Navigating Ethical Dilemmas in End-of-Life Care
Tonya Archer, a fifteen-year-old who experienced irreversible brain damage following cardiac arrest, presents a deeply challenging ethical dilemma. In this case, the key issue is balancing the family’s wishes to keep Tonya on life support with the medical recommendation to remove it due to her diagnosis of brain death. This paper explores ethical principles, professional codes, hospital mission values, and accrediting body guidelines to assess this case from multiple institutional and ethical perspectives.
Ethical Issues in End-of-Life Care
Tonya’s case raises valuable questions relative to minors’ right to any life-sustaining treatment, the moral dilemmas of continuing indicated treatment deemed as useless, and decisions over available resources in the healthcare setting. Parental involvement is the focus, but it has to be carefully coordinated with the possibilities of medical treatment. Here, Tonya’s absence of neurological activity reclaims ‘life’ from a medical standpoint while her family has life in her heartbeat and warmth, noting a relationship that disputes medical decisiveness (Akdeniz et al., 2021). This complicating fact epitomizes the moral dilemmas of end-of-life treatment, where kin’s wishes and doctor’s decisions are matters of great debate.
Ethical Decision-Making and Theoretical Foundations
This case underlines the key ethical principles—autonomy, beneficence, and non-maleficence—that shape the decision to continue or withdraw life support. Since Tonya is still a minor, her autonomy is with her parents, who then have to make this ethical decision. On the other hand, the principle of beneficence, in this case, pertains to what is clinically beneficial but may also take into consideration the family’s psychological well-being, hence softening the medical approach. The principle of non-maleficence, however, encourages the avoidance of prolonged suffering, not just for Tonya but also for her family through this emotional journey. From a deontological perspective, the stress is on a duty to act in the best interest of Tonya by being honest concerning her prognosis. In contrast, utilitarianism would still favor shifting scarce hospital resources to patients with recoverable conditions, once more representing a balance between institutional ethics and individual free will.
Professional Codes of Ethics
The healthcare ethics codes, particularly the American Medical Association (AMA) Code, act as guidelines for this case. The AMA Code advocates for compassion, the dignity of the patient, and the non-prolonging of interventions that are futile; hence, it supports the position of the hospital to discontinue life support. For this case, however, honesty and communication are the relevant principles of the code. Being highly transparent and paying respect to the view of the family entails sensitivity to ethical concerns (Olejarczyk & Young, 2024). While these codes, therefore, provide a structured approach to the care of the dying, they also emphasize limitations in the management of unique emotional complexities, such as those that Tonya’s family had to endure, and indicate an area where further support and guidance may be required.
Hospital Mission and Values in Ethical Alignment
The mission and values of the Saint Anthony Medical Center would include compassion, dignity, and ethical practice. Such values give the basic structure that guides transparent and compassionate communication with Tonya’s family while supporting the decision to withdraw life support. This is one of those occasions where institutional values guide sensitive decisions where family beliefs are opposed to medical realities. A mission statement that holds in high regard the dignity of every human life while at the same time being respectful of the limits medical intervention can play within it, this is a good balance of care, compassion, and professional integrity that enables the hospital to act with consistency in respect to its ethical commitments.
Role of Accrediting Bodies in End-of-Life Decision-Making
Accrediting bodies, such as The Joint Commission, enforce standards for ethical decision-making in healthcare, including end-of-life care guidelines. These bodies ensure that hospitals have systems that determine medical ‘futility’ in cases such as Tonya’s. By setting clear standards for patient care and ethical decision-making, The Joint Commission likely supports the decision to remove life support. Such guidelines ensure that hospitals uphold their ethical and professional responsibilities, promoting quality care that respects both patient dignity and institutional integrity. This case illustrates how accrediting bodies’ standards serve not only as safeguards for patient welfare but also as essential tools in navigating the ethical complexity of end-of-life situations (Young & Smith, 2022).
Conclusion
The case of Tonya represents the complications occurring around the time when decisions about the end of life are made at a crossroads of ethics, professions, and institutions. While respect for the desires of the family is called for in this instance, the ethical and professional norms, taking into consideration the mission of the hospital and other accrediting bodies, would indicate that discontinuing life support is the most compassionate and responsible decision to make. This also fits within a wider ethical perspective, respecting patient dignity yet being consistent with institutional values, professional ethics, and wider accrediting standards. Such cases will eventually underpin the requisite of comprehensible, empathic, and ethically framed interaction in health care.
