Should We Withhold Life Support? The Mr. Martinez Case
NURS FPX 3200 Assessment 3 Attempt 1 Should We Withhold Life Support? The Mr. Martinez Case
The question of withholding life support often arises during critical settings. However, how to respect such decisions and exercise this right in life support remains unclear (Robertsen et al., 2020). Moreover, the ethical principles dealing with life support suggests withholding actions, but it becomes extremely difficult in real situations when doctors and patient go through such a moral conundrum (Graham, 2020). It is evident from the surveys that health care professionals withdraw and withhold life support regularly, and they consider these interventions ethically equivalent, and they recommend intervention based on prognosis meantime they also consider patients’ wishes to be most important in deciding life support measures (Rubio et al., 2018). In the given case of Mr. Martinez, a seventy-five-year-old chronic obstructive pulmonary disease patient is in the hospital because of an upper respiratory tract infection. He and his wife had requested that CPR not be performed should he require it. However, accidentally his oxygen volume increases, and now he faces a critical condition that can be only solved once the paramedic intervenes. Earlier Mr. Martinez and his wife left a note of DNR, but right now intervention is necessary. Chronic conditions like Mr. Martinez’s carry a lot of moral weight in moral ethics whether to go with the physician’s decision or with the patient.
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Ethical Principles When Considering Limiting Life Support
Ethical Issues in Health Care
While overseeing a patient’s health, healthcare provider often faces disagreements about treatment decisions, access to resources, and waiting lists these challenges can pose ethical dilemmas (Gebreheat & Teame, 2021). Ethical challenges do not have the same consequences as unlawful action. For example, if healthcare providers face the challenge of the emergency room, then they are not required by any law to speed up the process, but it becomes ethical responsibility to discuss such concerns with other officials. There are more grave ethical issues in health care these are:
Do-not-resuscitate order
This order is written by a doctor, and it contains instructions for healthcare providers not to perform (CPR) cardiopulmonary resuscitation if the patient heart stops or stops breathing. The DNR doesn’t have instructions on other treatments and can be considered after taking consent from the patient. The ethical concern arises when it becomes unclear whether the patient was involved while taking such decisions (Morley et al., 2020).
Doctor and Patient Confidentiality
Violating patient confidentiality may have grave ethical and legal consequences for healthcare providers (Torabi et al., 2018). Withholding or giving away patient information can sometimes harm patients and it is against the ethics of healthcare providers.
Malpractice and Negligence
Negligence is the third leading cause of death in the U.S. patients who are affected by malpractices may never or take years to recover (Rappaport & Selbst, 2019).
There are four basics ethical principles healthcare provider considers before making any decision.
Autonomy
In a healthcare setting when patients are surrounded by professional staff it becomes easier that their autonomous decisions to get disrespected (Ha et al., 2021). The principle gives the patient the right to act according to his reason and decides for himself no matter what the circumstances are, it is the responsibility of the healthcare provider to protect the patient’s autonomy.
Justice
Healthcare operates with minimum resources. Sometimes there are not enough beds, ventilators, staff, doctors, or medicine to go around (Maves et al., 2020). The principle of justice enforces that healthcare workers treat each patient equally and without any discrimination.
Beneficence
It means acts of kindness, altruism, and charity. The application of Beneficence in healthcare is far-reaching. It ensures that healthcare providers treat patients well and requires them to compassionate, sensitive, and emphatic (Chadha, 2022).
NURS FPX 3200 Assessment 3 Attempt 1 Should We Withhold Life Support? The Mr. Martinez Case
In America and Canada, patients have the unequivocal right to deny medical treatment and it is very well established in their culture and ethically justify by the principle of autonomy, according to which anyone can opt according to his choice be it withholding or withdrawing life support (Long et al., 2019). Failure to observe ethical principles can lead to patient death, dissatisfaction, malpractice in the profession, and loss of privileges or licenses. Important issues are patient competence, consent, right to refuse treatment, emergency treatment, confidentiality, and continuity of care.
Moral Issues Associated with Limiting Life Support
Spirituality and religion have always had a significant impact on a person’s life and health issues. The freedom to self-determination and the significant development of patient autonomy have made a patient’s religious affiliation a crucial factor in medical decision-making (Chen & He, 2022). This is especially important when it comes to decisions about end-of-life care, such as ceasing and refusing treatment, medical futility, nutritional feeding, and do-not-resuscitate directives. The family unit, medical professionals, and the patient’s values and beliefs are all impacted by these difficulties (Chen & He, 2022). Conflict may emerge, for instance, between the medical view of “futility” and the religious sacredness of life. To resolve such conflict healthcare workers must learn about the socio-cultural and religious practices followed by the community they are serving. A mutual understanding like this could improve the patient’s experience and prevent conflict (Sapkota, 2020). End-of-life decisions or limiting life support are the decisions taken about individuals whose consent is either problematic or unavailable to withhold or withdraw treatments. The victims of these cases are mostly young children, people with dementia, old age people, and individuals who are permanently or temporarily unconscious. In such cases, their wishes may be known but are usually considered inauthentic and depend on others. By committing such immoral acts, you are depriving someone of their life something that is valuable. Many patients die in ICUs during limited life support because physicians believe that it would not be beneficial to further restorative care. CPR, mechanical ventilation, and other restorative drugs are commonly withheld. Deciding on whether to continue life support measures like CPR, nutrition, and hydration can be especially troubling for families. Mr. Martinez and his family view life-support equipment as an unbearable way to live. In either case, the decisions directly affect the patient’s quality of life. Choosing life support may come with unbearable consequences and may lead to preventable suffering near the end of life.
Considerations that Arise When Contemplating Limiting Life Support
Keeping Mr. Martinez on life-limiting support has many considerations to make, first is a benefit-to-risk ratio in staying in the hospital while accessing life support the process will cost Mr. Martinez’s family financially and physically. The scarcity of hospital resources will make it impossible for another prospective patient to deny health care with passing (Sapkota, 2020). Also, with the passing days, the trust between Mr. Martinez and the hospital will decrease over his health concern. The most important consideration to make, in chronic cases like Mr. Martinez, is whether to leave him to die or intervene. In times like these patients, his close family members, and clinicians are required to take timely decisions. Conflicting decisions arise during situations like these, and the best way to solve these conflicts is through communication, negotiation, and consensus building. The clinician uses varying methods to resolve conflicts with dying patients. The most common approach they use is educating the patient. A less common method is through obtaining assistance from a family member (Rainer et al., 2018). Rarely do doctors intervenes to take decisions without the consent of the patient or family member. In Mr. Martinez’s case, health workers would prefer to intervene to save the life from the accident considering the rights of beneficence and non-maleficence.
Conclusion
From the above discussion, Mr. Martinez along with his wife decided to go for a DNR order in which the doctor, as well as the patient, have the moral right to opt for death without any intervention. The idea of DNR has ignited a discussion during the past few years on moral grounds but right now it has got legal status, and the processes surrounding the DNR vary from one country to another. It has become clear that respect for patient autonomy must not be seen entirely in negative terms, but it should be seen as the provision of options for more enhanced choices, a view that is consistent with the philosophy of informed consent.
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NURS FPX 3200 Assessment 3 Attempt 1 Should We Withhold Life Support? The Mr. Martinez Case
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NURS FPX 3200 Assessment 3 Attempt 1 Should We Withhold Life Support? The Mr. Martinez Case
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