You Decide – Margie Whitson’s Request to Deactivate her Pacemaker

You Decide – Margie Whitson’s Request to Deactivate her Pacemaker

Identification

The dilemma, in this case, revolves around Margie Whitson’s request to deactivate her pacemaker. Margie, a 95-year-old woman who has experienced significant loss and poor health, believes that the only thing keeping her from joining her deceased family members in heaven is the pacemaker. She feels utterly alone and wishes to end her life. On the other hand, her cardiologist, Dr Rana Vijay, believes that deactivating the pacemaker would be ethically wrong since it is keeping her alive and saving lives is the goal of medicine.

The morals involved include autonomy, the right to self-determination and decision-making, and preserving life (Dzeng et al., 2022). Margie values her autonomy and believes she should have the right to make decisions about her own life, including choosing to end it. On the other hand, Dr Vijay adheres to the principle of preserving life and believes that it is ethically problematic to intentionally end a patient’s life. The conflict arises between Margie’s autonomy and her desire to end her life, and the physician’s duty to preserve life. Margie’s request challenges the conventional understanding of the physician’s role as a life-saving agent. The dilemma also raises questions about the broader societal perspectives on end-of-life choices and the ethical boundaries of medical interventions.

Information

Margie, a 95-year-old woman who has experienced significant loss and poor health, feels utterly alone and believes that the only thing preventing her from reuniting with her deceased family members in heaven is the pacemaker. She desires to exercise her autonomy and make the decision to end her life. However, her cardiologist, Dr Rana Vijay, opposes her request on ethical grounds, arguing that deactivating the pacemaker would go against the principle of preserving life, which is a fundamental aspect of medical practice.

Margie’s request raises complex moral and ethical considerations. It involves the clash between the principles of autonomy and the preservation of life. Margie values her autonomy and strongly believes that she should have the right to determine the course of her own life, including choosing to end it. She feels that her suffering and loneliness have reached a point where continuing to live is no longer desirable. On the other hand, Dr Vijay upholds the medical profession’s responsibility to save and preserve lives. He views the pacemaker as a life-saving device that should not be intentionally deactivated, as it would be contrary to medicine’s primary objective. The committee will need to carefully examine the legal, ethical, and moral implications surrounding end-of-life decisions (Bhaghamma & Ramesh, 2023). This also involves considering the patient’s autonomy, the physician’s duty, and the broader societal perspectives on the sanctity of life.

Communication

In discussing the case with Ms Mackin and Dr Vijay, it is clear that there is a dilemma regarding Mrs Whitson’s request to have her pacemaker deactivated. Both healthcare professionals are opposed to honouring her request due to ethical concerns. They believe that Mrs Whitson’s current distress and desire to end her life may be influenced by recent life events, particularly the loss of her son. They suggest that her disposition may improve for some time, and she may reconsider her decision. They do not view her current condition as a terminal illness or a situation that would ethically justify deactivating the pacemaker.

Ms Robison, the social worker, has recommended that the ethics committee review the case due to its severity. It is important for the committee to thoroughly analyze the ethical issues involved and consider all perspectives before making a recommendation. It is also crucial to ensure that all relevant information is shared among the committee members and other healthcare professionals involved to have a comprehensive understanding of the case and the patient’s circumstances.

Choice

After thorough analysis and careful consideration of the ethical issues surrounding Mrs Whitson’s request to deactivate her pacemaker, the ethics committee recommends against granting her request. While we empathize with Mrs Whitson’s grief and her desire to be reunited with her deceased family members, it is crucial to prioritize her overall well-being and consider the ethical implications of such a decision.

Mrs Whitson’s current medical condition does not meet the criteria for physician-assisted euthanasia or the deactivation of life-sustaining treatment, even in states where such laws exist. She has no terminal illness, and her pacemaker is essential for her survival. Deactivating the pacemaker would directly cause her death rather than allowing a natural progression of her health condition.

It is important to consider the potential impact on other patients and the healthcare system as a whole. Granting Mrs Whitson’s request could set a precedent that might lead to similar requests from other individuals experiencing distress or grief. Maintaining a consistent and ethical approach to end-of-life decisions is essential to ensure the fair and equitable treatment of all patients (Siri Hammersland Heradstveit et al., 2023). The committee recommends providing Mrs Whitson with additional support and counselling to help her cope with her grief and feelings of loneliness. It is crucial to explore alternatives to address her emotional distress and ensure that her physical and emotional well-being are adequately cared for. The committee suggests involving mental health professionals, chaplains, or support groups to assist Mrs Whitson during this difficult time.

In the case that this scenario takes place in a state where physician-assisted euthanasia laws are in place, the committee would need to reevaluate the situation. If such a law exists, it may provide a legal framework for Mrs Whitson’s request to be considered. However, even in these states, it is crucial to assess the case’s specific circumstances, including the patient’s medical condition and the presence of a terminal illness, to determine whether the request meets the requirements outlined in the law. Each case should be evaluated individually, considering the ethical, legal, and medical aspects involved.

References

Bhaghamma, G., & Ramesh. (2023). Legal and Ethical Perspectives on Euthanasia: A Comparative Study of India and Canada. International Journal of Law Management & Humanities, 6(2), 3017–3032. http://eprints.uni-mysore.ac.in/17488/

Dzeng, E., Bein, T., & Curtis, J. R. (2022). The role of policy and law in shaping the ethics and quality of end-of-life care in intensive care. Intensive Care Medicine, 48(3), 352–354. https://doi.org/10.1007/s00134-022-06623-2

Siri Hammersland Heradstveit, Marie Hamilton Larsen, Marianne Trygg Solberg, & Simen Alexander Steindal. (2023). Critical care nurses’ role in the decision-making process of withdrawal of life-sustaining treatment: A qualitative systematic review. https://doi.org/10.1111/jocn.16728

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Read the scenario and assignment instructions in the You Decide Overview. Prepare a 2-3 page (double-spaced) paper analyzing the key issues in this case, stating a recommendation