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The Moral And Ethical Issues Involved In End-of-Life Issues Discussion

The Moral And Ethical Issues Involved In End-of-Life Issues Discussion

Should we Withhold Life Support?

Healthcare professionals attending to patients with chronic illnesses are faced with several end-of-life issues. Medical practitioners are torn between letting a patient at the end-of-life stage continue living or ending one’s life through passive euthanasia or active. Making this decision becomes even harder when the client cannot decide on his or her treatment and no intentions regarding the end-of-life stage were communicated earlier, either through writing or a family member. The provided case study is about Mr Martinez, a 70yo male with chronic obstructive pulmonary disease (COPD). The patient was hospitalized following an upper respiratory tract infection. The client and his wife were against the performance of CPR in case he needed this treatment procedure. During the hospitalization, a healthcare provider wrote a DNR order in the charts. The interprofessional team used antibiotics, oxygen, and fluids to manage his condition, and he responded well to the treatment. Nonetheless, Mr Martinez went into respiratory failure following an inadvertently turn up of his oxygen. Upon entering his ward, the therapist found Mr Martinez in chronic distress and lay gasping for air. This paper focuses on Mr Martinez’s end-of-life care, including the client’s directives, patient’s quality of life, family’s stated preferences, moral issues relating to limiting life support, ethical principles most relevant in making sound ethical decisions, and important considerations. The Moral And Ethical Issues Involved In End-of-Life Issues Discussion

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The patient’s Directives

The patient’s directives refer to instructions given by the client concerning his end-of-life care. In the case study, Mr Martinez’s directives were against the performance of CPR in case he needed this treatment procedure. Thus, the client preferred losing his life if the CPR procedure was the only treatment intervention for managing his health condition.

The Patient’s Quality of Life

Mr Martinez has the chronic obstructive pulmonary disease. Additionally, he was hospitalized following an upper respiratory tract infection. The risk of being admitted due to upper respiratory tract infections among people with COPD increases with the severity of chronic obstructive pulmonary disease (Mathioudakis et al., 2019). Furthermore, upper respiratory tract infections in people with COPD result in poor health outcomes (Mathioudakis et al., 2019). Therefore, hospitalization for an upper respiratory tract infection indicates the high severity of Mr Martinez’s COPD. Additionally, upper respiratory tract infections contribute to adverse health outcomes. Consequently, Mr Martinez’s quality of life is relatively low.

The Family’s Stated Preferences

Healthcare providers also consider family preferences when making treatment decisions for a family member at the end-of-life stage. In this case, the healthcare provider should consider the client’s wife’s preference concerning Mr Martinez’s. His wife was against the performance of CPR in case he needed this treatment procedure during the hospitalization.

The Moral Issues Relating to Limiting Life Support

            Moral principles guide healthcare professionals in making significant decisions when providing end-of-life care. Moral principles claim it is wrong to take someone’s life away. For this reason, healthcare providers should not limit life support since it will likely lead to a patient’s death. On the contrary, these principles claim it is morally wrong to keep individuals alive without their consent. Keeping a person at the end-of-life stage alive will probably prolong suffering. Thus, healthcare providers should limit life support for end-of-life care patients, especially if the patient’s autonomy is against receiving life support. The Moral And Ethical Issues Involved In End-of-Life Issues Discussion

The most Significant Ethical Principles in Making Ethically Sound Decision

Healthcare professionals are also guided by ethical principles, including autonomy, beneficence, justice, nonmaleficence, and fidelity in reaching an ethnically sound decision concerning end-of-life care. According to Chang et al. (2021), adhering to ethical guidelines enables healthcare providers to make the best decision concerning end-of-life care. However, the most important ethical principle in making an ethically sound decision in end-of-life care is patient autonomy. A patient receiving end-of-life care can give directives concerning one’s treatment. In other cases, patients express their intentions regarding end-of-life care through writing or a conversation with a family member. Therefore, adhering to a patient’s autonomy enables a healthcare provider to make an ethnically sound decision regarding end-of-life treatment.

Important Considerations

The patient’s respiratory failure might result in implications, justifications, and conflicts of interest. First, respiratory failure will imply that the hospital provided him with low-quality care, resulting in this adverse health outcome. On the contrary, the healthcare providers would use the patient’s autonomy to justify his respiratory failure. The client and his wife had given directives against the performance of CPR in case he needed this treatment procedure, resulting in respiratory failure. Lastly, the patient’s respiratory failure can be associated with a conflict of interests between healthcare providers and the patient. The medical team would support CPR since it’s the most appropriate intervention for preventing respiratory failure. However, the patient and his wife were against the CRP procedure. The Moral And Ethical Issues Involved In End-of-Life Issues Discussion

Various factors, including patient and family directives, influence healthcare providers’ decisions concerning end-of-life care. Similarly, the healthcare professional should consider Mr Martinez and his wife’s directives, moral principles, and ethical considerations in making ethically sound decisions concerning Mr Martinez’s end-of-life care.

