Free Essay

Dna Do Not Res

In:

Submitted By johnsonlockett
Words 1720
Pages 7
Running Head: DNA

Do Not Resuscitate
Kimberly Johnson-Lockett
HCA322: Health Care Ethics & Medical Law

Instructor: Eugene Elliott

March 4, 2014

Do Not Resuscitate (DNR) orders are medical directives to withhold efforts to revive a patient who has a cardiac or respiratory arrest (Lee, M. B., M.D. 2012). DNR laws started in the late 70s because of the extensive practice of cardiopulmonary resuscitation (CPR). An unending discussion about DNR has involved the level to which patients or their surrogate have to make the decision to agree to such orders. Throughout the late 70’s and early 80s, a lot hospitals normally made DNR orders that did not including an discussion with the patient or the patient's family. Also, a lot hospitals did not clearly document the DNR order in the patient's chart. This practices were forsaken as the bioethics drive and the courts stressed the right of patients or their surrogate decision makers to decline medical treatment. This also including life insufficient treatment for example CPR. Most of health care providers, health professional groups and indorsing bodies started to support DNR policies. The DNR policies require that the patient be informed of the risks and benefits of CPR and to give consent that CPR not be used. (Lee, M. B., M.D. 2012) DNR is reflect one of the ethical dilemma in current society that came from medical development, ethical dilemmas arise in the area of health care when health care providers is in a position to choose between two or more harmful option, and a lot of time the physician are forced to deal with their value to solve ethical dilemmas. Most of health care professionals encourage DNR and try to negotiate and discuss other views built on ethical principles, they want to show consideration of autonomy, beneficence, non- maleficence, fair and justice. Also sadly these ethical values are directed to be with or not in favor for DNR depend on situation. (Lee, M.D. 2012) I will present the different views about DNR, the disagreement and counter argument, also focusing on ethical laws in order to defend human rights, and right to die or to live. Furthermore the value of autonomy, persons Do Not Resuscitate, integrity, respect and human dignity should be considered in defending the authors’ claim of agreeing DNR orders and patients wills (Torke 2011). According to Michigan State “The purpose of this policy is to provide a guideline to prehospital providers, who under certain circumstances may accommodate patients who do not wish to receive and/or may not benefit from cardiopulmonary resuscitation. This policy is drafted in accordance with Public Act 368 of 1978, as amended, as well as Act 192 and 193 of the Public Acts of 1996. This policy is intended to facilitate kind, humane, and compassionate service for patients who have executed a valid “Do-not-resuscitate order” under the aforementioned Acts (Michigan State)” DNR different from an advance directive and healthcare power of attorney, a DNR order is not a document that everyone needs. You can make DNR order before you go to the hospital if you do not want CPR or other unexpected measures that will be used on you if you collapse at home. CPR have and can save lives, but the achievement rates are not high. If the patients are seriously ill, CPR has make things worse; it can leave the patient painful injuries or brain-damaged. According to research “For one physician’s view on the ineffectiveness of CPR on patients who are old or ill typically, people consider a DNR if they have a terminal illness or are at a high risk for cardiac or respiratory arrest. In the words of the Texas law authorizing DNR orders, the document serves allow a person “to forgo resuscitation attempts and … have a natural death with peace and dignity” (Tork 2011). A pre-hospital DNR direction is usually an easy, one-page document; the patient will not need a lawyer to prepare it. Patient do need to talk to their physician, who will wittiness your signature on the DNR. In a lot states, you just need an adult witnesses or a notary public must also observe the patient sign the order. A lot of states have their own forms; and others, have the patient to just written it out. Their physician should be able to deliver the paperwork. Patient can find that a lot of states have the DNR forms online at the state health department’s website.

