Annotated Bibliography
Jerika McNealy
HCA 322
Instructor Linda Hoppe
June 18, 2015
Gupta, D. (2015). Origin, Maintenance and Future of Do-Not-Resuscitate (DNR). Indian Journal Of Palliative Care, 21(1), 8-9. doi:10.4103/0973-1075.150150 This source provides a brief description of how do-not-resuscitate came about, how it is maintained in the health care industry, and also its future in this industry. The author, Deepak Gupta, discusses how the quality of life overrules the quantity of life in today’s time because of the much advancement in technology. He also includes details of how, in the past, interventions were being used to resuscitate dying and patients. Deepak Gupta explains the necessity of having do-not-resuscitate policies
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(2000). The do-not-resuscitate decision: the context, process, and consequences of DNR orders. Death Studies, 24(4), 307-323. This article presents a study done to look at the DNR process and the consequences of it. It focuses mainly on the process and timing of the DNR decision, and also the impact of the DNR order. The conclusion at the end of the study was that there were differences discovered between the patients with a written DNR and the patients that were not-coded successfully. In the article, it also discusses how providers discussed the DNR decision with the patient on a consistent basis, and thus were able to make a decision early on in the process.
Tsang, J. C. (2010). The DNR Order: What Does it Mean?. Clinical Medicine Insights: Circulatory, Respiratory & Pulmonary Medicine, (4), 15-23. This article discusses what an actual DNR order is and what it means. The article emphasizes the importance of communicating and having a DNR discussion with the patient. The article also presents questions that should arise when having the DNR conversation with patients and also explains the strengths and weaknesses of the DNR order. It provides solutions as to possibly changing the pattern of practice by updating and/or establishing ethical committees and palliative
Atul Gawande’s book, “Being Mortal: Medicine and What Matters in the End,” explores different themes such as, aging, death, and the mishandling of both aging and death by the medical profession’s. This book also addresses what it means to live well near the end of life. It is not just to survive, not just to be safe, not just to stay alive as long as the medical technology allows, but, according to the author it is about what living truly means to an individual. The author describes that the idea of “Being Mortal” developed as he watched his elderly father go through a steep decline in his health and the eventual death. He soon realized that during his medical education and training he was never taught how to help his patients with managing
When a patient is at the end of life it is very important to value the patients self dignity and their decisions at the mere end of their lives. The end of life care is to relieve the weight of the patient 's shoulders physically and mentally. I approve of end of life caring. Basic end of life care is summarized by improving the care of quality of life and dignity of the ill person. The important themes to good ethics of end of life care is a combination of human rights,respect,dignified care,and privacy.
In Not Just a Death, a System Failure, author Barbara Morgan criticized the US health care system’s lack of palliative care, painful treatments, and unwillingness to face the end-of-life decision, which leads to many patients suffering the last part of their lives in discomfort. The author centers her argument on the anecdote about the dying of her late mother, who spent several months in the discomfort of intensive care until the time of her death. Moran’s point is one part valid since the treatments for serious diseases are dangerous, painful, and many times only focus on prolonging life rather than improving life. However, she neglected the fact that these treatments are optional, and patients are always open to spending the last part of their life away from the hospital. Treatments for serious diseases are known to have many side effects that deteriorate patents’ health.
“The cessation of the employment of extraordinary means to prolong the life of the body when there is irrefutable evidence that biological death is imminent is the decision of the
In the next paragraph, professor Sharon Ruston goes on to provide evidence for her thesis. And so the author tells the story of two doctors who advocate for the idea that to resuscitate a body considered dead is indeed possible. This scientific basis provides enormous credibility to the thesis supported by Ruston. These two doctors set
These protocols are to be met to provide patient comfort and avoid disaster. The Death
It brought to my awareness both the limitation and the capacity of medicine. Although there was no medical intervention that could cure the diseases of those terminal patients, their quality of life was improved by an outstanding team of doctors, nurses and volunteers. This awareness helped reconcile myself to the fact that certain things, such as death and terminal illness, can not be avoided or changed. By viewing death as a natural part of life, I will be able to offer my dying patients the best care possible while also understanding my limitation as a physician and a human being.
