Withholding Life Support

Withholding Life Support

The Patient’s Directives and Family’s Stated Preferences.

The patient’s directive and his family’s preference are in conflict. Mr. Martinez specifically asserts that he wants a “Do Not Resuscitate” (DNR) while his family is against this decision. Although the patient is currently doing well under treatment, a DNR order was still written in the patient’s chart.

The Patient’s Quality of Life.

The patient appears to be doing well for now under the current treatment regimen. He is being maintained with oxygen, antibiotics, and fluids. The respiratory failure due to an error on the part of the healthcare facility has left Martinez in respiratory distress. The patient is presently suffering from respiratory failure and is in great distress. He gasps for breath, and life has become difficult health-wise. COPD is a terminal illness characterized by progressive loss of the lungs’ ability to sustain normal breathing. Relieve of symptoms helps the patients to some degree (Hillas et al.,2015).

The Moral Issues Associated with Limiting Life Support.

There are two necessary conditions that need to be met prior to a healthcare professional getting permission to provide treatment. The first is that the treatment ought to be medically indicated. This means that the healthcare professional must conclude that based on the patient’s diagnosis and prognosis, treatment A has a considerable chance of benefitting the patient and has a low chance of causing any disproportionate harm. The second condition is that the patient, or the proxy to the patient, must give informed consent for treatment but only after getting sufficient information on the diagnosis and prognosis, as well as Treatment A’s nature, is provided (Travers et al., 2015).

When a doctor concludes that a ventilator is medically indicated for the patient, the doctor then informs the competent patient of the condition and the available options. If the patient refuses the option, then a necessary condition for treatment is not fulfilled. The physician, at this point, can ethically forego the treatment. If the physician forces the ventilation on the patient, then such a physician becomes liable for charges of battery. In Mr. Martinez’s case, the physician is morally obligated to save the patient’s life, especially because it was the hospital’s staff’s error that resulted in Mr. Martinez’s respiratory distress. The patient has the moral right to termination of his life through a DNR. Violating the patient’s wishes will attract legal action against the physician.

The Ethical Principles Most Relevant to Reaching an Ethically Sound Decision.

Non-maleficence is the ethical principle that calls for healthcare professionals, including nurses, to do no harm to their patients. Nurses should, at all times, provide care standards that minimize or avoid risk in relation to medical competence. One such way nurses can do this is by avoiding negligence toward the patient (Ong et al., 2016). This was not done when it came to caring for Mr. Martinez, as the oxygen levels were erroneously left to run at high amounts.

Autonomy means patients are able to make decisions regarding their health and treatment options without being coerced. The decisions are made following an understanding of relevant information that the patient receives from the medical team. A patient, based on this information, then makes voluntary and informed consent, allowing the healthcare team to proceed with treatment or not to proceed with it (Houska & Loučka, 2019).

Important Considerations Such as Implications, Justifications, And Any Conflicts of Interest That Might Arise Because Of The Patient’s Respiratory Failure.

The patient’s respiratory failure did not occur because of the natural course of the illness. Rather the patient went into respiratory distress following an error on the part of the healthcare team. When the patient signed the DNR, it may have specified under what conditions he should not be resuscitated; more specifically, under the illness’s natural course. However, if the DNR did not include this clause, then resuscitating the patient would constitute a criminal act (Munson, 2014). If the DNR had the specification, then failure to resuscitate him would constitute murder. The family of the patient was clear on their stand; they may sue the hospital for negligence resulting in untimely death. Hence, the best course of action will be to resuscitate and override the DNR.

References

Hillas, G., Perlikos, F., Tsiligianni, I., & Tzanakis, N. (2015). Managing comorbidities in COPD. International journal of chronic obstructive pulmonary disease, 10, 95.

Houska, A., & Loučka, M. (2019). Patients’ autonomy at the end of life: a critical review. Journal of pain and symptom management, 57(4), 835-845.

Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston, MA: Wadsworth

Ong-Flaherty DNP, C., Banks Ph.D., A., Doyle MSN, M., & Sharifi, C. O. (2016). The meaning of evidence and non-maleficence: cases from nursing. Online Journal of Health Ethics, 12(2), 2.

Travers, A. H., Perkins, G. D., Berg, R. A., Castren, M., Considine, J., Escalante, R., … & Yeung, J. (2015). Part 3: adult basic life support and automated external defibrillation: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation, 132(16_suppl_1), S51-S83.

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Withholding Life Support

This information and case study is Capella University website online, on the activity session in course room