The patient should follow whatever laws or rules that their state enforces. If you look at Florida their DNR form have to be printed out on yellow paper. If it is not on the yellow paper it is not valid and the emergency medical department do not have to honor it. If the patient move to another state or spend considerable time there, you will need to get a DNR order that conforms with that state law (Sanderson 2013). A pre-hospital DNR order would not have any result if the emergency medical staff does not see it before they begin CPR. If patient have a DNR order they should save a copy in a noticeable place for example on the refrigerator, by your bedside, where emergency staff could look for medication lists. The patient should keep one in their purse or wallet, when patient is traveling, it should be a copy in their suitcase also they should make sure whoever they are with knows where it is. Another idea is to buy a bracelets to alert emergency medical staff that you have a DNR (Sanderson 2013). According to Children Hospital in Detroit “A patient may present to the Emergency Department with a non-institutional DNR order form. Michigan laws allows a patient to execute a DNR order in a non-institutional setting. The patient should have an identification bracelet on their wrist imprinted with the words DO NOT RESUSCITATE ORDER (Children Hospital 2010)”. While Michigan law does not grant immunity regarding compliance with a non-institutional DNR order in an institutional setting such as a hospital/operating unit, the existence of a non-institutional DNR order form and identification bracelet is evidence of the patient’s wishes. (Children Hospital 2010) A lot states now have another form, this form is called” Physician Orders for Life-Sustaining Treatment” (POLST), which is a separate pieces of a DNR and an advance directive (AD). Within a POLST, you can say your wishes about DNR and speak on the treatment issues as well. Patient can find out more about these forms if they look on your states website that they live in.
The DNR is only one of its kind in the health care that is the single decision that has to be made previously before the incident has occurred. Without a DNR decision by the patient and the physician, all medical staff are obligatory to start CPR when the patient’s heart stop even if it is clear that this is not the best choice. Consequently, the DNR decision must be pass on to at least to the staff. (Sanderson 2013) A lot people consider DNR standard based on physicians and nurses position in decrease the suffering and uphold self-respect for terminally ill patients. This depends on the patient’s morals and treatment targets; there a lot of intervention man made hydration and nutrition, defibrillation, ventilation, pace making devices, pressers, etc. can be acceptable for a time, while acute resuscitation may not use because CPR are usually produces poor results and intensify suffering. Illness and death from CPR for patients with never- ending illness are very high, while other shapes of intervention, though still risky, can ensure a better likelihood for reaching their planned outcomes (Tork 2011). DNR is the way that must be on the patient and the family can reduce the long and painful period of non-desirable benefit of treatment, also “DNR” is the way in which patient and family could reduce the long and painful time before he/she dies (Tork 2011). Based on a Michigan law passed in 1990, the “Designation of a Patient Advocate” is legally binding and is sometimes called a “Durable Power of Attorney for Health Care.” Don’t confuse the term “Durable Power of Attorney for Health Care” with the term “Durable Power of Attorney,” which relates to decisions about your financial matters. Your Patient Advocate named in your Advance Directive for Health Care cannot make any decisions about your finances, unless you choose that same person to make financial decisions on your behalf in a separate legal document. This booklet and the enclosed legal documents do not address your finances or who will have the ability to make decisions related to your money. (Children’s Hospital 2013)
In conclusion DNR policies should require that the patient understand the problems and the benefits of CPR and too give consent not to use CPR. The patient need to talk with the doctor to understand the do and don’t if they sign a DNR.

Reference
Children Hospital of Detroit, MI Retrieved on March 4, 2014 from http://www.dmc.org/
Flegel, Ken,M.D.C.M., M.Sc, & Fletcher, John, MB,B.Chir, M.P.H. (2012). Choosing when and how to die: Are we ready to perform therapeutic homicide? Canadian Medical Association.Journal, 184(11), 1227. Retrieved from http://search.proquest.com/docview/1034107107?accountid=32521
Lee, M. B., M.D. (2012). Honoring the patient and the family: When the family refuses DNR. Care Management Journals, 13(2), 63-6. Retrieved from http://search.proquest.com/docview/1020993754?accountid=32521
Michigan Government Retrieved on March 3, 2014 from http://michigan.gov/documents/mdch/Do_not_resuscitate.policy_298357_7.pdf
Sanderson, A., M.D., Zurakowski, D., PhD., & Wolfe, Joanne,M.D., M.P.H. (2013). Clinician perspectives regarding the do-not-resuscitate order. Archives of Pediatrics & Adolescent Medicine, 167(10), 954. Retrieved from http://search.proquest.com/docview/1442583194?accountid=32521
Torke, A. M., Sachs, G. A., Helft, P. R., Petronio, S., Purnell, C., Hui, S., & Callahan, C. M. (2011). Timing of do-not-resuscitate orders for hospitalized older adults who require a surrogate decision-maker. Journal of the American Geriatrics Society, 59(7), 1326-1331. doi:http://dx.doi.org/10.1111/j.1532-5415.2011.03480.x

Similar Documents

Premium Essay

Neanderthals: A Narrative Analysis

...emerging technology in analysing DNA and skeletal comparisons, there is evidence that leads to a conclusion that the Neanderthals and modern humans did in fact interbreed. The Neanderthals and modern humans appear to have co-existed until as recently as 24,000 years ago (Bonvillian and Miller...

