Decisions in the health care profession are usually characterized by uncertainty. Despite calculated approaches and choices based on the available information, the outcome is not known in advance, whether it will be favorable or disadvantage the patient. One of the decisions involved requires choosing between withdrawing and withholding life sustaining mechanisms available for a particular patient (Welie & Ten Have, 2014). Each option presents moral implications on the part of the medical practitioner, depending on the impact and consequences of the decision. The ethical implications presented by the decision of withdrawal of life support mechanism should be explored regarding the implications by the patient, law, immediate family of the patient and moral code of ethics of the practitioner involved in the situation. …show more content…
This involves incorporation of the decision of the patient whose fate is under consideration. This principle of autonomy leads to informed consent or refusal, whereby treatment should not be initiated in absence of approval by the patient except in cases of emergency. The law supports the principle as a form of justice, provided there is presence of concise evidence supporting the patient's decision. The principle of autonomy highlights the main aspect of the dilemma of withdrawal of life support mechanism, the wellbeing of the patient. Other principles that must be factored in with regards to the patient are the principles of non-maleficence and beneficence, which require that treatment administered must not inflict harmful effects but should have the patient's best interests at heart. The patients that go against the prevalent medical advice should not be signed off as uncooperative but should be understood by the health care providers in order to avoid unnecessary conflict (Tong & Robert,
Healthcare creates unique dilemmas that must consider the common good of every patient. Medical professionals, on a frequent basis, face situations that require complicated, and at times, difficult decision-making. The medical matters they decide on are often sensitive and critical in regards to patient needs and care. In the Case of Marguerite M and the Angiogram, the medical team in both cases were faced with the critical question of which patient gets the necessary medical care when resources are limited. In like manner, when one patient receives the appropriate care at the expense of another, medical professionals face the possibility of liability and litigation. These medical circumstances place a burden on the healthcare professionals to think and act in the best interest of the patient while still considering the ethical and legal issues they may confront as a result of their choices and actions. Medical ethics and law are always evolving as rapid advances in all areas of healthcare take place.
The ethical principle of nonmaleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with nonmaleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, suffering of the patient and family would be evident. Autonomy is the right to making own decisions and freedom to choose a plan of action. When making decisions regarding treatment of another person, it is important to respect the expressed wishes of the individual. John says that his mother would want to live as long as she could, but questions arise related to her quality of life and perception of prolonged suffering by prolonging the dying process. In BOOK states that quality of life changes throughout one’s life ...
Patients are ultimately responsible for their own health and wellbeing and should be held responsible for the consequences of their decisions and actions. All people have the right to refuse treatment even where refusal may result in harm to themselves or in their own death and providers are legally bound to respect their decision. If patients cannot decide for themselves, but have previously decided to refuse treatment while still competent, their decision is legally binding. Where a patient's views are not known, the doctor has a responsibility to make a decision, but should consult other healthcare professionals and people close to the patient.
When patients suffering from serious health conditions are towards the end of their lives, they are given an option that can change their lives and the lives of those around them. This option is praised as an act of preserving dignity, but also condemned as an act of weakness. The terminally ill, as well as the disabled and the elderly, are given the choice to end their lives by the method of suicide involving the assistance of a physician. For several years, this method has been under debate on whether this option is ethical or unethical. Not only is this defective option unethical, but it puts ill and elderly patients under pressures that can lead to them choosing this alternative rather than the fighting for their lives.
There are many ethical issues that arise in the Karen Ann Quinlan case. First, there is the ethical right that each person has to receive or refuse medical treatment. But this can ethically problematic because some would see death as an intrinsic evil; therefore choosing death would be unethical. This, however, can be categorized as part of the larger issue of patient autonomy, the patient's right to live and abide by their own personal choices (Garrett 29). Recent thought has affirmed the idea of patient autonomy in medicine, now making it a central dogma of the American medical practice. In this case, patient autonomy is threatened because the patient is not able to communicate their desires for treatment. The physician cannot ask, and therefore cannot know, if the patient would want to continue treatment or withdraw treatment. In this case, the Karen was deemed incompetent...
...d how these determinations effect a physician’s approach to various types of critically ill patients? These types of questions come in to play when one attempts to critically analyze the differences between the types of terminally ill patients and the subtle ethical/legal nuances between withholding and withdrawing treatment. According to a review by Larry Gostin and Robert Weir about Nancy Cruzan, “…courts examine the physician’s respect for the desires of the patient and the level of care administered. A rule forbidding physicians from discontinuing a treatment that could have been withheld initially will discourage doctors from attempting certain types of care and force them prematurely to allow a patient to die. Physicians must be free to exercise their best professional judgment, especially when facing the sensitive question of whether to administer treatment.”
