The Importance Of Artificial Stutrition And Hydration

This problem first began to surface in the 1980s when the court had to face Cruzan v. Director, Missouri Department of Health. In this case the court had to decide by “clear and convincing evidence” that the comatose patient’s (Nancy Beth Cruzan) desire to terminate her life before the courts would allow her family’s wish of disconnecting her feeding tube be carried out. Unfortunately eight of nine judges said no to the proposition and concluded that the right

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.

Autonomy can override beneficence when life-support is withdrawn (Prozgar, 2010).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.

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’.

At the time of the Court’s ruling, eighteen states and Washington, D.C. had laws that allowed family members to withhold treatment from patients lacking the capacity to make medical decisions. The majority of these statutes required that the patient be terminally ill. As of June 1998, thirteen states require that the proxy have specific authorization and/or specific conditions be met in order to withhold artificial nutrition and hydration.

In society today, we often have to make decisions. Some of these decisions may mean the life or death of a loved one. The decision of whether or not to administer artificial nutrition and hydration as a form of life support is one decision that some people have to make. I feel that tube feedings, while okay for short term use are fine, but they should not be used as a form of long term care because the risks outweigh the benefits of having a feeding tube.

Glannon argues that controlled DCD might not just home the patient’s right to recover, but also harm the patient physically. He highlights the fact that the only way to keep a patient from harm includes given the patient an anesthetic. Further, Glannon asserts that organ donation causes death for some. Although I find the article insightful and thought provoking because it encourages the reader to examine her ideals about harm during the organ donation, it would be redundant to include this article in my paper as the previous source also discussed the

The chief ethical implication is the violation of the patient’s desire to not be intubated and go on the ventilator. The patient has an advanced directive, a legal document, which clearly states that he does not want to be on a ventilator. The patient does not appear to have changed his mind since the document was drawn up, as evidenced by the patient shaking his head and stating “no” when confronted with the physician’s desire to place the patient on the respirator.

Advance Directives by the patient designates no feeding tubes, artificial ventilation, or CPR. Concerns regarding alteration of mental status consequential to his illness provoke the physician to seek consultation from the designated Power of Attorney. Nursing responsibilities compel the nurse to consider if the proposed actions of Dr. G violate the patient’s rights of self determination and confidentiality and prompt the nurse to advocate for the patient’s desires regarding medical treatment. Health care providers have a responsibility to honor the patient’s autonomy and provide quality medical care (Badger, 2009 p122). Providing artificial nutrition and ventilation transgresses the patient’s directives and is unethical. The physician appears to be asserting a paternalistic approach in deciding what is best for this patient. Should the interventions be temporary and provide resolution of the condition, the physician can defend his actions as being healing and beneficial. However, there is a chance that the interventions may be permanent and futile; avoiding passive euthanasia and terminal dehydration, serving only to prolonging the illness. Violating the patient’s directives of care by performing invasive procedures can lead to legal incriminations of assault and battery.

Aiding the death of infants is a much disputed controversy in healthcare. H. Tristram Engelhardt Jr. provides an ethical view that there is a moral duty not to treat an impaired infant when this will only prolong a painful life or would only lead to a painful death. It is these individuals, like Engelhardt, who must defend this position against groups who consider that we have the ability to prolong the lives of impaired infants, thus we are obligated to do so.

The Superior Court of Los Angeles County became a pivotal case in a patient’s right to refuse treatment. In the initial case Ms. Bouvia and her legal team sought a court order to have the NGT removed and to stop all medical treatments she did not consent to. She argued that this treatment would not be a cure for her condition and would not improve her quality of life. The hospital staff argued the interest of the state prevailed over a patient’s right to refuse treatment. They noted that the state and healthcare teams viable interests include: “(1) preserving life, (2) preventing suicide, (3) protecting innocent third parties, and (4) maintaining the ethical standards of the medical profession, including supporting the right of physicians to effectively render necessary and appropriate medical services” (Liang & Lin, 2005). Additionally they sighted Ms. Bouvia’s failed previous attempt to “starve herself to death” in 1983 with the assistance of her medical team. The court denied her request citing these key interests and the fact that medical professionals felt that Ms. Bouvia could live 15-20 additional years with supplemental nutrition justified the state’s interest in preserving her life. The court also stated that any other decision would be condoning a medical team to aid and abet suicide.

Keeping a person alive by excessive treatment might devastate the family and make the dying suffer tremendously in the end. “Advance medical technology that seems to one person a godsend, extending life, may seem to another a curse that only prolong dying. Dignity can be devalued amid technology focused solely on the biological organism.”

I am so glad you chose this article because I learned so much from it. My knowledge of artificial nutrition and hydration (ANH) rights and regulations grew tremendously. I honestly did not know much about the topic before this article so it was really interesting to me. Knowing as much as we can about patient’s rights is one of the best things we can do for our clients and ourselves as well. “Beneficence means “to do good” and reflects the healthcare professional’s obligation to act for the benefit of the patient and to place the patient’s best interests above all other considerations.” (Geppert, Andrews, & Druyan, 2010, p. 80) As nurses we want to do everything possible to better the health of our patient, but when we have a patient that needs

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

Imagine being admitted to the hospital and being denied your right to have food and water. While it is known that adequate fluid and nutrition is needed for survival, many health professionals are currently going through an ethical dilemma of whether or not to provide artificial tube feeding for patients with terminal diseases. This ethical decision that affects health professionals must take into consideration the recent research that opposes ANH for this population. These studies have demonstrated that artificial nutrition provides higher risk of medical complications, increased pain, and false hope of health recovery to these patients. Professionals have to be mentally and physically prepared to explain to families the pros and cons of artificial nutrition so that together they can arrive to the best ethical decision for each patient (Brody, Hermer, Scott, Grumbles, Kutac, & McCammon, 2011). For Family and consumer science professionals such as dietetic students provide support to solve this problem when an ethical educational background is incorporated into their major (Hira,1996).