Words: 1313 - Pages: 6

Free Essay

Cjemsitry

...579 Atomic force microscopy and other scanning probe microscopies Helen G Hansma and Lía Pietrasanta The highlight of the past year is the unfolding and refolding of the muscle protein titin in the atomic force microscope. A related highlight in the intersection between experiment and theory is a recent review of the effects of molecular forces on biochemical kinetics. Other advances in scanning probe microscopy include entropic brushes, molecular sandwiches and applications of atomic force microscopy to gene therapy. Address Department of Physics, University of California, Santa Barbara, CA 93106, USA Current Opinion in Chemical Biology 1998, 2:579–584 http://biomednet.com/elecref/1367593100200579 © Current Biology Ltd ISSN 1367-5931 Abbreviations AFM atomic force microscopy/microscope SFM scanning force microscopy/microscope SICM scanning ion conductance microscopy/microscope SPM scanning probe microscopy/microscope STM scanning tunneling microscopy/microscope A new journal, Probe Microscopy, was launched in 1997 as a forum specifically devoted to the science and technology of SPM. AFM and SFM have been also newsworthy items in Science and Nature in the past year [14••,15•–17•,18••,19]. An introduction to AFM is covered well in a recent issue of Current Opinion in Chemical Biology, which describes and illustrates the design and mode of operation of AFM [4••]. The AFM images sample surfaces by raster-scanning a sharp tip back and forth over the surface. The tip is on...

Words: 4570 - Pages: 19

Free Essay

Forensic Science

...WEEK 1- INTRODUCTION TO FORENSIC SCIENCE Quote "Every contact leaves a trace." - Edmond Locard (1877 - 1966) Learning Objective(s) At the end of this topic, you should be able to: 1. Define 'Forensic Science'; 2. Explain the limits of Forensic Science; 3. Identify the types of forensic work; 4. Describe Locard's Exchange Principle; 5. Differentiate Reconstruction & Re-enactment. Synopsis To illustrate the scope and diversity of Forensic Science, place it in its legal context, and describe the various types of forensic work. There will also be a discussion of Comparison leading to Association, Reconstruction versus Re-enactment, Locard's Exchange Principle, and the limits of Forensic Science. Various case studies will also be analysed throughout the lecture. Case Studies Felicia Lee; Walter Dinivan; Madam Jetkor Miang Singh; Roberto Calvi; Buck Ruxton & the Jigsaw Murders; Acid Bath Haigh; 2005 London Bombings; "Brides in the Bath"; Gareth Williams; The Woodchipper Murder WEEK 2- CHEMICAL ANALYSIS IN FORENSIC SCIENCE Quote "Actus non facit reum nisi mens sit rea" The act is not culpable unless the mind is also guilty. Learning Objective(s) At the end of this topic, you should be able to: 2A. Atomic Structure & Spectroscopy 1. Explain the structure of the atom and Bohr's model; 2. Differentiate between emission and absorption spectroscopy; 3. Explain the chemistry behind EDX and SEM-EDX; 4. Explain the chemistry in NAA; 2B. Molecular...

