Tonya’s Case Ethics and Professional Codes
What are the Most Relevant End-of-Life Issues In Health Care Ethics As They Relate To This Case?
The person’s right to voice their choices on end-of-life treatment autonomously has to be ethically respected, considering the utilization of advanced treatment and the disease prognosis. The healthcare professional needs to respect the autonomy of the patient while putting into consideration the limitations of this ethical principle and carry out their duties without doing any harm to the patient (Wright, 2017).
The physician can work using the deontological theory and carry out their duties to gain the best outcome for the patient while acting for the benefit of the patient (Skelton,2017). Although the patient’s parents have a level of autonomy (the patient has not reached the age of making autonomous treatment decisions) in the choice of treatment, the physician can explain the treatment implications and emphasize the consequences. The parents will need to perform a self-beneficence on behalf of their daughter to make the autonomous decision to go ahead with the treatment and either prolong the days that the patient is on life support or not go ahead with a futile treatment for society’s greatest good by saving on emotional stress while saving on costs. If the patient’s parents insist that they want their daughter to continue on life support, which the physician advises is futile, then the physician has the responsibility to give the facts to the parents on withdrawing or withholding medical treatment and ensure there is no unnecessary resource utilization, without causing the patient harm (Kamik & Kanekar, 2016). The physician should respect the values and beliefs of the parents prior to withdrawing or withholding treatment or giving DNR instructions. The physician’s duty is also to preserve the life of the patient, though this ought not to be confused with the unnecessary utilization of resources, thus inflicting additional harm through the continuation of futile treatments.
The nursing code of ethics that supports this view is Provision 1: The nurse practices with compassion and respect for the inherent dignity, worth, and personal attributes of every person, without prejudice. The nurses will need to establish relationships of trust with the patient and also the patient’s parents and set aside any prejudice and bias. Provision 1.3 states that the Nature of Health Nurses respects the dignity and rights of all human beings regardless of the factors contributing to their health status. A nurse ought to remember that the patient’s worth is not affected by proximity to death, functional status, disability, or disease (Olson & Stokes, 2016). Hence, although the patient is in a vegetative state and the parents have refused euthanasia, the patient still needs to be treated with dignity.
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 removing
The expensive and futile treatment of end-of-life patients increases the unaffordable healthcare costs and promotes healthcare that is inequitable. Patient autonomy, as well as surrogate autonomy, needs to be respected, though still weighed against the utilization of treatment, which is expensive in futile cases with the increasing costs of healthcare. Therefore, in futile cases, patients and their kin can consider comfort care as a viable option. The advanced technology in this case study promises no recovery. In futile situations, healthcare rationing can be considered the greatest good for society, though this has to be weighed against the autonomy of the patient (Scott et al., 2019). Care rationing is present in the healthcare system and may be justified as equitable justice when carried out equitably and ethically (Close et al., 2019). Medical resource allocation is most times limited and, therefore, ought to be distributed in an equitable manner. There is a need for the evaluation and assessment of the medical advancement in treatment so as to avoid unnecessary use of the already limited resources. This can be attained through knowledge and good education on the implications of advanced treatment and improved decision-making in healthcare from the physician, the patient, and the patient’s skin.
This view on rationing of care is consistent with the mission statement and values of the hospital I identified, and also, an accrediting body would support my choice. Some form of rationing is desirable as it is inevitable considering the US states’ finances and the unfunded liabilities of Medicare. The government has spending caps and rules on pay-as-you-go that require taxes to be increased for any additional spending. When this is done, physicians will avoid attracting additional taxes on incremental spending on futile treatment and will thus advise their patients on making a less expensive decision, which is the termination of futile treatment (Leonhardt, 2009)
References
Close, E., White, B. P., Willmott, L., Gallois, C., Parker, M., Graves, N., & Winch, S. (2019). Doctors’ perceptions of how resource limitations relate to futility in end-of-life decision making: a qualitative analysis. Journal of Medical Ethics, 45(6), 373-379.
Karnik, S., & Kanekar, A. (2016, June). Ethical issues surrounding end-of-life care: a narrative review. In Healthcare (Vol. 4, No. 2, p. 24). Multidisciplinary Digital Publishing Institute.
Leonhardt, D. (2009). Health Care Rationing Rhetoric Overlooks Reality. https://www.nytimes.com/2009/06/17/business/economy/17leonhardt.html
Olson, L. L., & Stokes, F. (2016). The ANA code of ethics for nurses with interpretive statements: Resource for nursing regulation. Journal of Nursing Regulation, 7(2), 9-20.
Scott, P. A., Harvey, C., Felzmann, H., Suhonen, R., Habermann, M., Halvorsen, K., … & Papastavrou, E. (2019). Resource allocation and rationing in nursing care: A discussion paper. Nursing Ethics, 26(5), 1528-1539.
Skelton, L. (2017). Ethical Theories and Perspectives on End-of-Life Decisions. Dialogue & Nexus, 4(1), 13.
Wright, M. S. (2017). End of life and autonomy: the case for relational nudges in end-of-life decision-making law and policy. Md. L. Rev., 77, 1062.
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Question 
Write a 2-page paper that examines end-of-life issues in relationship to hospitals, professional ethics, and accrediting bodies.
Tonya’s Case-Ethics and Professional Codes
This information and case study is on the Capella University website online, in the activity session in the course room.