Ethics

Running head: ANALYSIS OF ETHICAL DILEMMA FROM CURRENT EVENTS Analysis of Ethical Dilemma from Current Events Gabriele Varley Grand Canyon University Ethical Decision Making in Health Care NRS 437V Jude Belmonte September 05, 2010 Analysis of Ethical Dilemma from Current Events When does a person have the ‘right to die’' In recent years there has been concern in the medical community regarding a person’s ability to clearly make the decision on terminating their life. In Australia, an interesting case was brought before the Supreme Court of Australia by a residential treatment facility. Mr. Rossiter (MR), a quadriplegic, was in the residential center decided he no longer wished to live. He communicated through a tracheotomy and only had limited movements. Nutrition, hydration and medications were delivered way of a percutaneous gastronomy tube (PEG). MR requested that feeding and hydration be stopped and that only medications for pain relief be given. Though he communicated to his doctors that he no longer wished to live, he did not have the ability to end his own life. The facility was faced with a dilemma, respecting MR’s right to autonomy by complying with wishes of stopping feedings and hydration which could lead to criminal prosecution. The alternative is that the facility continues to feed and hydrate MR which would then violate his right to autonomy by preventing him from making his health care decisions. The concern of a possible law suit lead to the facility bring suit against MR so that clarification of MR’s ‘right to die’ request can be determined (Mair, 2010). When determining the best course of action the patient’s wishes must be considered and be paramount. Doing so will maintain a patient’s autonomy. Also important is the Quality of life an individual will have. Should an intervention contribute to suffering rather than relieve suffering the principle of non-malefience may sway the decision maker to discontinue the feeding. In many situations feeding will not enhance the individual’s life but will only prolong it. It was also found that once artificial measures such as PEG feedings are implemented, it can be psychologically difficult to decide on their removal (Burkhart & Nathaniel, 2008). This writer’s values do not support continuing feeding or hydrating an individual that is completely unable to provide his own care. Lack of support for an individual to stop what can be considered as force feeding is not ethically acceptable to this writer. If an individual did not have disabilities and lived independently he could choose to stop eating or hydrating. Unfortunately, MR he does not have the option. As stated in the code of ethics for nurses 1.4, MR has the right to self-determination and that right should be respected and upheld (Burkhart & Nathaniel, 2008). “Patients have the moral and legal right to determine what will be done with their own person; to be given accurate, complete and understandable information ….” (Burkhart & Nathaniel, p. 496). Furthermore, this writer has utilitarian beliefs which arebbased on the rule that the “greatest good can be done for the greatest number” (Burkhart & Nathaniel, p. 388). Healthcare costs today are “skyrocketing”. Person kept alive by what can be considered as artificial means contributes to the increased cost of healthcare. The question that should be asked of society is whether technology should be imposed on someone simply because it exists, not whether they have a right to refuse it. Alternatives to MR’s situation do exist. Before any decisions are made, a process should be in place to assess MR’s mental capacity to determine if he is fit to make sound decisions regarding his health care. Since his communication skills are limited it may be difficult to determine how competent he may be. If an evaluation is not done there can be further legal consequences. Involvement of MR’s family should be implemented should he agree. Once again, as stated previously, legal consequences can arise if family is found not to support MR’s decision. Since his communication skills are limited, it may be difficult to determine how competent he may be. Information regarding the consequences of his decision should be given in terms that he understands. He may not be aware of the physiological changes he will have once he begins the process. Information is imperative to make an informed decision and to provide informed consent; therefore it must be provided. The best plan of action is to take a holistic approach to determine the best course of treatment or refusal of treatment. MR’s physical and spiritual needs must be assessed. Although MR has stated he wants to end his life, an understanding of his spiritual and cultural beliefs is necessary to provide him with support. Neglecting to address spiritual and cultural beliefs can make the process of dying even more traumatic. As stated earlier, assuring MR is mentally and psychologically fit is necessary to assure that he has complete understanding of the entire process. A medical plan of care must be made and followed to assure that MR’s wishes are carried out. All care providers must have a complete understanding of MR’s situation. Involvement of the hospital ethics committee can also be beneficial since they can provide important information to the health care team. Family, if available and allowed by MR, should be given the opportunity to participate in MR’s care. Closure is important for family members; therefore caregivers should also consider the family’s needs as part of the plan of care. In conclusion, the answer to the question does a person have the ‘right to die’' The answer is yes. Being a prisoner in one’s body could easily be described as torture to an individual. A definition of living used as an adjective is defined by MiriamWebster as “exhibiting the life or motion of nature” ( n.d.) 2010. The life that MR has is without motion could be defined as not living. References . (n.d.). In Miriam Webster Dictionary . Retrieved Sept 5, 2010, from http://www.merriam-webster.com/dictionary/living Burkhart, M. A., & Nathaniel, A. K. (2008). Ethics issues in contemporary nursing (3rd ed.). Canada: Delmar Leaning . Mair, J. (2010). Respect for autonomy; or the right to die'. Health Information Journal, 39(1), 46-50. Retrieved from Academic Search Premier database .