Do You Agree Or Disagree With Dr. Blues Assessment And Justification For The Dnr

Though ethics committees have been helpful, scores of physician-patient disagreements end up in the U.S. court system with inconsistent results. The states adopted individual “statutes regulating DNR orders and their provisions vary in analysis throughout the U.S.” (Bishop, Brothers, Perry & Ahmad, 2010). One ethical dilemma that is constant in emergency rooms, the intensive care unit and terminally ill persons is a futility of treatment. In the case of CPR/DNR, New York State wanted to enact a law that describes the decisive responsibilities of the patient, and the family or surrogate, and physician. “In April 2003, the New-York Attorney General asserted that the DNR law would require a physician to obtain a consent of the patient’s health care surrogate before entering a DNR order, even when the physician

Secondly, the patient should be capable of making and communicating health care decisions for him or herself. Thirdly, the patient must be diagnosed with a terminal illness that will lead to death within six months.  Interested patients must also provide the request for termination in writing to the physician. In addition, physicians are expected to inform patients to alternative means of care including hospice care and other medications. Only after precautions evaluation, the laws then permit patients to make the ultimate life ending decision.

The patient is experiencing a major illness or disease within their body. All patients who qualify for this act are terminally ill and have six months or less to live. They have exhausted all treatment options or are opting to forgo treatment in favor of quality and not quantity of life. The medications administered to facilitate dying cause CNS depression which lowers the heart rate and respirations and increases drowsiness causing sedation and then ultimately death.

“One of the obligations for nursing staff and everyone is to take care of the dead body whose perfused organs are being maintained by machines”, a panelist interjected. Many hospitals have policies whereby if one is hired by the hospital and has a personal, moral, or religious objection to certain things, then every effort will be made for someone else to participate – termination of pregnancy serves as an example, he continued. Furthermore, he emphasized that there does not have to be a conscientious objection on the part of the doctors or nurses based on spiritual, philosophical, or religious grounds; it’s solely based on not being required to give treatments that one believes are futile. As another member put it succinctly, “You can recuse yourself from performing such duties”. Moreover, the idea of futility is a vague idea, mentioned a panelist; he stressed that in this particular instance, regarding the woman’s brain-death state, this is totally futile. The whole idea behind a religious exemption is, as he put it: “You are not dead based on spiritual grounds. The family believes that it is not actual death – it is not cardiopulmonary death”. In addition, the doctor emphasized that many health practitioners also hold the same religious ideals and would conclude that the person is not dead.

Thirty-six year old James Foster accompanied by his wife Megan signs his do-not-resuscitate order (DNR). Both Mr. Foster and his wife are understanding of what a do-not-resuscitate order is and are in agreeance. James has stage IV prostate cancer, but he is young and his wife believes he will pull through. A month passes, and early one morning James stops breathing, the patient is coding. Nurse Compton rushes in along with other medical professionals. Mrs. Foster is screaming, “Save him. Save him. Do whatever it takes to save him. Do not let him die.” Nurse Compton knows that Mr. Foster has a do-not-resuscitate order on file and feels not only sad in regards to the situational pain that Mrs. Foster is exhibiting, but morally conflicted with

Physicians should respect the patients decision to abandon life continuing treatment, deliberately causing death is morally impermissible.

decision”. A physician, although it should be their obligation to help a patient, should not feel

Do Not Resuscitate, "is a written physician's order that prevents the healthcare learn from initialing cardiopulmonary resuscitation (CPR) in the event that a patient's heart stops" (Earp, French, & Gilkey, 2008, p. 348). It had all started within the year of 1960, Kouwenhoven and his colleagues, were the first to announce closed chest cardiac massage as an efficient way of resuscitating victims when undergoing a cardiac arrest (Yuen, Reid, & Fetters, 2011, p. 791). As a patient advocate, my goal is to be able to provide the upmost care to my patients. DNR policy is relatively what patients need to be aware of because it is their only chance of getting any wishes to be followed through towards the end. Yuen (2011) explains how with DNR there

There are a few lawful and moral problems of the do not resuscitate order. The DNR came about by the misunderstanding of CPR. When a person is in cardiac arrest the emergency team is called to their home to give them urgent medical attention. The emergency medical team’s first response is to give the person CPR to help save their life. If an emergency team doesn’t give there patient CPR they could end up dyeing. “During the last decade, the time from cardiac arrest to start of cardiopulmonary resuscitation(CPR)

If I should be in an incurable or irreversible mental or physical condition with no reasonable expectation of recovery, I direct my attending physician to withhold or withdraw treatment that merely prolongs my dying.

