Autonomy and Terminal Illness
“Make Me Less Short Of Breath”

Sally was a competent 62-year-old, who called paramedics because she was becoming more short of breath. The paramedics brought Sally to emergency room because she wanted to be “less short breath.” (Section 6 of the Hippocratic Oath, right base ethics: Sally should be treated as an individual person and not as a cancer patient.) People get scared and panic when they cannot breathe. Sally has the right to informed consent in treatment decisions.
The attending physician should not sign the DNR without informing Sally. The attending physician should inform Sally that CPR is a potential treatment option, and that it entails certain benefits and risks (informed consent). CPR manually performs to maintain oxygenate blood flow to keep vital organs alive. Sally has the right to make decision about own care and the outcome of the treatment. “Sally wants to live.” I would suggest consult a pulmonologist on Sally case (Section 4 Hippocratic Oath). “A physician should act only in the patient's interest when providing medical care, which might have the effect of weakening the physical and mental condition of the patient” (World Medical Association Declaration of Helsinki). Ethical rules bind you to your duty (deontological ethics). The rights and responsibilities of the physician and the oncologist is to improve the quality of life for Sally, “make her less short of breath”, Sally should have the tharacentesis and then have the option of mechanical breathing machine to help her breathe. Some may argue why suffer more, the process of dying may be lengthen but it’s her wish.
The spouse wanted Sally to be comfortable which involve also being less short of breath. Sally who had breast cancer and now metastases to her bone and lung is having difficulty breathing. The cancer was growing in Sally lung and