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PHI FPX 3200 Assessment 3 Should We Withhold Life Support? The Mr. Martinez Case

Name 

Capella University 

PHI FPX 3200 

Prof. Name 

November, 2024

Should We Withhold Life Support? The Mr. Martinez Case

The termination of life support is an ethically charged issue and one which has very heavy emotional connotations. Autonomy is a principle where a patient is free to decide on his or her healthcare. At the same time, beneficence means that healthcare workers should act in the best interest of their patient, nonmaleficence means do no harm to the patient, and lastly, justice should be kept into consideration while considering not to prolong the life of the patient by using the life support gadgets (Cohen et al., 2020).

Mr. Martinez’s Case Description

It has also become evident to the client that Mr. Martinez is suffering from Chronic Obstructive Pulmonary Disease or disease COPD. He realized that his illness could not be cured, there was no hope for it to be treated with medical assistance and that is why he refused to use life support measures such as CPR. He and his wife both filled out a “Do Not Resuscitate” (DNR) form acknowledging the fact that he did not want any life-preserving measures if it was evident that his health would worsen. From an ethical point of view, this decision is very complex First of all, applying the theory of autonomy, Martinez has all the right to decide for him deeply about his health conditions. The caregivers must bow to this demand of the patient and give him the care that he is seeking.

Moral Issues Associated with Limiting Life Support

The possibility to refuse life-sustaining treatment has raised serious ethical dilemmas that put millions of people against their conscience. The precaution of life support is not futile since the supporters of life support assert that it would be ethically wrong to kill a patient whilst on the other hand the opponents also argue that to drag a patient’s suffering out for an undesired long time against their wish is equally immoral. Healthcare givers and caregivers working in health facilities are left to approximate many moral and ethical issues involving the use of life-sustaining technology. Such questions include: respect for patients’ autonomy and their freedom to choose their treatment; nonmaleficence; optimizing benefits and minimizing harm; and distributive justice considering the effects left on families and loved ones (Minello et al., 2019).

Such a concept means the right of the patients to make decisions concerning their treatment and a right to reject any treatment that they do not wish to take. This principle is especially essential considering that end-of-life care is an emotionally charged area of practice. One of the ways that healthcare practitioners are expected to approach patients is by honoring the patient’s autonomy and all the decisions they make (Minello et al., 2019). This is a consequence of the ethical principles of beneficence and nonmaleficence which entail the need for the health worker to act in the patient’s best interest without causing harm to the patient.

This means that assistance in life-sustaining activities should be restricted, especially where such assistance is generating significant pain and distress. The accountant also needs to look into the risk of violating the principle of distributive justice when prying on limiting life support. This principle states that care, treatment, and other facilities’ services should be provided to a person based on some rational criteria of needs and not discriminative to them. Such a decision may be very daunting for healthcare officials especially when resources are scarce (Soar et al., 2019). When it comes to rationing and especially where decisions have to be made on when to withdraw, discontinue, or withhold life-sustaining measures these need to be made in congruence with these available resources.

Assumptions

The discussion of end-of-life care is made under the following assumptions that inform the provision of care delivery. The first consideration is the ethical dilemma; for the patients, it is unethical to decide on the end of their life but on the other hand, the healthcare providers need to honor the patient’s wishes according to the Patient’s right to autonomy. This idea holds that all humans have an inherent right of autonomy when it comes to healthcare especially the right, or the ability, to decide how they will be treated particularly when they are near their death (Flammer et al., 2020). Also, healthcare providers are obliged to provide care that is good for the particular person, also known as nonmaleficence – not harm. When providers and caregivers understand and follow these assumptions caring for clients and their families can be improved.

Ethical Principles When Considering Limiting Life Support

One of which is the difficult question of what is referred to as the limitation of ‘life support,’ The ethics of this matter requires the navigation of several ethical principles. Thus, ethical considerations are most important when it comes to the following ethical principles. Autonomy as a right in health care means recognizing the patient’s right to make choices regarding his or her health. In doing so, it is for the benefit of patients, and nurses should ask themselves whether the patients would benefit from any form of treatment that is to be continued or their suffering will be extended (Stein & Song, 2021). Nonmaleficence tied the health care providers with directives that the patients ought not to be further harmed, and in the care delivery, they should consider the possible losses and gains for continued treatment. Finally, justice has it that healthcare resources must be provided to the correct destinations in the right proportions. In the end, the choice to be made should be reasonable and allow for the best quality patient care which is probable, legal, and ethical.

Real-World Consequences of Ignoring Ethical Principles

 Ethical principles come as a framework of ethical-moral guidelines by which right and appropriate choice is made for the overall welfare of the patient. This is especially important in palliative care scenarios whereby clinicians are hard-pressed to decide when or if to resuscitate a client, feed him/her, or even communicate with the patient who is nearing the end of his/her life (Zhang & Min, 2021). The implications of unethical actions in these scenarios are dire and go way beyond the standards and rules keeping in mind. Because the principle of respect for autonomy is violated, patients may undergo treatments that can be against their beliefs and feelings which lead to emotional suffering which is a violation of the patient’s human rights. This can cause the breakdown of patient-physician rapport, and patient and family participation in decision-making, therefore complicating the end-of-life treatment process (Rezaei Aghdam et al., 2019). 