References

Chang, T., Darshani, S., Manikavasagam, P., & Arambepola, C. (2021). A cross-sectional study is a knowledge and attitudes about end-of-life decisions, good death and principles of medical ethics among doctors in tertiary care hospitals in Sri Lanka. BMC Medical Ethics, 22(1), 1-14. https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-021-00631-5

Mathioudakis, A. G., Janssens, W., Sivapalan, P., Singanayagam, A., Dransfield, M. T., Jensen, J. U. S., & Vestbo, J. (2020). Acute exacerbations of chronic obstructive pulmonary disease: in search of diagnostic biomarkers and treatable traits. Thorax, 75(6), 520-527. https://creativecommons.org/licenses/by/4.0/

End-of-Life Issues

With our framework of ethical theories and principles in hand, we begin our look at some of the critical ethical issues in our contemporary world, starting with end-of-life issues. This assessment covers ethical questions related to end-of-life care. Passive euthanasia is the removal or refusal of life-sustaining treatment. Examples of passive euthanasia include removal of a feeding tube or a ventilator, or forgoing a life-prolonging surgery. Passive euthanasia is legal in all 50 states, and the principle of autonomy gives informed patients the right to refuse any and all treatments. Patients who are unable to make such decisions in the moment (because they are unconscious, for example) might have made their intentions clear beforehand with an advance directive or similar document. Things become more complicated, however, when a patient who is unable to make treatment choices has not made his or her wishes clear, either formally in a written document, or informally in conversations with family members or friends. Another problem concerns cases in which there is disagreement about whether the treatment is sustaining the life of a person in the full sense or merely as a body that, because of severe and irreversible brain trauma, is no longer truly a living person. The Moral And Ethical Issues Involved In End-of-Life Issues Discussion

Active euthanasia, or assisted suicide, introduces further difficult moral questions. A patient who has a terminal illness and who has refused treatments that would merely prolong a potentially very painful and debilitating death might want the process of dying to be hastened and made less painful. The patient might want to take his or her own life before the disease reaches its horrible final stages. Should patients be legally allowed to have help in this endeavor? If suicide itself is not morally wrong, at least in cases like these, is it wrong for another person to directly help bring about the patient’s death? Is it wrong for doctors, a role we naturally associate with healing and the promotion of life, to use their medical expertise to deliberately end a patient’s life if the patient wants this? The Moral And Ethical Issues Involved In End-of-Life Issues Discussion

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Articulate ethical issues in health care.
    • Articulate the moral issues associated with limiting life support.
  • Competency 2: Apply sound ethical thinking related to a health care issue.
    • Demonstrate sound ethical thinking and relevant ethical principles when considering limiting life support.
    • Explain important considerations that arise when contemplating limiting life support.
  • 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.
    • Exhibit proficiency in clear and effective academic writing skills. The Moral And Ethical Issues Involved In End-of-Life Issues Discussion

Preparation

  • Case Study: Mr. Martinez.

This media piece provides the context for this assessment; make sure you have reviewed the case study thoroughly.

Additionally, it may be useful to think through the following issues as they relate to Mr. Martinez’s case:

  • Should Mr. Martinez be transferred to intensive care, where his respiratory failure can be treated by a ventilator, and by CPR if necessary, and his oxygen level can be monitored?
    • What are the key ethical issues or models at play in this case study?
    • What are the key end-of-life issues at play in this case study?
    • How can an understanding of models and best-practice help to guide health care practitioners to make ethical and legal decisions?

Instructions

In a 2–3 page analysis of the case study, address the following:

  • The patient’s directives.
  • The patient’s quality of life.
  • The family’s stated preferences.
  • The moral issues associated with limiting life support.
  • The ethical principles most relevant to reaching an ethically sound decision.
  • Important considerations such as implications, justifications, and any conflicts of interest that might arise because of the patient’s respiratory failure.

When writing your assessment submission assume that doctors cannot contact Mrs. Martinez and must make this choice on their own. To help you reach an objective, ethically sound decision, draw upon concepts and arguments from the suggested resources or your independent research. Support your response with clear, concise, and correct examples, weaving and citing the readings and media throughout your answer. The Moral And Ethical Issues Involved In End-of-Life Issues Discussion

Submission 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.
  • Length:2–3 typed, double-spaced pages.
  • Font and font size:Times New Roman, 12 point.

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Case Study

Mr. Martinez was a seventy-five-year-old chronic obstructive pulmonary disease patient. He was 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. A DNR order was written in the charts. In his room on the third floor, he was being maintained with antibiotics, fluids, and oxygen and seemed to be doing better. However, Mr. Martinez’s oxygen was inadvertently turned up, and this caused him to go into respiratory failure. When found by the therapist, he was in terrible distress and lay gasping in his bed. The Moral And Ethical Issues Involved In End-of-Life Issues Discussion