Barney says no (Case study)

A physician must understand that when it comes to deciding to withhold or withdraw life sustaining treatment it is ultimately the patient’s decision unless the patient is not competent enough to make this choice. I believe that a person can lose their life at any point. Death is certain and no one can run from it. In my opinion, a patient’s autonomy is of utmost importance anytime during healthcare however the physician can name some recommendations of what would be the best option for the patient. When it comes to patients they deserve to be treated with respect and ultimately be treated as an end not as a means to an end.

The World Health Organisation (2010) defines palliative care as: An approach that improves the quality of life of patients and their families facing problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. It is also our duty to support John and his wife`s in their decision for John to die at home, Department of health (2008) patients should have a choice over the care they receive and where.

Rarely any physician intends to harm patients when he or she provides treatment to them. Patients see physicians and specialists in full faith that they will get help with a condition. What complicates the patient-doctor relationship is that the outcome of each patient’s treatment is different because of individual health conditions and the course of treatment chosen by the doctor. Problems arise when a patient is not satisfied with care provided by the doctor or in extreme cases when a patient dies. Since most of the time it is hard to clearly determine whether the outcome was solely a result of the course of treatment chosen by the doctor or whether other factors played a role too, quite often patients take their

Very often, deliberate decisions are made which results in the end of a life. For example, a person could be kept on life support, but instead, a family member or other significant person might choose to switch off the life support machine resulting in the official death of a patient. There is also the case that resuscitation of a patient may eventually prove to be trivial and a doctor might suggest just making the patient as comfortable as possible until their eventual passing. In the above situations, a medical professional’s decisions would not be questioned or doubted. It is conventional practice (Warnock and MacDonald 2008).

Palliative care is a relatively new concept, stemming from the hospice movement of the 1960s. This type of care focuses on the quality of life of its patients at any time in their treatment process. Palliative care is a concept that is often used synonymously with hospice care. Although it can be congregated with hospice care, they are not the same thing. Thus, it can easily be misunderstood. Sherner (2015) explains that both clinicians and people alternate palliative care and hospice. Unfortunately, she says, these people believe that palliative care implies the patient is refusing curative care. The purpose of this analysis is to explore the concept, clarify the meaning, and differentiate the concept of palliative care.

I must be aware, as the patient’s advocate, of the choice of each individual patient regarding his or her medical management or, as in this case, the withholding of treatment.

In nursing, the goal of care is usually to restore the patient back to the highest level of health possible. In some cases, however, the goals of care change when a curative approach is no longer appropriate. The new goals of care could simply be palliation and pain control rather than a restoration back to full health. This type of care is called palliative care. Palliative care is not the same as end-of-life care, but the two go hand-in-hand at times. The goal of end-of-life care is a “good” death, good being defined by the patient. Palliation is part of that “good” death. Both palliative care and end-of-life

A patients suffering cant be relieved all the time despite flawless palliative care, continuing to live causes misery that can only end with death.

In terms of the intensity and duration, the disease is life-long and is accompanied by increasing emotional and physical pain. Most of this pain is derived from slowly loosing major bodily functions like walking, speaking, eating, blinking, and even breathing (Canadian medical journal: http://www.cmaj.ca) The extent of those affected include himself and his family members who are most likely suffering emotionally as well. The degree of pain and the extent to which this pain affects others is greater than the pleasure that could be derived from allowing the disease to progress further in answering no to Rob’s request. Thus, under utilitarian principles, the doctor should uphold Rob’s request for physician-assisted death.

The clinical features Mrs Lee now 83 is displaying changes to health and cognition noted in the last three to four months, with two transient ischaemic attacks but no significant medical issues. Although currently taking three medications for high blood pressure. Changes in word finding, getting words mixed up and confusing identifying words. Insisting everything is fine showing a lack of insight into her changes or difficulties. Short term memory Mrs Lees has difficulty retaining recent memories, however long term memory appears reasonable. Although Mrs Lees home is reasonably well maintained, she is emaciated and personal hygiene is poor. There is also evidence of emotionally Liable being frequently teary with no reason. History includes

effort must be made on the part of the patient as medicine can not cure

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. 6th ed. New York: Oxford University Press, 2008.

I have always believed that health cannot be optimized through the treatment of disease only. Rather, health should be addressed on a biological, physical, psychological, social, and spiritual continuum. Palliative care addresses an often-overlooked aspect of the patient experience, which is symptom management of their chronic illnesses. Health care professionals tend to treat acute episodes of

Bioethics is multidisciplinary. It blends law, philosophy, insights from the humanities and medicine to bear on the the complex interaction of human life, science, and technology. Although its

A palliative approach can be provided in the resident’s familiar surrounding if adequately skilled care is available, which reduces the need for transfer to an acute care setting; thereby, avoiding potential distress to the resident and his/her family.