Ethical Challenges in Withdrawing Life Support

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

A physician cannot force a patient to undergo a procedure or treatment against his or her will. Physicians must make informed refusal an integral part of their informed consent process. Physician should understand what patients' needs and balance between the psychological need and social and physical health. Sometimes, the stress environment of the doctor made him frustrated and they don't spend enough time with their patient to get the optimum information and don't show interest about patients’ psychosocial problems. When a patient feel that their doctors have a lack of knowledge of other treatment options may also contribute to why patients refuse our treatment plan. Good physician-patient relationship allows a trusting relationship to develop. Most patients will agree to doctors’ treatment strategies if they have a good communication and patients are kept fully informed by their

The principles of justice, nonmaleficence, and beneficence must be considered in this situation as the patient herself has neither voice nor living will expressing her desires. An ethical theory that applies to this situation is rule utilitarianism. This theory is a hybrid of deontological and utilitarian approaches (Purtilo & Doherty, 2012). Terri’s husband feels that he is legally honoring her wishes by allowing Terri to die as the natural consequence of her unfortunate medical condition. Using the utilitarian theory removing her feeding tube justifies the end goal of death. For her family, they feel a duty to Terri and having her feeding tube removed betrays their sense of duty and right. Conflict resolution, in this case, must consider promoting the person’s good or prevention of further harm to the patient. Ethical theories and principles can guide the best

The healthcare system is complex with nearly every decision made posing an ethical dilemma for patients, providers, and healthcare leaders. With an influx of new medical knowledge from evidence based practices and new technologies more decisions are being made available to patients and families. Terminally ill patients for instance are faced with numerous options when it comes to treatment including whether or not they end their life by terminating treatment altogether or seek controversial options such as Physician’s Assisted Suicide. The topic of Physician’s Assisted Suicide or (PAS) is very intricate with numerous pros and cons, moral ethics, and ways to address the issue within the healthcare practice.

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.

With major advancement in medical treatments, it is now possible to keep a patient alive, which would not have been possible in former times. This has made end of life issue one of the most controversial issues in healthcare. Medical improvements have set the stage for ethical and legal controversies about not only the patient’s rights but also the family’s rights and the medical profession’s proper role. It is critical that any decision made in such situation is ethical and legal to preserve the rights of the patient and also protect the healthcare institution involved. It is very important when making decisions to discontinue treatments to make sure all other alternatives have been explored.

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 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’.

The autonomy of a competent patient is an issue not often debated in medical ethics. Refusal of unwanted treatment is a basic right, likened to the common law of battery, available to all people capable of a competent choice. These fundamental rules of medical ethics entered a completely new forum as medical technology developed highly effective life-sustaining care during the 20th century. Several watershed cases elucidated these emerging issues in the 1960’s and 70’s, none more effectively than that of Karen Ann Quinlan. Fundamentally, this case established that a once-competent patient without the possibility of recovery could have their autonomy exercised by a surrogate in regard to the

A Patient's Rights to Refuse Treatment and How it Relates to Learned Helplessness of Individuals

When entering a medical facility the last situation you ever hope to be faced with is whether or not to put yourself through medical treatment. Over the years treatment outcomes and survival rate have increase with difficult surgeries. However, for some individuals the quality of life is faced by the quantity of life that a lifesaving treatment may bring. This topic has been all through newspapers and spreads nationwide as individuals forego curative medical treatment because of religious beliefs.

Wow Christine, this is a great topic to ponder on. I don’t think that I have a strong stance on whether I’m pro or against life support. I feel that life support should initially be used to prolong life or death until a physician can run all medical test on a patient. Usually these medical test will tell you if there is brain activity going on. However, when organs begin to shut down I don’t think that a patient should be left on a life support machine.

Autonomy can override beneficence when life-support is withdrawn (Prozgar, 2010). In addition, when a physician takes the position of withdrawing life-supporting equipment, the principle of non-maleficence is severed. Since helping patients die violates the physician’s virtue of duty to save lives,” distributed justice is served by releasing a room in the intensive care unit for a patient who has a higher chance of resolving their medical problems (Pozgar, G. 2010). There are so many inflict fuzzy gray areas and ideas about conflicting DNR policies that political disputes had to go to the courts to sort out the issues legally.

There are many ethical issues that the medical field faces daily. One major issue that is a common debate recently is death and dying and the ethical dilemmas associated with this stage in life. There are many different routes a patient can take when they are diagnosed with a terminal illness, two routes that are often up for debate are palliative care and physician assisted suicide. Many ethical concepts are brought up in the debate of these routes of care, sometimes even conflicting one another. Since medicine has advanced over many years we are experiencing a growing population of elders. With this increase in the elderly population, the debate of death and dying has become an important topic to

Should there be ethical limits to the use of medical technology to prolong life? An example of technology to prolong life would be life support. There are many types of life support such as ventilators, artificial nutrition and hydration (or tube feeding), and kidney dialysis. There are many positives to life support but just like anything else there are also negatives. In some cases life support just prolongs the patient’s suffering. In other cases life support can harm the family members by giving them false hope. There are many scenarios in which life support can be used, such as when a patient is waiting for an organ transplant. When many think of life support they always assume that the case is extreme. However this is not the case, someone who is on life support can still live a relatively normal life and not be confined to a hospital. Many elderly people have pacemakers to help keep their heart running. While, they might have to visit the doctor more often to make sure the pacemaker is in prime condition they can still hang out with the family and go to their grandchild’s talent show. Keep in mind that there are still very extreme cases in which someone might need to be put on life support and that this is not a light topic. When a family member is put on life support for whatever reason when is the right time to take them off? Should there be different regulations depending on what kind of life support it is? Should there be ethical limits?