PHI FPX 3200 CU Should Life Support Be Withheld? Mr. Martinez’s Situation
PHI FPX 3200 CU Should Life Support Be Withheld Mr. Martinez’s Situation
Ethical dilemmas, healthcare standards, and moral issues have all had a significant impact on patients’ treatment rights. The right to make decisions or refuse treatment has been significantly impacted, as it remains unclear how best to uphold and practice this right when providing healthcare services. Numerous moral and ethical dilemmas have influenced the decision to withdraw, limit, or withhold end-of-life support in the current era. This has been attributed to several contentious healthcare decisions. End-of-life decisions and preferences have resulted in euthanasia and dysthanasia being practiced (Cano et al., 2020). End-of-life decisions are influenced by a variety of factors, including cultural values and religious beliefs. For example, patients have made these choices based on their religious beliefs, traditional values, and cultural practices. As a result, other individuals have made similar choices to ensure they live high-quality lives while they are still alive. Along with this, this paper discusses the ethical and moral issues surrounding end-of-life care. The paper accomplishes this goal by incorporating Mr. Martinez’s case into its discourse.
Nursing education is theory driven. Theories are derived from the humanities, sciences, and Biblical concepts. Nursing knowledge, theory, research, and health promotion are influenced by spiritual perspectives, and ethical, legal, political, historical, and social influences. The faculty values excellence in teaching with an individual focus on the learner. Teaching includes a variety of methods, learning modalities, and practice situations. Faculty provide opportunities for students to give comprehensive care to diverse client populations, and the learning environment is created and arranged to meet individual learning outcomes that are consistent with the College of Nursing and Health Care Professions program outcomes. The College of Nursing and Health Care Professions supports life-long learning endeavors and fosters an appreciation of diversity among traditional and nontraditional learners. Students are educated to provide, direct, and evaluate client-centered care while focusing on the person as an integrated whole.
The Ethical Consequences of Life Support Reduction
The analysis of ethical and moral concerns about limiting life support has intersected with the analysis of underlying assumptions. To begin, patients’ decisions to withdraw or withhold end-of-life care do not reflect suicidal intent, as the primary cause of death is the patient’s condition. Second, care practitioners’ decisions to honor patients’ end-of-life wishes do not constitute murder or euthanasia. Thirdly, patients and their relatives wish to extend the lives of their loved ones in any way possible. Thirdly, healthcare professionals have a critical role to play in ensuring peaceful and dignified deaths and end-of-life experiences. They must ensure that patients die with as little or no pain as possible.
The debate over whether or not to withdraw or withhold life support has become heated. This is because each of the two opposing sides arguing for and against the topic feels more accurate, as they all believe they are on the same page. Each side believes their position is founded on noble morals and ethics (Keele et al., 2016). One critical aspect of end-of-life care is that it prolongs and sustains life, thereby providing opportunities for the best alternatives and, most likely, the best treatment plans. Simultaneously, religious beliefs assert that life is sacred (Keele et al., 2016). This implies that failing to save or support life is unethical. Withdrawal of life support in Mr. Martinez’s case would appear to result in premature death, which is morally wrong. Perhaps the ICU can assist Martinez in resolving his health issue. He and his family members, however, direct that the CRP be used. This could result in additional complications, which could result in additional issues affecting both family members and care providers. At this point, his life was in jeopardy due to a lack of time to make an informed decision about the fittest intervention.
Ethical Principles to Follow When Determining When to Terminate Life Support
Each care practitioner must have a thorough understanding of the various principles governing end-of-life decisions. Respect for the right to self-determination is one of these principles. The right to autonomy implies that the patient has a right to participate in the decision-making process regarding treatment. This principle states that patients have the right to direct their treatment or medical needs in accordance with their freedom of self-determination (Grignoli et al., 2018). As stated in this principle, in Mr. Martinez’s scenario, the healthcare facility has been directed to follow the DNR request. Beneficial principles should also be considered when providing end-of-life care. At this point, healthcare practitioners are obligated to promote and enhance the patient’s greatest good. This entails identifying and weighing the benefits and drawbacks of specific treatment decisions, particularly from the perspective of patients (Giles et al., 2018). This is demonstrated in the case presented by the caregivers’ efforts to maintain Martinez’s life through antibiotics, fluids, and oxygen. Ignoring these principles may have negative consequences for healthcare practitioners.
A Vital Consideration When Considering Limiting Life Support
The quality of life of patients is one of the factors that care practitioners must consider when deciding whether to limit end-of-life support. Mr. Martinez’s situation is easily remedied. Despite this, the necessary treatment could not be carried out due to his desire. Consideration of a patient’s health concerns and life quality may promote sound decision-making, thereby avoiding health complexity in the long run. While adhering to moral and ethical principles is critical, it is also necessary to consider the potential consequences of a decision. Following this, it is critical to involve the patient in a thorough informed consent process to assist the patient in making decisions (Muramoto, 2016). Thus, one recommendation for Mr. Martinez’s case is that he be informed of the potential consequences of his decision. Additionally, an ethical analysis can be conducted prior to the DNR request being accepted.
