Introduction
When a family has to decide how much is too much, as Plakovic (2016) puts it during end-of-life care, there is a clear ethical dilemma that crops up for family members and care providers. That dilemma is related to the issue of how to approach end-of-life treatment. For instance, some individual have strict preferences when it comes to whether or not they want to be resuscitated or kept alive by a machine. Others have no instructions set aside before hand for care providers and family to go by. The ethical dilemma is complicated by the fact that care providers have an oath to care for all life—but at the end-of-the-life, what is the line between postponing the inevitable inhumanely and giving as much humane care as is possible? That blurred line is a complicated one to walk. The two major points that this paper will address when it comes to end-of-life care and the “do not resuscitate” (DNR) clause are related to the principles of nonmaleficence and autonomy and the ethical theory that is discussed in relation to this issue is deontology, also known as duty ethics.
What is the Ethical Dilemma?
The ethical dilemma associated with end-of-life care and the DNR clause is whether life of a patient should be prolonged just because it is mechanically possible to prolong it even though there is no hope for improvement and there will be an extremely low quality of life—basically the person will be unresponsive or in a terminal state. Should the care provider continue to recommend that the life of the patient be prolonged? What should the care provider advise to the patient’s family? How should the issue of DNR be approached?
As the example of Mary attempting to ensure that the best care is provided to her father CJ, who the health care team believe is in a terminal state, shows the complexity of the ethical situations (Plakovic, 2016). On the one hand, it is understandable that the daughter wants to see her father get better; on the other, it is understandable that the son sees the writing on the wall and does not want to prolong the father’s suffering unnecessarily. Yet the health care providers have to respect the family’s wishes and in the case of conflict, with the son bowing out and the daughter taking charge, the health care providers have to continue to provide care even though—as the case shows—the patient would be dead in a matter of days no matter what. Sometimes it is difficult to communicate that reality to the patient. Emotions cloud reason, and loved ones do not want to say goodbye without first attempting to do all they can do to see if the loved one improves. As Yuen, Reid and Fetters (2011) explain, even in cases where there are DNR orders (as in Mary’s father’s case) there are still ethical issues—because it is not always a clear case of the patient needing resuscitation. Weissman (1999) notes that DNR orders are in need of reform because there is no clear way to navigate the subject—or, as one of the participants in Weissman’s (1999) study...…Society I am Currently Living In
In my society, assisted suicide is still not accepted as a moral solution, so I am in the majority in the sense that I believe it to be immoral. However, in terms of DNR and end of life care much of society is still confused about the issue and so there is a lot of uncertainty regarding what it means to advise a patient’s family that the end of life is near for the loved one (Garrido et al., 2015). Care for patients who are at the end of their life is not something that many people want to discuss because death is an issue for them that is unpleasant. However, it is an issue that all family members should discuss because a DNR can help to make it easier for all when that time comes.
Conclusion
The ethics involved in end of life care and how to go about addressing that situation can be complex particularly for family members who disagree about what the best course of action is in the case of a loved one not having a clear DNR on file. Care providers should try to communicate the situation to the patient’s loved ones in an effective but respectful way; however, if loved ones do not accept the reality and want to hold out hope for improvement, the care providers can continue to give treatment. It is in everyone’s best interests, however, to continue to speak to the loved ones to try to get them to see the reasons why prolonging the inevitable is…
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