Should We Withhold Life Support
Mr. X is a 75-year-old male who was admitted to the hospital for an upper respiratory tract infection. Mr. X also has a history of chronic obstructive pulmonary disease. He was being treated with antibiotics, fluid, and oxygen, and seemed like he was doing better. Mr. X’s oxygen was inadvertently turned up, and this caused him to go into respiratory failure. When the respiratory therapist found him, he was in distress and gasping in his bed. Mr. X had a DNR order in his chart and his wife and he had requested that CPR not be performed.
Patient Directive and Family Preference
Patients have the right to choose their end-of-life care and how they want to exit this world. Mr. X and his wife had made the decision for DNR while he was competent. Advanced care planning is a process that encourages people to identify their values, reflect upon the meanings and consequences of serious illness, define goals and preferences for future medical treatment and care, and discuss these goals with family and healthcare providers. (Killackey T, 2020). Advance care planning is important for chronically ill patients. This talk between family members can be hard but it’s easier when the day comes and decisions need to be made. Mr. X and his wife made the tough decision to have a DNR order. Mrs. Martinez supported her husband’s decision.
Quality of Life
Mr. X and his wife had a conversation with his physician to obtain the DNR Order. There are guidelines to follow when obtaining an order. Some options you can have artificial nutrition, intubation, or just end-of-life comfort care. I support Mr. X decision to a DNR. When doing CPR, ribs can get broken and it’s not guaranteed you will survive after advanced critical life support. Being dependent on a ventilator is not quality of life. Personally, as an Emergency Room Nurse, I have seen so many nursing home patients who do not have a quality of life and they are a full code that if I do CPR on them, they would break a rib and die. Family and patients need to have tough conversations like this and know what their loved ones would like to have and not have.
Moral Issues and Ethical Principles
PHI FPX 3200 Assessment 3 Should We Withhold Life Support?
As nurses, we take an oath to help others, prevent death and provide the best possible care to patients. The end-of-life needs and desires of patients, whether it is related to a terminal illness or age-related end-of-life physiological function, can vary from patient to patient. Each dying patient’s case should be approached in an individual and patient-centered fashion while supporting the dying patient’s desired preferences related to end–of–life treatment. This serves to recognize the dying patient’s individual rights related to self-determination of preserving his or her dignity during the end-of-life process. (Atkinson Smith, 2020). The ethical principle of beneficence would be in the best interest of Mr. X. Beneficence is providing the best care, doing good, and preventing and removing harm from patients. Mr. X made his end-of-life needs to be known and was written and witnessed by a physician.
Conclusion
Every patient has the right to choose what medical intervention should be used and how they want to be treated during end-of-life care. Mr. X was competent when he made the decision for DNR. Although he can be saved by performing CPR and transferring to ICU for further care, it was already decided that he does not wish to have any life-saving interventions. The healthcare staff should provide the best quality of care to Mr. X and respect his wishes. In the end, life support should be withheld for Mr. X because his needs/wants were known and on paper. His wishes should be respected and followed.
PHI FPX 3200 Assessment 3 Should We Withhold Life Support?
References
Atkinson Smith, M. , Torres, L. & Burton, T. (2020). Patient Rights at the End of Life. Professional Case Management, 25 (2), 77-84. doi: 10.1097/NCM.0000000000000392.
Killackey T, Peter E, Maciver J, Mohammed S. Advance care planning with chronically ill patients: A relational autonomy approach. Nursing Ethics. 2020;27(2):360-371. doi:10.1177/0969733019848031
