End_of_Life_Treatment_Decision_Making_in_a_Patient_Diagnosed_with_Copd

CONTEMPORARY ETHICAL AN PROFESSIONAL ISSUES IN HEALTHCARE Formative portfolio outline : Proforma A Name : S.G. Priyalatha Matriculation Number: 40135094 Outline the topic/issue that you have selected for your portfolio development (Max 200words) |End-of-Life Treatment Decision Making in a patient with COPD… who decides' Patient, Family or Healthcare Practitioner… | | | |Chronic obstructive pulmonary disease (COPD) is a chronic respiratory illness with multiple symptoms and a decline in the functional parameters| |that affects the quality of life. The uncertain nature of its prognosis makes the approach of palliative care and discussion of end of life | |issues difficult even in the advanced stage. (Choudhuri, 2012) | | | |In patients with COPD, often they get hospitalized for exacerbation. Besides the functional decline of parameters and their extreme discomfort | |in breathing, their psychosocial aspect of life is greatly impacted as well. On one hand the patient as an individual is coming to terms with | |accepting the disease process and the discussed prognosis, yet on the other, during every admission, healthcare providers instil fear and | |anxiety to patients. Physicians will bring up end of life discussion with patient and family, with the decision skewed towards conservative | |management; no intubation and mechanical ventilation. | | | |These sensitive decisions, often leaves patients and family in a dilemma and conflicting minds on if this current admission is the last. | | | |There are studies that argue the practice of introducing palliative care for COPD patients. Pinnock et al 2011 have concluded in their study | |that the current model of palliative care adapted from the traditional cancer model. They also suggest that a point of transition to palliative| |care is meaningless and impractical in COPD, a condition with no coherent story and an unanticipated end. | Provide the rationale for your selection of the topic (Max 100 words) |Healthcare has its own culture, own dynamics. The doctor-patient relationship is held by trust. Trust is one of the primary ethical issues that| |complicate the doctor-patient relationship. If the healthcare providers don't hold higher ethical standard, the trust is often challenged. The | |drive by the healthcare provider going the extra mile to lay the alternative treatment modalities for the best interest of patient and the | |family is most worshiped. | | | |In my 12 years of nursing line, I have encountered many patients diagnosed as COPD, seeking for help. My own father was diagnosed with COPD in | |2001, when he was 46 years of age. | | | |We, as the family face equal dilemma in the decision that my father has made of being influenced to make on not wanting to be actively | |resuscitated with mechanical ventilation in time of collapse. | | | |Taking this topic for my portfolio will help me understand the ethical and moral values involve in this crucial decision making. | What is your prior knowledge of/ current ideas about the ethical issues relevant to the topic' ( Max 100 words) |Healthcare setting is vulnerable with many dilemmas in decision making. This entails ethical practices that the healthcare practitioners are | |supposed to heed to. Therefore, if a case emerges to contravene the following health ethics is taken as great dilemma and require correct | |intervention from the person in charge or even the management depending with the Consequentialism and Utilitarianism theories (Crisp, 1997). | | | |The various general health ethics are as follows; | | | |Autonomy - this allows people to have the right to take control of their bodies and their decisions are respected even if the decision made is | |not of the best interest of the patient. | | | |Beneficence - this principle allows healthcare providers to do their duty well and to ensure no harm is done to others. | | | |Nonmaleficence – this enforce that healthcare providers should cause no harm to patients intentionally. | | | |Justice – this principle demands that as far as possible, all treatments offered to patients must be justified as fair. | | | |With the above definitions, I will then argue on the statement Autonomy versus Nonmaleficence | What aspects do you wish to explore i relation to the ethical issues relevant to the topic' i.e you should provide 3 learning outcomes. Using words appropriate to level 11 1. Examine the treatment modalities of Chronic Obstructive Pulmonary Disease (COPD) 2. Argue and challenge the medical ethic practices 3. Critically explore literatures to support my argument Outline your strategy for exploring the topic (e.g. Literature search, search engines, including key words that you will enter in your search) |I will explore for articles and literatures using Google Scholar to search. There are various literature search links such as PubMed Mobile, | |NIH Public Access, CMAJ, Wiley online library, BMJ, Cochrane. | | | | | |Keywords used: End of Life Decision Making, COPD, Patient’s Rights, Family’s Rights, Conflicts in Decision Making. Can the Family over right | |Patient’s Decision, Physician’s Role in Family Conference, Medical Decision Making, Palliative Care |