Case Study_4 Discussion

.docx

School

Schenectady County Community College, SUNY *

*We aren’t endorsed by this school

Course

101

Subject

Medicine

Date

Apr 3, 2024

Type

docx

Pages

2

Uploaded by artisushil

Report
1) What are the three best ways to realize a dignified death with cancer? According to the case the three best ways to realize a dignified death with cancer include: a) Being hopeful and yet circumspect in prognosis. b) Identifying appropriate surrogate decision makers. c) Developing trust through years of compassionate care. 2) What caused the biggest problem for the patient in this case? In this case caused of the biggest problem was patient making the decision concerning his end- of-life matters which was brought up by the dilemma within the medical and ethical team and the family decision concerning care of the patient. According to the medical team, the patient’s cancer had metastasized, and it was futile to employ any surgical intervention to prolong his life since he had a poor prognosis. Because of how long he had survived with the condition, it had given the family false hope for a probable cure. This can be evidenced in them asking for a surgical intervention to remove part of the tumor which according to the medical team was futile. Another thing that made this case complicated was the patient had no surrogate, no power of attorney or no living will concerning end of life matters. The son who was felt to have been in a better position to act as a surrogate was not able to because he had not been chosen previously. There was also the issue of poor follow up over the years, and lack of primary care physician who could have streamlined the patient’s care and aided the family in making better decision concerning his end-of-life issues, acceptance that the condition had a poor prognosis and was terminal and helping the family to come up with a surrogate that could help with making decision which would be of beneficence that is of patient’s own best interest. 3) “The primary concern of surrogacy should be that of enacting the medical decision that represent the medical preferences expressed by the patient’s” What were the surrogacy issues in this case? Some of the surrogacy issues in this case were that there was no clear surrogate to make end of life issues decision for the family. The son who had a close and intimate decision with the patient was the most probable fit for the position of surrogacy but had not been chosen previously to act in this position. This resulted in a chaotic situation due to lack background preparation or relationship and with limited medical information. The son had conversation with his father regarding terminal illness and seemed to be in the best position to understand the limits of medicine in dealing with his father’s malignancy. The other issue was the false hope of a probable cure by the family and patient defying all odds and survived much longer than anyone expected. This complicated the chances of successful surrogacy. His son new what the patient’s wishes were including him wanting to die at home but because he was not the designated surrogate, it made it difficult for him to push for this directive to be enacted. This was worsened and complicated by the other members of the family who had contrary opinions necessitating an ethical team or board to be enacted to help advice the family and help make decisions for end- of-life matters for the patient. 4) Go to http://www.nysba.org/FHCDA/ and read some of the provisions and FAQ and share here something new that you learned and an example of why it is important.
Something I have learned the FHCDA provisions of Decisions for Minor Patients- Allows a physician to accept a life-sustaining treatment decision by an emancipated minor without parental consent, although a decision by the minor to forgo such treatment requires ethics review committee approval. Example : The best interests of conjoined twins to be separated, where one (Twin B) was near death. If they remained conjoined, it was highly likely that twin B died Twin A would also die, but if separated Twin A would have 60 to 80 percent chance of survival. Though the TWIN consented to the separation, in that case the hospital sought declaration lawfulness of operation given it would result in the death of Twin B. The court found that it was in the best interests of Twin A to authorize the procedure. Though the right to life of both twins was equal and operation would benefit only Twin A, Twin B would not suffer a corresponding detriment because her capacity to live was already fatally compromised. Continuance of the life of Twin B, were the surgery not performed, would confer no additional benefit. The parents or guardian of a patient under 18makes decision about life-sustaining treatment in accordance with the minor’s best interest. They consider the minor’s wishes as appropriate under the circumstances. For a decision to withhold or withdraw life-sustaining treatment, the minor patient must also consent if he or she has decision- making capacity. It is assumed that an unmarried minor lacks decision-making capacity unless a doctor determines that the patient has the capacity to decide about life- sustaining treatment. Minor who are married make their own decisions, the same as adults.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
  • Access to all documents
  • Unlimited textbook solutions
  • 24/7 expert homework help