Ethical Analysis Paper

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

The NMC (2015) are the providers of the Nursing Code of Conduct. The code contains the professional standards to which all nurses must uphold, allowing for accountability of patients that come into their care. As well as the code of conduct, all nursing professionals have a responsibility to develop their knowledge in relation to law within clinical practice, and furthermore, ethical frameworks that are linked to judgment and decision making when providing care (Savage & Moore, 2006). In light of this, the overall aim of this essay is to elaborate on issues surrounding law and ethics in nursing. To do so, a case study has been chosen from a previous clinical experience. The focus of the case study will be on the decision of withdrawal from life sustaining treatment. Emphasis will be largely on the law and ethics concerning the issue of withdrawal from treatment. Moreover, the ethics and law involved in the palliative/advanced end of life care planning and decision making. In order to protect the identity and uphold the confidentiality of the case study, a pseudonym will be used throughout. Hendrick (2005) portrays confidentiality as being ‘one of the most important and well established moral obligations of health-care ethics’.

In Ethic Case Study 74-Ethical Issues over DNR Orders: “Mr. Warden, a 93-year-old white male, is admitted to Centerville Community Hospital from Centerville Estates Nursing Home. Mr. Warden has had multiple strokes and is only partially responsive to painful stimuli. He's not recognize or responding the nursing staff. The patient has a flexion contractures and a large infected decubitus ulcer over his left sacral area, along with many other medical conditions such as congestive heart failure”(Buchbinder, 2014)."Do-not-resuscitate (DNR) orders have been in use in hospitals nationwide for over 20 years"(Yuen, 2011).

The ethical principles for nurses to practice with beneficence and no maleficence. This legal battle between Terri Schiavo’s husband and her family was an ethical debate between continuing artificial life or remove her feeding tube by the request of her husband. Using the theories of utilitarianism and deontology can be applied or considered in making the most ethically correct resolution. The cases are very complex and raise many moral and ethical issues. The cases have brought awareness to society of “the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for health care, are a healthcare proxy clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions. Terri Schiavo should impress upon laypersons and professionals alike the uncertainty of the context in which issues of continuation and termination are argued ethically. Nobody knows what Mrs. Schiavo would have wanted. She left no advance directive and in its absence her husband says one thing and her parents

“An ethical dilemma exists when a choice has to be made in which the consequences may have a potential positive or negative outcome.”("Topic 4: Contemporary Ethical Dilemmas (How do managers evaluate beginning-of-life dilemmas?). ", n.d.) The given scenario presents a patient named Jamilah Shah, who is of Turkish descent, 90 years old and collapsed at the side of her bed in the extended care facility in which she resides. The patient suffers from Chronic Pulmonary disease and diabetes mellitus. The patient was rushed to the ER were the EKG and lab tests revealed she suffered a heart attack and she was started on anticoagulants. The patient has no advance directives and a communication barrier exists, the ER department contacts the emergency contact, one of the patient 's sons Bashir. The patient 's family arrives at the hospital and her son states that he makes the decisions and the wants a do not resuscitate order for his mother and no medical intervention other than comfort care. The social worker handling Jamilahs case is concerned by her family 's lack of support and that the family 's wishes are at odds with the patient 's request for help and her expressed desire to live. Furthermore if the patient does not receive a cardiac catheterization or is considered for a coronary bypass, she will surely die.

Many people who are in hospice care are terminally ill. Hospice care specializes in the end of life care and work very hard to grant there patient’s wishes such as do not resuscitate. Hospice care is only to make you feel comfortable at the end of life. They are not required to perform CPR on their patients and should not force their patients to fill out the DNR order. “The right approach to DNR discussions and decisions varies even within a particular culture, and needs framework balanced upon the specifics of an individual case scenario” (Yang, G. M., Kwee, A. K., & Krishna, L. (2012). Some but not all hospices require that the patient’s family call EMS to give their family member CPR. If there is not a DNR and the patient is ready to pass than an EMS may not be able to grant their wishes because by law the EMS may have to give CPR. CPR can be painful and traumatizing for patients who are terminally ill.

There are many ethical issues involved in the scenario provided. De Segonzac (2016) presented a scenario where a DNR patient is being resuscitated against her wishes. In the scenario, Dr. Natalie Manning is attempting to stop Dr. Will Halstead from going against a patient’s DNR order. He continues to ask the husband if he “wants her to live”, while the daughter is asking her father to help her mother. Dr. Halstead blatantly goes against the patient’s known wishes by performing CPR on her.