References
Akdeniz, M., Yardımcı, B., & Kavukcu, E. (2021). Ethical considerations in end-of-life care. SAGE Open Medicine, 9(9). https://doi.org/10.1177/20503121211000918
Olejarczyk, J., & Young, M. (2024, May 6). Patient rights and ethics. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538279/
Young, M., & Smith, M. A. (2022). Standards and evaluation of healthcare quality, safety, and person-centered care. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK576432/
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Question 
Assessment 5 Instructions: Tonya’s case
Write a 2–3 page paper that examines end-of-life issues in relationship to hospitals, professional ethics, and accrediting bodies.
How Institutional Conceptual Frameworks Influence Ethical Decision Making
We wrap things up by exploring institutions and groups designed to help ensure that hospital staff at all levels think and act ethically in caring for patients. Accrediting bodies are oversight agencies charged with performing accreditation of hospitals and helping to establish standards for health care delivery. Their aim is to keep the quality of care as high as possible and to make sure the care is delivered ethically. Ethics committees are groups of individuals within hospitals that meet regularly to advise staff on ethically difficult cases and to promote an ethical institutional culture.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
- Competency 2: Apply sound ethical thinking related to a health care issue.
- Demonstrate sound ethical thinking in applying ethical principles and moral theories to a specific case.
- Competency 3: Analyze ethical issues associated with patient care from the perspectives of various health care professionals.
- Explain professional codes of ethics and apply them in to a specific case.
- Competency 4: Explain the conceptual framework that health care leaders use to make ethical decisions.
- Explain organizational documents like mission and value statements and use them to analyze a case study.
- Explain the role of accrediting bodies and applies this understanding in analyzing a case study.
- Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
- Provides validation and support within written communications by including relevant examples and supporting evidence using APA citations.
- Produce writing with minimal errors in grammar, usage, spelling, and mechanics.
Preparation
Complete the Case Study: Tonya Archer media activity, which is linked later in this assessment.
Before you begin creating your submission for this assessment, make sure you have worked through the Tonya Archer case study. This will provide the foundational context for the assessment, for which you will be carrying out independent research by using the Internet to complete the following:
- Identify the professional code of ethics for your professional specialty or a specialty that you are interested in.
- With a local hospital in mind (perhaps one you work for), locate the mission, vision, and values statement of that hospital.
After you identify the professional ethics code and the hospital mission, vision, and values statements relevant to your work and interests, it may be useful to complete the following:
- Identify which item in the ethical code you believe is the most important and explain why.
- Name something in the code you would like to see addressed in more depth. Why?
- Which item in the code do you think would be the most challenging to follow and why?
- Does your code make an explicit distinction between what is legal and what is ethical? That is, is the code clear that, while an action may be legal, it may not be ethical?
- Finally, how well does your professional code of ethics align with the mission and values statement of your hospital? Can you imagine a situation in which following one would make it challenging to follow the other?
Navigating Ethical Dilemmas in End-of-Life Care
Instructions
For this assessment you will apply some concepts we have learned in the course, particularly those relating to the basic principles of health care ethics, professional codes of ethics, and values of health care institutions.
Write a paper that answers the following questions as it relates to the Tonya Archer Case Study:
- What are the most relevant end-of-life issues in health care ethics as they relate to this case?
- What should the hospital do? Should doctors simply keep Tonya on life support, as the parents want? Or, since all medical evidence indicates that Tonya’s brain damage is permanent, should life support be removed?
Support your answer with the following considerations in mind:
- Explain which principles of health care ethics and which moral theory are the best philosophical foundations for your view.
- Is your view supported by your professional code of ethics? If so, explain how. If not, explain what your code gets wrong about a case like this.
- Is your view consistent with the mission statement and values of the hospital you identified in your independent research you conducted to prepare to complete this assessment?
- Would an accrediting body, like The Joint Commission, support your choice? Why or why not?
Submission Requirements
Your paper should meet the following requirements:
- Written communication: Written communication is free of errors that detract from the overall message.
- APA formatting: Resources and citations are formatted according to current APA style and formatting guidelines. Refer to Evidence and APA for guidance.
- Length: 2–3 typed, double-spaced pages.
- Font and font size: Times New Roman, 12 point.