Oftentimes, grief can be a challenging thing to overcome as a healthcare provider. It not only stymies people from making sound decisions, but it can end up with blame focused in areas where it should not be. This is with particular regard to patient families. In the case of this 72-year-old patient, there are a number of issues in this situation that are both unethical and downright illegal, including the fact that the patient’s living will is not currently being respected.
Legal/Ethical issue 1: The legality of the living will parameters
Both the legal and ethical issues of this situation have the do with the legality of the living will. As this was a document drafted and signed by the patient when she was in sound mental condition, the contents of it should be respected, even with regard to this situation. The husband has stated that the patient never intended for the living
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Even if the next-of-kin was not a surrogate, the facility will generally turn to this person for decisions. However, the living will should be respected before the decision of the next-of-kin because it is a specific accounting of what the patient actually wanted. In this regard, the husband is extremely emotion and may not be making decisions based on the facts such as they are nor is he respecting the legality of the living will. In fact, what he is doing is attempting to interpret it, which is not the role of this decision-maker. Legally, going along with what the husband wants in the face of what the living will states is reckless; it is the very purpose of such a document. Ethically, there is a bit more of a gray area. The hospital has tried to give the husband time to reconcile his feelings of grief, but it can’t afford to continue to ignore the wishes of the patient’s living will for the husband’s grief to
If such a person, while capable, had implemented the document written living or mercy will, that will would be credible evidence of that inept person 's purpose and it would be given countless weight by the person who substitute their decision on behalf of the lethally ill
In some cultures, family members make treatment decisions on behalf of their loved-ones. Provided the patient consents to this arrangement and is assured that any questions about his/her medical care will be answered, the physician may seek consent from a family member in lieu of the patient.”
The first ethical mistake that was made was the DNR status being deflected by the team. In “ANA’s Code of Ethics for Nurses with Interpretive Statements”, it states the right to self-determination in Provision 1.4. This provision guides nurses to know that “patients have the moral and legal right to determine what will be done with and to their own person”. The role of the nurse is to be an advocate for the patients’ wishes (ANA, 2015). There should have been a push to have the DNR signed the first time the family asked for it and not deflected (Chen, 2019).
The living will protects a person’s predetermined choices relating to how their physician carries out their health care or end-of-life care in the event that they become unconscious or mentally incapable. Write your living
In some cases, a patient’s family states an opinion of the patient’s care plan before
The patient’s family is also cared for by hospice during and following the patient’s demise; however, this is not a service provided by
However, it did not go as smooth as one would hope for. We met with the patient 's family, which consisted of the son and daughter in law. After a quick assessment of the family, it was clear the son and daughter in law had the final decision.
In the documentary, Bill Moyers talks to three terminally ill patients, their families, and their doctors about the concerns with physician-assisted suicide (PAS). PAS allows a terminally ill patient to hasten an inevitable and unavoidable death through a lethal dose. The patients considered PAS in order to end their prolonged suffering. The legal role of advance directives in end of life issues allows a patient to specify how he wishes to be treated by a healthcare provider during a progressively weakened state. Advance directives may provide patients with freedom to choose end of life treatment, but moral and religious implications, the ethical battle between a physician’s duty to care and inner-conscious, and state laws pose threats to PAS.
It is extremely important that every patient has the opportunity to control the care they wish to receive in case of medical emergencies. These wishes may be addressed through legal documentation, known as advanced directives. Through the use of advanced directives patients can appoint a healthcare proxy, express their living will, and make decisions about hospice and palliative care. Advanced directives allow patients to make decisions that may be hard for their families, and their providers to make during this difficult time. “A living will spells out what types of medical treatment a person wants at the end of life if he’s unable to speak for himself ("Power of Attorney, Living Will, and Advance Directive - AARP").”
Wednesday, October 22 Reading Response 2 “Living Will” by Danielle Ofri is about an author who is a doctor who came across a patient that is suicidal. “They All Just Went Away” by Joyce Carol Oates is about a young lonely girl who finds herself attracted in entering abandoned house and is entranced by other peoples lives and what they left by. Although these stories are very different, I believe both the authors share a similar idea, but different outlooks, of how the main characters in each essay struggle to do the right thing. “Living Will” gives us a better perspective of what doctors today have to face with their jobs. The author, Danielle Ofri, came across a severely ill patient, Wilburn Reston, which really makes her think.
The ethical principle of autonomy provides for respect for the patient’s autonomy to make decisions and choices concerning their life and death. Respecting the patient’s autonomy goes against the principles of beneficence and non-maleficence. There also exists the issue of religious beliefs the patient, family, or the caretaker holds, with which the caretaker has to grapple. The caretaker thus faces issues of fidelity to patient welfare by not abandoning the patient or their family, compassionate provision of pain relief methods, and the moral precept to neither hasten death nor prolong life.
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.
The dying patient no longer has quality of life, they have lost their independence, are lonely, are forced to endure inevitable pain, are publicly humiliated, are suffering immensely, and are forced to watch their loved ones grieve because of them. It is an innate Constitutional Right to choose how to die, since we all will die. There comes a point when the poking and prodding becomes too much, when the patient wants to just die in silence in the loving arms of their
The theory fails to mention the young adult patient that is dying maybe from auto collision or other incidences that subjected them to the dying stage of their life who may not have thought of making an end of life decision. The situation that put care team in a dilemma and may delay care or prolong needed care than necessary. Ruland and Moore was derived from doctoral theory course in the accumulations of empirical knowledge, clinical practice knowledge and synthesized knowledge which did not address the lower level of educators that are still scared to talk to patients about living will or who is yet to understand how to help a patient in an acute situation with a living will. Miller, B. (2017) states that physicians and nurses report discomfort in discussing end of life care with the patient from other cultures. He further expresses that the contributing factor to their inability to talk about the end of life care is lack of knowledge among practicing nurses regarding their role in educating patients (Miller,
THE EUTHANASIA CONTROVERSY Summary Euthanasia has constantly been a heated debate amongst commentators, such as the likes of legal academics, medical practitioners and legislators for many years. Hence, the task of this essay is to discuss the different faces minted on both sides of the coin – should physicians and/or loved ones have the right to participate in active euthanasia? In order to do so, the essay will need to explore the arguments for and against legalizing euthanasia, specifically active euthanasia and subsequently provide a stand on whether or not it should be an accepted practice.