Ethical challenges in withdrawing life support
But even if we grant that this is not how patient decision making incompetence should be ascertained, that does not tell us how it should be done. Withholding and withdrawing life support in critical care settings: ethical issues concerning consent.
Life support ethical dilemma
The ethical analysis proceeds in three stages. Finally, the need for the health care team to obtain consent for the continuation of the ventilation is discussed. Firstly, the treatment must be medically indicated. Is he angry and upset about the disappointing outcome of the surgery but deep down longing for a few more years on this earth? A therapist does not need to justify why he is not offering to a patient a treatment option that is deemed futile though he may have to explain to the patient what renders this particular intervention futile. Removing the endotracheal tube sometimes allows conscious patients to talk to their loved ones, ending a silence forced on them by their treatment. If the uncle pushes the kid under water and drowns him, surely he is guilty of murder, Rachels contends. But if Mr.
But upon weaning Ms. Uncertainty or disputation about the prognosis raises the voltage of the fear and potential remorse that is a normal condition of care and support at the end of life.
For example, cardiopulmonary resuscitation in terminal cancer patients is not endorsed because of its violation of the dignity of the irremediably ill, and its unproductive cost to society. And health professionals are not the only ones to reason in this fashion.
Life sustaining treatment ethical issues
This definition contains two terms that health care professionals use routinely but that are actually very difficult to define and ascertain. Providing treatment that might hasten death In the presentation of this case, it is stated that providing potent sedatives and analgesics could affect the respiratory centre and thus hasten death in a terminally ill patient. Retrieved August 25, 6. Terry Schiavo wanted the artificial nutrition and hydration stopped after his wife had been in a persistent vegetative state PVS for more than two years [ 4 ]. An ethics consultant, especially one skilled and experienced in management of end-of-life issues, can be a helpful negotiator and guide. How does this translate to the domain of life-sustaining medical interventions? However, as the case develops, differences in reasoning between doctors and members of the general public diminish somewhat, although they never quite disappear. Withholding and withdrawing life support in critical care settings: ethical issues concerning consent. We will show that in most instances, the morally safer route is to forgo life-sustaining treatments, particularly when their likelihood to effectuate a truly beneficial outcome has become small relative to the odds of actually harming the patient. The most important value-based argument emphasized by the general public was that 'the primary task of health care is to save lives'. A few respondents identified two arguments as being the most important when they were asked to prioritize them; in such cases, both arguments were identified as being most important. This equation of a patient refusal with patient decision making incompetence makes a mockery of patient autonomy and signals a return to old-fashioned paternalism.
Finally, it is interesting that neither members of the general public nor physicians considered the cost of such an operation or the age of the patient.
Exactly how much time of life can be gained through medical interventions and at what price has yet to be ascertained.
Finally, the need for the health care team to obtain consent for the continuation of the ventilation is discussed. A therapist does not need to justify why he is not offering to a patient a treatment option that is deemed futile though he may have to explain to the patient what renders this particular intervention futile.
The medical team is not in agreement on how to proceed. Such forgoing of a futile medical intervention is not tantamount to passive euthanasia but acquiescence in the mortality of human beings and the limits of medical power.
But in the absence of evidence to the contrary, it is much more reasonable to assume that health care professionals who conclude that a treatment is doing more harm than good and hence needs to be forgone, do so out of the humble acknowledgment of and acquiescence in their own limits and in the limits of modern medicine more in general.
They thus retain greater decision-making burden and power and face weaker obligations to secure consent from patients or proxies.
Dax Cowart refused further treatment of his life-threatening burns [ 3 ].
based on 108 review