An Integrative Review. JAN Journal of Advanced Nursing, 1744. Karlsson, M. B.-F. (2015). A Qualitative Metasynthesis From Nurses’ Perspective When Dealing With Ethical Dilemmas and Ethical Problems in End-of-Life Care. International Journal for Human Caring, 40-48.
Atul Gawanda is an Author and a surgeon who tackles the toughest part of his profession on aging and dying. He argues that most Doctor’s lack the ability to provide hospice care for their terminally ill patient but instead use medication to comfort them. Doctors are only taught how to save lives but omit the vital part of giving hope to their fatal patient to make their last phase of life a meaningful one. We are often faced with situations, where when we are in our most vulnerable state of health and we go see a Doctor and all he cares about is diagnosing us and finding the right medication to cure us. But does not give us the autonomy to articulate what matters most in our life, to facilitate our healing process and make us feel better about
Relevant legal and ethical considerations, focusing on the 4 main ethical principles and how each of these apply to this case using research evidence. Focusing on the ethical theory of Beauchamp and Childress, it is considered one of the most fundamental elements for beginning a discussion in the Not for resuscitation (NFR) debate. (Fornari, 2015). The four main ethical principles, autonomy, non-maleficence, beneficence and justice hold the grounding block for issues of this nature. End of life care is an imperative characteristic of acute stroke nursing, as stroke mortality rates remain high, regardless of enhancements in the health care industry.
However, what families do not realize is that this declaration of death opens the door to helping countless numbers of current and future patients through things such as organ donation and scientific research as well as offering the loved ones and the patient themselves something equally as important: closure. Yet, they have their own reasons to keep them alive such as not being to let go, religious reasons, or a strong hope for a full recovery. For this research paper, I plan to determine how different understandings of death, specifically brain death, affect the end of life decisions. (add more: defining death: when physicians and families differ) The Uniform Declaration of Death Act or the UDDA was put in place in 1981 after winning approval from both the American Medical Association and the American Bar Association to be used as a guideline for states to follow suit and to limit the ongoing debate about what it means to die. Since healthcare is a state by state basis, states have the right to decide what they believe constitutes death for the people of their state.
Assisted suicide is a rather controversial issue in contemporary society. When a terminally ill patient formally requests to be euthanized by a board certified physician, an ethical dilemma arises. Can someone ethically end the life of another human being, even if the patient will die in less than six months? Unlike traditional suicide, euthanasia included multiple individuals including the patient, doctor, and witnesses, where each party involved has a set of legal responsibilities. In order to understand this quandary and eventually reach a conclusion, each party involved must have their responsibilities analyzed and the underlying guidelines of moral ethics must be investigated.
Also, death can be diagnosed using this type of information that considers whether it is cardio-respiratory or neurological. For example, if a person is said to be dead, the health care staff does not have to be worried about the patient’s family convicting the health care professional of committing homicide, only if they provided acceptable medical assistance. Given these facts, it is difficult to set apart heart lung cadavers and brain dead cadavers because both deal with the same concept of a dead body part being used and there are also various legal issues with this situation. To provide a better outlook on the concept of death was put together by the National Conference of Commissioners of Uniform State Laws in which they said, “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead”. This definition is very relatable to both Professor Iltis’s and Professor Cherry’s definition.
request it. Support for the concept of euthanasia by lethal injection came from the growing perception that people were living longer and more and more were dying lingering deaths, as well as the publicity surrounding the increasing medical use of subcutaneous injections with syringes for the relief of pain. Th en, in the post–World War II era, the accepted defi nition of euthanasia broadened to include the withdrawal of life-prolonging medical treatment for dying adults or infants with severe defects, or physician-assisted suicide (PAS)—the act of providing a terminally ill patient with the drugs to kill himself or herself. Th ese changes refl ected sweeping shift s in personal values, as well as a host of demographic, scientifi c, medical,
They form a legal document of your preference in treatment in case of injury, and you fall incapacitated so that your loved ones, family members as well as doctors know the right procedure they are legally bound to do. DNR order gives an alert to emergency personnel that in the event of a medical emergency, your choice is not to receive a CPR (Cardiopulmonary resuscitation). The regulation is for critically ill patients who not wish to prolong life during treatment when they are close to death (California Healthcare, 2017). Euthanasia, sometimes called mercy killing, involves taking someone’s life in an event he/she no longer has an interest in living. This arises in cases of terminal illness or other conditions that are debilitating.