Words: 1646 - Pages: 7

Premium Essay

Dna Reproductive Process

...When the two strands of DNA double helix are separated, each can serve as a template for the replication of a new complementary strand, producing two daughter molecules each of which contains two DNA strands with an antiparallel orientation. The enzymes involved in DNA replication process are template-directed polymerases that can synthesize the complementary sequence of each strand with extraordinary fidelity. This complex leads to the local denaturation and unwinding of an adjacent A + T rich region of DNA. The interaction of proteins with the origin is what defines the start site of replication and provides a short region of single stranded DNA essential to initiation of synthesis of the nascent DNA strand. Then helicase binds and allows for processive unwinding of double stranded DNA into single stranded DNA. As helicase unwinds the DNA, DNA single stranded protiens bind and stabilize the single stranded DNA. The polymerase III holoenzyme binds to template DNA as a part of a multi protein complex that consists of several polymerase accessory factors. DNA polymerase synthesizes DNA only in the 5 ' to 3 ' direction and only one of the several different types of polymerases is involved at the replication fork. As the DNA strands are anti parallel, the DNA polymerase functions asymmetrically. On the leading (forward) strand, the DNA is synthesized continuously. On the lagging strand (retro strand) the DNA is synthesized in short (1-5 kb) fragments. These DNA fragments are called...

Words: 1062 - Pages: 5

Premium Essay

Use Of Technology In Michael Crichton's Jurassic Park

...discusses how a man used technology wrong to create a park full of dinosaurs for money. The reason why relying on technology posed serious dangerous issues was because of the fact the power to create the dinosaurs was not understood and ultimately the park organizers knew nothing about the creatures they created until it was too late and people’s lives were in danger and deaths resulted. This can be seen through three direct examples in the novel, one being the electrical fences which stopped working due to a power outage and the T-Rex’s got out putting people’s lives in danger and killing others, second being by which the computers were used to track data but tracked the wrong data instead, and finally genetic engineering which used frog DNA making the animals able to change sex and...

Words: 924 - Pages: 4

Premium Essay

Case 22.15 Cj Capstone Project

...Confidence will grow in the lab with certification as well. Once a lab is deemed certified, it must continue to demonstrate quality and adaptability to remain certified. If not, or if the lab suffers any setback or does not abide by the bylaws of the ASCLD, revocation of the certification will occur. Labs that want to be certified should also draft a memo, or justification letter, to the ASCLD and to its management for becoming certified. The memo should state all reasons why the lab is wanting certification, the program it specializes in (type of lab, in other words) and why certification would help the lab. All labs also need testing requirements, such as testing for DNA, using the principles of ASCLD. All labs deal with biological matter, so there has to be safety standards set in order to protect workers from exposure. A good example of this is if someone was exposed to blood collected form a scene or evidence, or a victim. OSHA sets standards and regulations that must be followed, so labs need to have policies in place, and visible to all employees. There are examples of all such a memos...

Words: 1438 - Pages: 6

Free Essay

How Has Our Knowledge of Dna Improved the Study of Criminal Forensics?

...How has our knowledge of DNA improved the study of criminal forensics? Introduction Through genetics, the study of DNA, we are able to figure out what and how genes are responsible for many things like our hair color or why do some people look a lot like their parents and others don’t. It also allows us to understand better how species evolve and how are they related to each other. It is important to understand how DNA mutates, changes and replicates in order to get information about what mechanisms cause DNA to change. In the 1970s scientists developed a DNA sequencing technique and other methods to manipulate and analyze DNA. This gave them the basic tools to start exploring the DNA blueprint which provided the techniques for a vast international project called The Human Genome Project (MRC). The Human Genome Project which was a major international project with the goal of decoding all our genetic information by 2003. A rough draft was done in June 2003 and it was a huge milestone that helped us understand how our genes can determine who we are (Genome Project). Many of today’s advances in DNA and biotechnology allow scientists and medical doctors to potentially cure genetic disorders through gene therapy by inserting, deleting or manipulating genes (Tillery, page 686). Another use of DNA technology is the creation of mutation by transferring DNA from one organism to another through techniques like cloning and introducing new DNA sequence into an organism to alter...

Words: 1437 - Pages: 6

Premium Essay

How Do Transgenic Organisms Work

...altered by the insertion of a modified gene or a gene from another organism using the techniques of genetic engineering. Explain how transgenic organisms work. What is the process? A flowchart is helpful: The genes of one species are modified, or transplanted into another organism. Transgenic Organisms are possible due to recombinant DNA technology (the procedure used to combine DNA segments) . This technology gives scientist the ability to practically cut, paste and copy molecules of DNA. This allows scientists to remove the gene from one organism and place it into another organism, giving it a trait encoded into that gene. Plants are commonly used in these experiments, the flowchart shows this process. The steps in the process are: The plasma is removed from bacterium, and the T-DNA is cut by a restriction enzyme Foreign DNA is cut by the same enzyme The foreign DNA is inserted into the T-DNA of the plasmid...

