Being Mortal Atul Gawande Character Analysis

John Hardwig in Is There A Duty to Die? suggested there is a downside to medicine because it increases our life expectancy (Hardwig 35). What are we suppose to do with our lives, especially if we reach a point where we are incapacitated and miserable as our life progresses? In this paper I will argue that if I have a progressively increasing and incurable case of dementia and refuse to accept my duty to end my life, I forget my responsibility to my family and fail to see the importance of my own moral agent; this is because as a human, one of the most important obligations in life is maintain not only individual duty but also communal duty. I will begin my argument with a discussion of individual duty; here I will talk about how dementia will eventually lead to the deterioration of my mental capacities and explain why dignity lies within the last choice of my moral agent.

She also states that Gawande has had situations where he is overstating and giving some false hope due to him not being able to tell his patients about their health.

To argue the first premise, he appeals to common knowledge that doctors hold their occupations because they are more knowledgeable in a medical context on the options for improving health and longevity. With this in mind, he then establishes that individuals who consult physicians do so in order to prolong their life and improve their well-being. By establishing these foundational premises for paternalism in a medical context, Goldman can now argue that given a patient that is determined to be acting out of line with his true values and his actions might result in harm that is severe, certain, and irreversible, it is the physician’s professional to override the patients’ immediate rights in order to preserve that patients’ more long-term desires. But how can the physician determine whether the patient is acting in line with his true values in the case of withholding medical information from the patient?

1. Dr. Gawande explains that in his training as a surgeon, he has struggled with the fear of not being able to fix a problem for a patient, even when he knows the odds are not good. If you were Dr. Gawande’s patient, what would you like him to know about your hopes for how he would handle a difficult situation like this?

The Dying of the Light is an article by Dr. Craig Bowron that captures the controversy surrounding the role of medication in prolonging life. The author describes that many medical advancements have become a burden to particularly elderly patients who in most instances are ready to embrace the reality of death. Dr. Bowron believes that dying in these modern times has become a tiring and unnatural process. “Everyone wants to grow old and die in his or her sleep, but the truth is most of us will die in pieces,” Bowron notes (Bowron). The article does not advocate for euthanasia or the management of health care costs due to terminal or chronic illness. Bowron faults humanity for not embracing life and death with dignity as it was in the past.

Throughout our lives, we are plagued by the notion of ‘ethics’ or morals - the basis of our everyday behavior. The medical field is no exception, with doctors constantly reminded of the ethical duties they must carry out for each of their patients. An example of unethical doctors is demonstrated in Daniel Keyes’s short story, Flowers for Algernon. The story features Charlie Gordon, a man with an intellectual disability who strives to become smarter. He is a candidate for a new surgical procedure that is used to triple one’s intelligence which was directed by Dr. Strauss and Dr. Nemur. Although the procedure holds promise for helping a vast amount of people, Dr. Nemur and Dr. Strauss acted unethically by selecting Charlie to undergo the operation because they did not finish testing the procedure and because Charlie was unable to make a proper decision.

Although they are surrounded by healthcare providers who are tasked with saving their lives, they are not in a place where they feel comfortable. The author’s purpose is to send a message to the American society that they should be doing the opposite of putting the elderly in the hospitals and nursing homes, and instead take care of them. In the twenty-first century, medicine “take[s] that small child running through the yard, being chased by her brother with a grasshopper on his finger, and imprison her in a shell that does not come close to radiating the life of what she once had” (Profeta). The elderly are forcibly being placed in hospitals and nursing homes by their families, who do not want to take care of them. The memory shows the patient’s childhood of when she was full of joy, and all of that was taken away when she was put in a healthcare facility. They are now trapped in a place where they do not want to be in with physicians who do value their well-being, and rely on the technology of medicine to save them, but do not value their wishes to end their own

The medical world has never been black and white. A lot of the medical discovers had multiple ethical gray areas. Through the questionable testing and nameless patients, doctors were able to get away with faulty practices. Particularly in America during the 20th century, doctors from the United States Public Health Services observed the effects of Syphilis, an infectious diseases, on 600 African American males. This was called the Tuskegee Syphilis Experiment. For 40 years the doctors watched how the disease attacked the human body. Instead of curing the patients the doctors left them infested. The ethical issue at hand is seen in the actions and in the rituals of the doctors presiding over this experiment. Ancient philosophers such as Confucius and Aristotle would agree with this ethical issue. Confucius’s role ethics will show that the doctors were deficient in performing their roles properly, and Aristotle’s virtue ethics will show that the doctors are not acting in accordance with virtue. Therefore, the doctors were acting in an unethical capacity.

