Case study: Arthur Sampson

Arthur Sampson is eighty four years old and lives independently. He has diabetes for which he receives daily insulin and to date he has been able to administer his own injection and maintain a balanced diet. His diabetes has, therefore, been stable. Recently, however, he experienced a respiratory infection which made him feel very unwell, lost his appetite and therefore experience hypoglycaemia. This resulted in his coming into hospital to both stabilise his diabetes and to treat the respiratory infection. He is now being considered for discharge and is very concerned that the hospital team seem to be suggesting that his recent hospitalisation means that he needs help managing his diabetes and that he will therefore need a district nurse to call. Apart from feeling as though people are trying to make him dependent Arthur resents this as he likes to go out and about seeing his friends and waiting for the district nurse to call will limit his freedom to do this. He has told the team that he is perfectly able to care for himself and that he takes full responsibility for this. However, the consultant has told him that they have a duty of care and need to make sure that he has support.

• What ethical principles are being challenged in this case study?
• How would you act if you were the nurse supporting Arthurs care?