To summarize, the decision to withdraw life support is complicated. The decision is influenced by religious values, customs, and individual perspectives. For instance, individuals may prefer to withdraw from life support in order to ensure a dignified and painless death. Simultaneously, individuals may wish to place themselves on life support as a result of their religious values, which suggest that life is sacred. The right to beneficence and the principle of autonomy are two ethical principles that influence the decision to withdraw life support. When making decisions about end-of-life care, it is important to consider the patient’s quality of life and health status.
References
C. Cano, A. Silva, A. Barboza, B. Bazzo, C. Martins, et al (2020). End-of-life issues: a conceptual framework for euthanasia, dysthanasia, and orthothanasia Bioética, 28(2), pp. 376-383. https://doi.org/10.1590/1983-80422020282399
T. Giles, S. de Lacey, and E. Muir-Cochrane (2018). How do clinicians apply beneficence principles when deciding whether to allow or deny family presence during cardiopulmonary resuscitation? Clinical Nursing, 27(5-6), pp. 1214-1224. https://doi.org/10.1111/jocn.14222
N. Grignoli, V. Di Bernardo, and R. Malacrida (2018). New perspectives on critical care decision-making in which relational autonomy is substituted for shared decision-making. Intensive Care Medicine, 22(1), pp. 1-6. https://doi.org/10.1186/s13054-018-2187-6
L. Keele, K. Meert, R. Berg, H. Dalton, C. Newth, et al (2016). Limiting and withdrawing life support in the PICU: Who is discussed with these options? Pediatric Critical Care Medicine, vol. 17, no. 2, pp. 110–120. https://doi.org/10.1097/pcc.0000000000000614
O. Muramoto (2016). A conceptual argument for informed consent for the diagnosis of brain death. Philosophical, ethical, and humanistic considerations in medicine, 11(1), pp. 1-15. https://doi.org/10.1186/s13010-016-0042-4
PHI FPX3200 CU Withholding Life Support Essay
Assessment 3 Instructions: Should We Withhold Life Support? The Mr. Martinez Case
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Write a 2-3 page paper that examines the moral and ethical issues involved in making a decision regarding limiting life support.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.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?Demonstration of ProficiencyBy 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.Preparation
Case Study: Mr. Martinez.
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?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:InstructionsIn 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.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.
Resources: End-of-Life Issues
End-of-Life IssuesThe Suicide Plan.This video explores the clandestine world of assisted suicide. Physician-assisted suicide is legal in two U.S. states—Oregon and Washington—but only for individuals facing a terminal illness. Elsewhere, individuals contemplating suicide turn to friends, family members, and activist right-to-die organizations. When people choose to kill themselves, those who help them (assisters) face a range of legal consequences, so they are advised to hide evidence and tell few people about their intentions. This documentary offers a balanced, informative viewpoint about an issue few want to contemplate.Running time: 01:25:38.Think about the following questions:
What are your thoughts about those individuals who were arrested for helping a parent or friend die? Though they broke the law, do you believe they did anything morally wrong?Did the film change your mind, in either direction, about laws that forbid physician-assisted suicide?What do you think of Dr. Timothy Quill’s claim in the video that there is no moral difference between a doctor removing life-sustaining treatment upon a patient’s request (which is legal) and a doctor hastening the death of a terminally ill patient who asks for such help (which is illegal in most U.S. states)? Do you agree or disagree?Should those who have a treatable illness but do not choose to go through treatment and linger be permitted to receive assistance to kill themselves?Additional End-of-Life IssuesEmanuel, L. L, Barry, M. J., Stoeckle, J. D., Ettelson, L. M., & Emanuel, E. J. (1991). Advance directives for medical care: A case for greater use. The New England Journal of Medicine, 324(13), 889-895.This seminal work examines the case for expanding the use of advanced medical directives by using hypothetical scenarios.Gedge, E., Giacomini, M., & Cook, D. (2007). Withholding and withdrawing life support in critical care settings: Ethical issues concerning consent. Journal of Medical Ethics, 33(4), 215.More recent seminal work regarding the ethical guidelines and issues with regards to life support technology.Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston, MA: Wadsworth. Available in the courseroom via the VitalSource Bookshelf link.Chapter 7, “Euthanasia and Assisted Suicide,” pages 300-334.
Resources: Optional Enrichment
Ethical Issues: Reproductive ControlIf you would like to learn more about ethical issues surrounding reproductive control, you may want to read Optional Enrichment: Reproductive Control [DOC] for an overview of some of the ethical considerations.