A clear consequence of failing to observe the principle of beneficence is that patients who are receiving treatments that are of little or no benefit will suffer needlessly. Nonmaleficence is also important in end-of-life situations because in any end-of-life situation, the patients are vulnerable to risks of complications, and mistakes among others if enough precaution is not undertaken (Zhang & Min, 2021). Last but not least, communitarian justice may allow for unjust treatment by those with power in a society where there are socially and economically disadvantaged societies or the elimination of this principle may lock in place hard-to-alter adverse prejudices within the society against any community thereby causing suffering to the vulnerable. 

Important Considerations when Contemplating Limiting Life Support

Thus, thinking of restricting life support is not an easy and unbiassed decision and several important points have to be taken into consideration. In this connection, the practitioner is in a dilemma of accommodating patient’s preferences, as well as needs, on the one hand, and an independent assessment based on medical factors and professional standards, on the other hand. The do not resuscitate order from the Martinez case has the following critical factors to contemplate; The subjects that have been selected are as follows; The first consideration is The freedom of the individual or the patient in healthcare matters, as postulated by healthcare workers (Ghiggia et al., 2021) Second, healthcare workers need to respect the individual’s rights and self-governance on matters regarding their health. Here, Mr. Martinez’s decision not to undergo any life-supporting measures was well-informed and the life-sustaining treatment was refused under a duly executed Do Not Resuscitate order therefore he has the right. 

Second, attending physicians should consult the patient’s medical condition when they think about withdrawal of life-sustaining treatment. Mr. Martinez was diagnosed with COPD and the doctor pointed out that his condition will not change and hence the life-sustaining treatments may not be availing. Thirdly, patient’s preferences and the quality of life they would experience if their life support is limited. Mr. As to why Martinez did not use any life support measures, this could be because he would not want to live a life being on a mechanical body. Measurable activities emerging from the healthcare-providing side are needed to ensure that in any process of working, the activities to be taken will further the patient’s goals and support in terms of health.

 The signed DNR order also shows that Mr. Martinez made the decision voluntarily and with adequate information and he also has the right not to take treatment. It is also crucial for healthcare providers to follow the legal and ethical standards provided to the patients at their time of death. Thus, believing these critical measures, that is, caring, empathy, respect to the patient values, healthcare providers are likely to give the patient a compassionate and dignified treatment (Blomberg et al., 2019). 

Recommendation for Decision-Making

The recommendations involve that the decision on whether or not to withdraw or withhold life support should be made dependent upon the likely prognosis of the patient. Furthermore, the clinician should take the initiative to add some suggestions that correspond with the principle of the patients, regarding the extent of life support that is to be given (Rababa, 2020). This would keep the individual’s self-governance subjected to interventions that would not otherwise benefit him or her in the management of the disease in question.

PHI FPX 3200 Assessment 3 Conclusion

To summarize, the decision of whether to withdraw or restrict life support is a multifaceted moral dilemma that needs further analysis. Mr Martinez’s case shows that a patient’s right to accept or reject treatment with or without rational reasons must be respected together with the principles of rescue, do not harm, and fair distribution of ventilators as principles of beneficence, nonmaleficence, and justice respectively. Healthcare antecedents face a dilemma of whether to withdraw or withhold the life-prolonging treatment and whether or not it will harm the patient’s health and quality of life. In the end, it should be possible to arrive at an ethically acceptable action that is reasonable and that advances the patient’s values and goals. 

PHI FPX 3200 Assessment 3 References

Blomberg, A.-C., Bisholt, B., & Lindwall, L. (2019). Value conflicts in perioperative practice. Nursing Ethics, 26(7-8), 2213–2224. https://doi.org/10.1177/0969733018798169 

Cohen, I. G., Crespo, A. M., & White, D. B. (2020). Potential legal liability for withdrawing or withholding ventilators during COVID-19. JAMA. https://doi.org/10.1001/jama.2020.5442 

Flammer, E., Frank, U., & Steinert, T. (2020). Freedom restrictive coercive measures in forensic psychiatry. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00146

Minello, C., George, B., Allano, G., Maindet, C., Burnod, A., & Lemaire, A. (2019). Assessing cancer pain: The first step toward improving patients’ quality of life. Supportive Care in Cancer, 27(8), 3095–3104. https://doi.org/10.1007/s00520-019-04825-x 

Rezaei Aghdam, A., Watson, J., Cliff, C., & Miah, S. J. (2019). Improving theoretical understanding towards patient-driven healthcare innovation: Online value co-creation perspective: A systematic review (preprint). Journal of Medical Internet Research. https://doi.org/10.2196/16324 

Soar, J., Maconochie, I., Wyckoff, M. H., Olasveengen, T. M., Singletary, E. M., Greif, R., Aickin, R., Bhanji, F., Donnino, M. Bendall, J., Berg, K. M., Berry, D. C., Bigham, B. L., & Bingham, R. (2019). 2019 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations: Circulation, 140(24), e826–e880. https://doi.org/10.1161/CIR.0000000000000734 

Stein, E., & Song, S. J. (2021). Ethical challenges of nonmaleficence in mental health care for forcibly displaced children and adolescents. Global Mental Health Ethics, 225–244. https://doi.org/10.1007/978-3-030-66296-7_14 

Zhang, Z., & Min, X. (2020). The ethical dilemma of truth-telling in healthcare in China. Journal of Bioethical Inquiry, 17. https://doi.org/10.1007/s11673-020-09979-6 

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