Some people think we can have an altered way of not applying the DNR order. Some people think that if a healthcare worker would apply the life- sustaining treatment the patient would have a better chance of fighting the condition or even feel better or happier. A physician is going to look at the goals of the patient and the family or whomever the caregiver is an help them achieve those goals or at least put them in the right direction towards

Almost all states have statutes supporting the right of adult patients to refuse care and to provide directives about end-of-life care when patient unable to make decisions. The United States Supreme Court also has recognized that the constitution gives competent adults can refuse unwanted medical treatment (Koppel & Sullivan, 2011). Uniform Right of the Terminally Ill Act of 1989 enacted the permission of an individual to execute a declaration that guides a healthcare provider (physician) to withdraw life-sustaining treatment when a patient is in terminally ill condition and unable to make decisions Withdrawal of life-sustaining treatment is not applicable without the approval of patient or surrogates. (Houghton & Lombard, 1990). “Patient Self-Determination Act of 1990 was enacted to ensure that patients are informed of their

There are complex religious, moral, ethical and legal aspects associated with placing a DNR order. Most of the religions agree that God alone has the right to initiate and terminate life. But is it morally right to resuscitate someone who is at the end stage of life to survive a poor quality of life? When it comes to ethics as a health care providers are we following the principle of do no harm? is cardio pulmonary resuscitation always beneficial for the patient? More, if choices are to live with morbidity or to die with dignity you have to do what’s good for the patient. Lastly patient has the right to make decision about their own health, therefore respecting their wish to die is only fair.

This act has been morally criticized by some, but still approved and improved by the authorities all over the world. It is part of the New York State's Patients' Bill of Rights and California Health Care Directive. DNR is considered legal in many parts of the world and this practice is considered as an ethical act as it fulfills a patient's will of not bearing the suffering or pain he/she might go through in his/her respective medical state. Any human being has the right to define his/her own limits and if a person does not want to go through some treatment which might be traumatic for him/her, the authorities and his/her loved ones along with the medical institutions/specialists must respect the patient's decision. However, DNR does not mean that the patient's treatment should stop completely. Only CPR and ACLS are to be avoided. DNR rights are only granted to close family members like the patient's spouse, children (if they are legally old enough), parents or siblings. Other than that, a person specified by the patient legally can

Ethical dilemma may also arise in cases where a patient may feel their right to DNR should be carried out when giving direct order. The DNR process, however, is required to be documented by a physician. Andrew Putnam (2003) presents a case where an eighty-eight year old patient’s code status was DNR; “However, the patient has never signed formal advance directive statement or assigned durable power of attorney for her health care to anyone.” (Putnam, 2003, 2025) Ethics can be simply stated as doing the right thing (Roberts, 2002, 242); but in this case ethics is questioned because the physician was faced with the decision to carry out the wishes of the patient or to make a decision based on legality. In this case, it may have been morally right to carry out the wishes of the patient who wanted DNR orders carried out, but it may have been the right choice to do the legal thing and not carried out due to lack of signed documentation.

In end-of-life scenarios, where the patient may not be able to communicate their wishes, decisions must be made either by the healthcare professional(s) or family member(s). However, who gets to decide or where the line should be drawn are not always clear. Consequently, not all decisions may be ethically permissible. To illustrate, I will discuss a scenario in which physicians and family are not in agreement. Upon proving a brief summary and explaining the ethical dilemma, I will provide moral reasons for two ethically permissible choices from which, by referencing the principle of autonomy and Utilitarianism, will determine which course of action ought to be carried out.

This paper is to write about the rights of patients whom have been diagnosed with a terminally ill disease. This paper will also look at states that allow this and states that do not. Also we will be looking into nurses, the physician, and the patient and what might be their roles in assisted suicide and where ANA Ethics for Nurses stand.

The phenomenon of death is a complex event wrought with controversy both medically and philosophically. Because the organ systems do not shut down all at once, the process of dying can vary from a few minutes to several months depending on the medical problem. Furthermore, it is difficult to determine the exact moment when a person is no longer a person. While the advancement of medical knowledge and technology significantly decreases errors in when to call a time of death; it has also, paradoxically, increased ethical problems between families and doctors. Since the limitations of modern treatments are not well known to the public, families sometimes continue to demand medical intervention against physician recommendations or patient wishes. Moreover, the laws and hospital policies provide guidelines, but cannot perfectly resolve medical disputes with all its complexities. To ensure that patient and family wishes are respected without completely overriding the medical decision-making process, hospitals need to expand the use and awareness of ethical committees to solve disputes before they end