The autonomy of a competent patient is an issue not often debated in medical ethics. Refusal of unwanted treatment is a basic right, likened to the common law of battery, available to all people capable of a competent choice. These fundamental rules of medical ethics entered a completely new forum as medical technology developed highly effective life-sustaining care during the 20th century. Several watershed cases elucidated these emerging issues in the 1960’s and 70’s, none more effectively than that of Karen Ann Quinlan. Fundamentally, this case established that a once-competent patient without the possibility of recovery could have their autonomy exercised by a surrogate in regard to the refusal of life-sustaining treatment. This decision had a profound effect on medical ethics, including treatment of incompetent patients in end-of-life situations, creation of advance directives, physician-assisted suicide (PAS) and active euthanasia.
...endent judgments about their own fate. In keeping with this trend there is now a growing drive to review the current laws on euthanasia and assisted suicide.” (McCormack, 1998) Nurses are faced with various ethical dilemmas every day. If theses ethical decisions are not treated in a professional manner there can be harsh consequences for both the patient and the nurse.
As precious as life is to come in to this world, there is debate about whether life going out of this world should hold the same amount of pricelessness, happiness, and peace in cases of the terminally ill with no chance of long-term survival. This deliberation of whether physician assisted suicide should be permitted is a major medical ethical concern, however, as a future nurse, this argument does not have a place in modern medicine. In the following sections, the ethical principles of autonomy, beneficence, and nonmaleficence are discussed with regard to the patient’s best interest and the personal views and opinions of a prospective nurse.
Autonomy and beneficence are the two core ethical values that often conflict with each other and prevent nurse from making a correct decision. Autonomy is the right and a freedom to making own decisions without influence from others. It is one of the fundamental ethical rights. It identifies each man as unique person that possesses his own set of values, beliefs and views about the health. As nurses we have an obligation to respect individuals’ choices and rights to self-determination. It is also vital that patients make their own decisions based on accurate knowledge and sufficiently understand the situation.
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
This can be seen in the case study as ethical and legal arise in resuscitation settings, as every situation will have its differences it is essential that the paramedic has knowledge in the areas of health ethics and laws relating to providing health care. The laws can be interpreted differently and direction by state guidelines may be required. Paramedics face ethical decisions that they will be required to interpret themselves and act in a way that they believe is right. Obstacles arise such as families’ wishes for the patients’ outcome, communicating with the key stakeholders is imperative in making informed and good health practice decision. It could be argued that the paramedics in the case study acted in the best interest of the patient as there was no formal directive and they did not have enough information regarding the patients’ wishes in relation to the current situation. More consultation with the key stakeholders may have provided a better approach in reducing the stress and understanding of why the resuscitation was happening. Overall, ethically it could be argued that commencing resuscitation and terminating once appropriate information was available is the right thing to do for the
The aim of the analysis is meant to clarify the meaning of the word autonomy thereby the introduction of a concept. Clarification is needed as the word autonomy does have several meanings and not all apply to medical terminology, some meanings span to philosophy, technology and general decision making. The medical meaning is significant in the care of patients for improved outcomes through choice and educated decision making on the part of the patient. Autonomy can be empowering as a concept or even as a single word.
The principle of autonomy states, that an individual’s decision must be respected in all cases, also an individual can act freely in accordance to their plan. For example, in a case where a patient and family demands to continue medical or surgical care and a physician want the patient to stop further treatment. In this case the patient’s choice will matter the most. According to the principle of autonomy it will be the patients and family choice whether to continue or discontinue treatment. The principle of beneficence which states, “one must promote good” comes into play in this case. In accordance to beneficence the patient will not benefit from the physicians responses personally. He/she will not benefit from harming her body with more surgeries. The patient will be going against the principle non-maleficence, which states that “one must cause no harm to an individual” by causing harm to herself. In this case the physician is justified in his/her actions by discontinuing medical or surgical care to the patient because it will not it her. These principles are what healthcare provider use to help and guide patients with the ...
A divergent set of issues and opinions involving medical care for the very seriously ill patient have dogged the bioethics community for decades. While sophisticated medical technology has allowed people to live longer, it has also caused protracted death, most often to the severe detriment of individuals and their families. Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center, believes too many Americans are “dying badly.” In discussing this issue, he stated, “Families cannot imagine there could be anything worse than their loved one dying, but in fact, there are things worse.” “It’s having someone you love…suffering, dying connected to machines” (CBS News, 2014). In the not distant past, the knowledge, skills, and technology were simply not available to cure, much less prolong the deaths of gravely ill people. In addition to the ethical and moral dilemmas this presents, the costs of intensive treatment often do not realize appreciable benefits. However, cost alone should not determine when care becomes “futile” as this veers medicine into an even more dangerous ethical quagmire. While preserving life with the best possible care is always good medicine, the suffering and protracted deaths caused from the continued use of futile measures benefits no one. For this reason, the determination of futility should be a joint decision between the physician, the patient, and his or her surrogate.