Words: 994 - Pages: 4

Premium Essay

Regulating DNA Evidence

...‘unofficially’ regulate DNA analysis and force ‘private companies to adopt its technological system’” (Edmond 130). These debates in the courtroom have led to regulations that are in place to ensure the proper gathering and testing of DNA evidence so that only accurate evidence is admitted in court. Suspects have a right to a fair trial and following the DNA wars, fair trials include correct evidence to be presented otherwise they may be acquitted or a mistrial may be declared. One of the factors to ensuring correct evidence is a process known as the chain of custody. The chain of custody, if followed properly, keeps track of continuity of possession. Evidence must be correctly...

Words: 1602 - Pages: 7

Premium Essay

Summer Research Report

...week. These were later used by the majority of lab students who had reached the cloning stage. My first PCR with plasmid pgbr22 failed, but the second was successful. PCR with pmCherry had to be completed 3 times to get a successful result and PNIC-BSa4 PCR had to be completed twice to get a successful result. The three practice PCRs were completed the 5th week of lab. Protein expression using PfDXR was started in week 3 and the sample of protein was purified the following week. I received my target protein Rickettsia prowazskii FabG (RpFabG), responsible for epidemic typhus, during week 5 of research. I worked on designing tail primers for this specific protein with two other researchers in my group that also had the same target. A virtual RE Digest gel was also done with PNiCBSa4 accepting vector and Fab G 3-ketoacyl-ACP reductase insert to help visualize and understand the next steps for our research. Primary PCR was completed with an oligo primer mix for RpFabG, followed by Secondary PCR and PCR2. The sample was nano-dropped after PCR2 to determine that the concentration was high. My first attempt had a concentration average of 9.4ng/uL, so I had to restart and complete primary PCR twice before being able to move onto secondary PCR. The primary and secondary PCR gels showed that the concentration was weak so I made a second oligo-mix after consulting with Dr. B. I completed primary and secondary PCR once again with both the old and new oligo-mixes. With the old oligo-mix, primary...

Words: 794 - Pages: 4

Premium Essay

Ethical Dilemmas Of Cloning Research Paper

...blastomere into an enucleated oocyte to produce an offspring, which gave them suspicion of cloning in 1987 (Prather, 2016). The history of cloning gives rise to our ethical and moral guards about the issue of the use of stem cells or adult cells to proliferate and make another organism. The first mammal to be cloned using an adult mammary gland cell are two lambs at Roslin Institute in Scotland, a year later Dolly the sheep is cloned. The premise of the procedure included removing the nucleus from a somatic cell of the animal to be cloned, transfer it into a hosts de-enucleated, unfertilized egg cell (oocyte), and then implant the re-nucleated embryonic cell in the womb of the chosen surrogate mother (Ogden, 2014). Another technique that can be used is genetic engineering, using incomplete DNA sequences extracted from the specimen, and insert the DNA fragments from close living relatives or from those manufactured synthetically (Ogden, 2014). Using one’s cells to multiply another organism takes away a lot from that individual and raises many ethical concerns ranging from autonomy, informed consent, and individuality. In order to protect the welfare of the human population there is current legislation in place for consumable cloned food, but cloned extinct species there are many uncertainties. One example includes: pre-market approval of the cloned product under the scope of regulation number 258/97 (Vaque, 2014). Regulation is being placed upon consumable products, so it is only...