For further enrichment, you may wish to explore the following resources:
Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston, MA: Wadsworth. Available in the courseroom via the VitalSource Bookshelf link.Chapter 4, “Reproductive Control,” pages 189-236.Chapter 5, “Abortion,” pages 237-274.Lyerly, A. D., & Rothman, B. K. (2004). Paternalism. Retrieved from http://virtualmentor.ama-assn.org/2004/02/ccas1-04…This article presents a clinical case where a physician refuses to perform a medical procedure. (Disclaimer: The viewpoints expressed in the AMA Journal of Ethics are those of the authors and do not necessarily reflect the views and policies of the AMA.) The case study is followed by commentaries from physicians taking different positions.Ethical Issues Surrounding Genetic ControlWe are living in a time when the pace of knowledge is outstripping our ability to come to grips with the ethical challenges presented by genetic engineering. If you would like to learn more about the current and emerging ethical issues in the rapidly changing field of genetics, and the challenges and opportunities of genetic engineering, you may want to read Optional Enrichment: Genetic Control [DOC].
For further enrichment, you may wish to explore the following resources:
Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston, MA: Wadsworth. Available in the courseroom via the VitalSource Bookshelf link.Chapter 3, “Genetic Control,” pages 120-188.Sandel, M. J. (2004). Embryo ethics—The moral logic of stem-cell research. The New England Journal of Medicine, 351(3), 207-209.In this brief article, philosopher Michael Sandel discusses the ethical questions surrounding stem cell research. He considers several moral objections to their use, but sides with those who argue that use of embryonic stem cells is not morally wrong.A Duty Not to Reproduce? | Transcript.This video shows a discussion between a physician and expectant parents. Dr. Mendez delivers news to the expectant parents that their unborn male child has Tay-Sachs disease, a fatal and untreatable genetic disorder affecting the nervous system. Most commonly diagnosed among infants, Tay-Sachs affects the body’s inability to break down fatty substances, eventually building to toxic levels within the brain. As the disease progresses, the individual becomes blind and deaf and experiences progressive paralysis before dying around age 15.Running time: 01:44.
Explanation & Answer length: 3 pages
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Spirituality is the way to find meaning, hope, comfort, and inner peace in life. Many people find spirituality through religion. Some people find it through music, art, or a connection with nature. Others find it in their values and principles. Spirituality involves the recognition of a feeling or sense or belief that there is something greater than myself, something more to being human than sensory experience, and that the greater whole of which we are part is cosmic or divine in nature.
Healthy spirituality gives a sense of peace, wholeness, and balance among the physical, emotional, social, and spiritual aspects of our lives. However, for most people, the path to such spirituality passes through struggles and suffering and often includes experiences that are frightening and painful. Positive beliefs, comfort, and strength gained from religion, meditation, and prayer can contribute to well-being. It may even promote healing. Improving your spiritual health may not cure an illness, but it may help you feel better.
Patients who are spiritual may utilize their beliefs in coping with illness, pain, and life stresses. Some studies indicate that those who are spiritual tend to have a more positive outlook and a better quality of life (Bogue, 2020).
Similar to other caring activities and procedures, spiritual care improves people’s spiritual well-being and performance as well as the quality of their spiritual life. Spiritual care has positive effects on individuals’ stress responses, and spiritual well-being such as the balance between physical, psychosocial, and spiritual aspects of self, a sense of integrity and excellence, and interpersonal relationships. Spiritual well-being is important for an individual’s health potential and the experience of illness/hospitalization can threaten the optimum achievement of this potential. Professional nursing embraces spiritual care as a dimension of practice.
Nurses’ practice patterns in the area of spiritual care can be grouped into two categories including religious and nonreligious interventions. Religious interventions include treating patients’ religious beliefs without prejudice, providing them with opportunities for connecting with God and expressing their values and beliefs, helping them practice their religion, and referring them to clerical and religious leaders (O’Brien, et al., 2019). Nonreligious interventions include nurses’ presence for patients and their families, making direct eye contact when communicating with patients, sympathizing with patients and their families, listening to patients and their families attentively, and having love and enthusiasm for patients.
Although spiritual care is meant to help people, I frequently gain as a nurse. Interpersonal trust and a connection with the patient require high emotional intelligence. It’s important to realize that spirituality isn’t always theological care (Ross et al., 2018). Whereas the healthcare industry easily incorporates spirituality into therapy, spiritual care is essential in all sectors of operation. For the sake of our clients, we as caregivers must respect spiritual support, learn the required skills, and schedule time to satisfy these needs.
References
Bogue, D. W., & Hogan, M. (2020). Practicing dignity: An introduction to Christian values and decision making in Health Care. Retrieved from https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/1
O’Brien, M., Kinloch, K., Groves, K., & Jack, B. (2019, August 9). Meeting patients’ spiritual needs during end of life care: A qualitative study of nurses’ and healthcare professionals’ perceptions of spiritual care training. Edge Hill University. Retrieved from https://research.edgehill.ac.uk/en/publications/meeting-patients-spiritual-needs-during-end-of-life-care-a-qualit-2
Ross , L., McSherry, W., Giske, T., Van Leeuwen, R., Schep-Akkerman, A., Koslander, T., Hall, J., Ostergaard Steenfeldt , V., & Jarvis, P. (2018, August). Nursing and midwifery students’ perceptions of spirituality, spiritual care, and spiritual care competency: A prospective, Longitudinal, correlational European study. Nurse education today. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29763841/