Constantine A. Manthous’ article Counterpoint: Is it Ethical To Order “Do Not Resuscitate” Without Patient Consent? looks at the issues of withholding life-sustaining therapies, such as CPR, in cases where these therapies will only prolong the suffering of the patient. Manthous begins his argument by stating that CPR, which is often ineffective, remains the only medical procedure in cases of cardiac arrest. Manthous goes on to state that a doctor issuing a “Do Not Resuscitate” order unilaterally is unethical, as it deprives the patient of their right to self-determination. Only after receiving informed consent from the patient is the issuance of a DNR order ethically appropriate.

At this time the client is suggesting that he no longer wants to be on any type of life support. As a social worker I would suggest a meeting with the family to discuss if it is beneficial for Roger to continue treatment. I would also need to find out if Roger and his family are deeply religious. Its possible that Roger or his family may have some deeply religious and moral issues they are dealing with at this time. Either way, the decision made will have a direct bearing on the patient’s quality of life. Roger cannot talk or eat. And getting nourishment from feeding tubes and IV’s is not the same as eating or having something to drink. Opting for artificial life support may come with unintended consequences and may lead to preventable suffering near the end of

Therefore, although I do not wish for my effectiveness to be judged based on the factors that Dr. Ofri discusses in Finding a Quality Doctor like blood pressure rates, or diabetes rate, practicing in a hospital means I likely will to some degree (Ofri). On the other hand, one of the principle factors of running a business is keeping their consumers happy. Therefore, within my practice, I will rely heavily on patient reviews, of which I will have them complete after each visit. I work best by hearing others’ critiques me thus; a patient’s voice will be imperative in my practice to help me make a better experience for them. Another factor to ensuring maximal patient satisfaction in a perfect world, is making sure that my patients’ have a significant ability to choose their course of care. Patient satisfaction and choice are factors that has repeatedly come up in my experience within New Visions, abroad, and at Bellevue. In our society, birth is often highly medicalized, filled with intervention. If it is taking too long for a mother to become fully dilated, then doctors are quick to prescribe Pitocin. If there is the slightest sign of danger, then doctors push for a C-section. In high school, I remember learning from my New Visions preceptor that nearly one in

Doctors are not as a matter of course anticipated that would experience this expansive meaning of beneficence.an illustration is resuscitating a suffocating casualty. On the other hand, no-maleficence intends "no mischief." Physicians must avoid giving inadequate medications or acting with noxiousness toward patients. This standard, in any case, offers minimal helpful direction to doctors subsequent to numerous valuable treatments likewise have genuine dangers. The appropriate moral issue is whether the advantages exceed the weights. Doctors ought not to give insufficient medicines to patients as these offer danger with no probability of advantage and along these lines have a possibility of hurting patients (Gabaldón & Aguilera, 2008). Moreover, doctors should not do anything that would intentionally hurt patients without the activity being adjusted by relative advantage. Since numerous solutions, systems, and intercessions reason hurt notwithstanding advantage, the rule of non-perniciousness gives minimal solid direction under the watchful eye of patients. An illustration from my practice is halting a solution that is appeared to be destructive

A Do not resuscitate (DNR) order is a legal document written by a licensed physician, which is developed in consultation with the patient, surrogate decision maker, and attending physician. This document indicates whether the patient will receive resuscitative care, cardiopulmonary resuscitation (CPR), or advanced medical directives, in the setting of cardiac and/or respiratory arrest. A DNR can also be referred as a no code when identifying a patient’s resuscitation status. If a patient has an existing DNR it allows the resuscitation team, taking care of the patient, to either withhold or stop any resuscitation measures, and therefore respect the patient’s wishes. Historically, DNR orders did not become active in the care of patients until 1974, when it was identified that patients who received CPR, and survived, had significant morbidities (Braddock & Derbenwick-Clark, 2014). Braddock and Derbenwick-Clark further noted, the American Heart Association (AHA) recommended that physicians, in consultation with the patient, family, and or surrogate, place on the patients chart when CPR was not indicated. This documentation is now what we refer to as the DNR order and has become the standard to allow autonomous respect for patients, and their families, to make informed medical decisions. Therefore, the purpose of this paper is to discuss the legal aspects, ethical issues, and the application surrounding the DNR order.