurse, how would you approach and direct the care for Mr. Bowen? SCIENCE HEALTH SCIENCE NURSING NURSING 531

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