Words: 2296 - Pages: 10

Free Essay

Molecular Genetics

...Electrophoresis for the Separation of DNA Fragments Pei Yun Lee, John Costumbrado, Chih-Yuan Hsu, Yong Hoon Kim Department of Molecular, Cell, and Developmental Biology, University of California Los Angeles Video Article Chapters 0:05 Title 1:31 Preparation of the Gel 3:21 Setting up Gel Apparatus and Separating DNA Fragments 4:55 Observing Separated DNA Fragments 5:43 Results: Agarose Gel Electrophoresis of PCR Products 6:23 Conclusion Cite this Article Lee, P. Y., Costumbrado, J., Hsu, C. Y., Kim, Y. H. Agarose Gel Electrophoresis for the Separation of DNA Fragments. J. Vis. Exp. (62), e3923, doi:10.3791/3923 (2012). Abstract Agarose gel electrophoresis is the most effective way of separating DNA fragments of varying sizes ranging from 100 bp to 25 kb1. Agarose is isolated from the seaweed genera Gelidium and Gracilaria, and consists of repeated agarobiose (L- and D-galactose) subunits2. During gelation, agarose polymers associate non-covalently and form a network of bundles whose pore sizes determine a gel's molecular sieving properties. The use of agarose gel electrophoresis revolutionized the separation of DNA. Prior to the adoption of agarose gels, DNA was primarily separated using sucrose density gradient centrifugation, which only provided an approximation of size. To separate DNA using agarose gel electrophoresis, the DNA is loaded into pre-cast wells in the gel and a current applied. The phosphate backbone of the DNA (and RNA) molecule is negatively...

Words: 2118 - Pages: 9

Free Essay

Dna Overturned

...Tommie Brown Grand Canyon University The History of Criminal Investigations DNA Overturned June 29, 2016 Many cases have been solved with good investigation work and the technology of DNA. As a result of this technology many convicted criminals have been released due to DNA overturned in their cases. This was true in the case of Anthony Capozzi who spent 22 years in prison for a crime he did not commit (innocenceproject.org). In the mid-1980s Capozzi was wrongfully convicted of committing two sexual assaults in Buffalo, New York. It was DNA testing that proved his innocence (innocenceproject.org). The true perpetrator’s identity was revealed and DNA testing also revealed that this criminal committed multiple rapes and murders. The crimes itself consist of several women being raped along the bike path in Delaware Park. The crimes took place around December of 1983 and July of 1984. The attacker had it all planned out as he would wait for the right moment then move in for the attack. The attacker apparently surprised his victims from behind by threatening them with a gun. Once the victim was at his mercy he went on to rape them and when finished he gave them instructions to remain on the ground for up to 20 minutes before they move (innocenceproject.org)...

Words: 1161 - Pages: 5

Premium Essay

Gattaca Film Analysis

...the Gattaca movie produced in a 1997, many futuristic technologies regarding that time has been shown. Now is 20 years past the time that the movie was initially released and we are using some concept technologies used in the movies such as electric cars. One of the futuristic technologies showed in the movie was the rapid identification of people from their genetics. The question is have we discovered a method to identify a person from his DNA as shown in the movie? In the movie, each time the main character, Vincent, was entering the Gattaca facility, he was going through some processes for his identity verification. They were gates that required the people to place his finger on the designated pad to verify the identity. The device identified the person using the blood droplet taken from...

Words: 753 - Pages: 4

Premium Essay

Database Theories

...Modern Database Applications | [Type the document title] | | | Contents 1. Gray, J. (2009). Jim Gray on eScience: A transformed scientific method. The Fourth Paradigm: Data-intensive scientific discovery 2 2. Rowley, J. (2007). Wisdom hierarchy: Representations of the DIKW hierarchy. Journal of Information Science 3 3. Goldman, N. (2013). Towards practical, high-capacity, low-maintenance information storage in synthesized DNA. 4 4. Gray, J. (1981). The transaction concept: virtues and limitations. In: VLDB '81: Proceedings of the seventh international conference on Very Large Data Bases 5 5. Codd, E. F. (1970). A Relational Model of Data for Large Shared Data Banks. Communications of the ACM 7 6. Chen, P. (1976). The entity-relationship model: Toward a unified view of data. ACM Transactions on Database Systems 8 1. Gray, J. (2009). Jim Gray on eScience: A transformed scientific method. The Fourth Paradigm: Data-intensive scientific discovery Gray states that there is need to distinguish data-intensive science from computational science; he defines an emerging fourth paradigm for scientific exploration. This paradigm is derived from the deluge of data being produced within scientific research fields, and the necessity for tools which can be utilised within the whole research cycle; data capture, curation, analysis and visualisation. He identified that currently the data being produced is not being organised, or published in a systematic...

Words: 3050 - Pages: 13