A person who is dying of a terminal illness is faced with only one certainty; they will die from this disease. A doctor can say roughly the amount of time that a patient has, but they exact date and level of pain is hard to determine. Many may look to a physician for the answer on if they should/shouldn’t choose PAS, however, the only role a physician plays is giving the medical diagnosis and working with the patient to get what the patient feels is the best option. Therefore, the decision the patient makes doesn’t make the physician a moral guide, but rather a person doing their job. The last big decision people who are terminally ill have is when/how to die and it has to be their own and it has to be respected.

It is more important to help a person suffering from mental illness to recover, before they are legally allowed to make such a terminal decision, and after a “thorough and comprehensive attempt to improve their life we have still not made living acceptable to them, we need to allow assistance to die” (Purdy, 2015). The exclusion of mental health as a condition, ties into the safeguard of type of condition. The 2007 British Attitude Survey shows that 84% of respondents agreed that a doctor should “definitely” or “probably” be legally allowed to end a patient’s life at their request” if they are suffering from unbearable pain and terminal illness (p39). However, if assisted dying were to be legalised extending this right to those suffering from painful chronic illnesses or severe disabilities should also be considered, if these individuals make the request, sufferer from terrible quality of life and show no sign of recovery. For example, it seems immoral to allow a cancer patient to request assisted dying, but not allow a paralysed individual, like Tony Nicklinson, to request the same consideration.

I worked in a long term care facility for three years before going to an internal medicine office. When starting right away I noticed, with my medication passes, that most of the residents were on some type on medication for depression or a mood disorder. I started to think that it must be a common diagnosis for most of these patients because of being in a nursing facility instead of living at home, in which they had been staying most of their adult lives. I then began to think of some of the residents that where immobile and couldn’t ingest orally anymore and would have to rely on internal feedings to keep them alive. It was hard to image how they must have felt. I could see the emotional impact that it had on them losing their ability to

Michael H., a 68-year-old man, was admitted for exploratory surgery of his abdomen. He is frail, and his attending physician describes him as “emotionally labile.” Marcy R. is a social worker at BFL General Hospital, who is assigned to the unit that Michael H has been admitted. After Michael’s surgery, Marcy R. was approached by Michael H.’s daughter, Ellen B. in which Ellen has told Marcy that her father’s physician had just informed her that the lab report from the exploratory surgery shows that her father has terminal cancer. Ellen said that she and the family are in shock and they have decided that they not want the hospital staff to tell her father about the terminal nature of his cancer once he recovers from anesthesia. In this essay, I will discuss the ethical dilemma of “to tell Michael or not to tell him he has terminal cancer. He has the right to confidentiality by not withholding information from him when he has been diagnosed with terminal cancer, informed consent, and self-determination.

There are four basic ethical and bioethical principles that have a strong influence in the practice of medicine, predominantly medicine that deals with those who are dying. The first is beneficence, which directs the physician and health care worker to take positive actions, specifically by restoring health and relieving suffering (Bongard et al., 2008). Then there is nonmaleficence. Goldman and Schafer (2012) add that nonmaleficence is the idea that people should not be harmed or injured knowingly. The third ethical principle is autonomy,

Today we are face with death in a different setting then our ancestors, instead of dying at a younger age and dying in our home with our families, people are now dying at a hospital or in a medical setting. We are living longer because of the advances in medicine, this is causing us to develop diseases that our ancestors never had to face. Our ancestors did not live long enough to develop some of the diseases we face today. As Jones (2011) provides, “we don’t just die of different diseases then our ancestors, we also die in different circumstances” (p. 302). The changes in circumstances have caused us to reevaluate what is believed to be ethical when faced with dying. There are many medical options a terminal ill or elderly patient that is dying can choose from, however there is great debate whether some of these options are ethical.

Today, medical interventions have made it possible to save or prolong lives, but should the process of dying be left to nature? (Brogden, 2001). Phrases such as, “killing is always considered murder,” and “while life is present, so is hope” are not enough to contract with the present medical knowledge in the Canadian health care system, which is proficient of giving injured patients a chance to live, which in the past would not have been possible (Brogden, 2001). According to Brogden, a number of economic and ethical questions arise concerning the increasing elderly population. This is the reason why the Canadian society ought to endeavor to come to a decision on what is right and ethical when it comes to facing death.