Should We Withhold Life Support? The Mr. Martinez Case
Should We Withhold Life Support? The Mr. Martinez Case
People’s life and health depend on how various body organ functions. If vital organs such as lungs and kidneys fail to meet the required functioning threshold, the chances of dying increase. In some cases, when death is imminent, life support is applied to substitute the functions of vital organs artificially. The primary role of life support is to increase patients’ chances of recovering independently by buying time. Although this technique has some benefits, it is among the most controversial due to its use’s moral issues. This paper discusses Mr. Martinez case while focusing on critical areas relevant to his case, including patient’s directives, quality of life, preferences, moral issues, and ethical principles considered in decision making.
Patient’s Directives
End-of-life care remains a controversial issue due to the need to respect patients’ preferences. In this case study, Mr. Martinez had given a directive not to be put under cardiopulmonary resuscitation (CPR) if the situation prompted its requirement. Unfortunately, his oxygen was inadvertently turned up, causing respiratory failure. The situation implies that death is inevitable, and the only rational way of enhancing recovery is life support. Failure to respect the patient’s directive implies that the care process is not evidence-based. According to Melnyk (2018), evidence-based practice integrates clinical expertise, research evidence, and patients’ preferences in health practice. Always, it is crucial to consider patients’ preferences about their health irrespective of the situation.
The Patient’s Quality of Life
From a health perspective, health care organizations should enhance patients’ safety as much as possible. The interventions used should be based on patients’ conditions, to improve their quality of life. Mr. Martinez case study shows that his life is at risk. There was an expectation that he would do well under antibiotics, fluids, and oxygen. Unfortunately, the accidental turning up of oxygen puts him at risk of respiratory failure. Considering that he is in terrible distress and gasping for breath, interventions used should improve the quality of life while reasoning with the family about the most rational way forward.
Family’s Stated Preferences
When deciding critical health matters such as end-of-life support, advance directives cannot be overlooked regardless of the patient’s
condition. Omondi et al. (2017) posited that the advance directive allows patients to document their health care decision plans in advance if they get terminally ill or experience a condition requiring life support. As they make such decisions, families play a vital role as proxies. Families advise health care providers about the patient’s care preference, and the same case applies to Mr. Martinez’s situation. Together with his wife, Mr. Martinez preferred CPR not to be performed on him. Since he is in a situation where he cannot make an independent decision, health care providers should respond as the wife directs.
Moral Issues Associated with Limiting Life Support
Life support is morally contentious since people splitting over the issue defend their stances passionately. When initially introduced, life support techniques were viewed as lifesaving and were supported a lot. Life support helps to sustain life longer, giving opportunities for hope and solutions. Despite giving critically ill patients a chance to prolong life and recover, life support is generally a method of prolonging suffering (Mercadante et al., 2018). It is morally wrong to prolong someone’s suffering, particularly in situations where they have not consented. In the same case, it is unethical to use medical resources injudiciously. Medical resources should be used for the right reasons and equitably, and using them to prolong suffering violates this principle.
Ethical Principles to Reach an Ethically Sound Decision
Despite the family’s stance and other moral obligations, a decision for the good of Mr. Martinez must be made. To ensure that the outcome does not cause ethical issues, several ethical principles serve as the basis for decision-making. The first principle is autonomy. Here, and as preserved in the Federal Patient Self-Determination Act (PSDA), patients have a right to autonomously give directions regarding their end-of-life treatment choices (Teoli & Ghassemzadeh, 2019). Accordingly, the decision made must consider Mr. Martinez’s will and its impact on the quality of life. The second ethical principle is beneficence. Physicians should perform their duties rightfully as they ensure that patients and families are adequately informed about the benefits and drawbacks of a treatment option. Physicians should be guided by the deontology theory, which recommends doing what benefits the patient the most (Karnik & Kanekar, 2016). The third important principle is the rationing of care and futile treatment. It is irrational to stick to a treatment option that will be financially and emotionally burdening to patients and their families.
In conclusion, despite all people being mortal, it is vital to prevent death if possible. Life support technologies are among the medical interventions with profound impacts on people’s health. Although their value cannot be questioned, life support technologies spark heated debates due to ethical concerns associated with their use. Before making any decision, like in Mr. Martinez case, it is crucial to consider the patient’s preference. Autonomy should be respected while considering other principles, such as beneficence and futile treatment.
References
Karnik, S., & Kanekar, A. (2016). Ethical issues surrounding end-of-life care: a narrative review. In Healthcare (Vol. 4, No. 2, p. 24). Multidisciplinary Digital Publishing Institute. doi:10.3390/healthcare4020024
Mercadante, S., Gregoretti, C., & Cortegiani, A. (2018). Palliative care in intensive care units: why, where, what, who, when, how. BMC anesthesiology, 18(1), 1-6. https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-018-0574-9
Omondi, S., Weru, J., Shaikh, A. J., & Yonga, G. (2017). Factors that influence advance directives completion amongst terminally ill patients at a tertiary hospital in Kenya. BMC palliative care, 16(1), 1-11. https://link.springer.com/article/10.1186/s12904-017-0186-z
Teoli, D., & Ghassemzadeh, S. (2019). Patient self-determination act. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK538297/