...you expressed a desire to travel to Holland and participate in its physician- assisted suicide program. As your primary care doctor and oncologist for the past fifteen years I am very empathetic and very concerned not only with your physical health but your emotional health and experiences as well. Even though we have exhausted all therapeutic treatment options; I would really like for you consider hospice care here in the United States. Because I truly believe that hospice care can provide comfort and support to you, family, and friends. Hospice care is designed for those who are nearing the end of life. All care services are provided by a team of health care professionals who maximize comfort for a terminally ill patients by reducing pain and addressing physical, psychological, social and spiritual needs. To help families, hospice care also provides counseling, respite care and practical support. You are considering traveling to another country to end your life but if decide to stay here hospice gives you the option to receive this care in your home. In addition to hospice care for your consideration; the Federal Drug Administration has recently approved a new pain medication that wasn’t available before. This medication is was formulated and strictly marketed to treat pain associated with an illness' such as yours and of magnitude. The drug will be available in two weeks and it will be readily available. I have also investigated the probability of your insurance...
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...Case 1: Is It Permissible to Shut Off this Pacemaker? The following case is based on a real clinical dilemma that led to a request for an ethics consultation. Some details have been changed to preserve patient privacy. The goal of this column is to address ethical dilemmas faced by patients, families and healthcare professionals, offering careful analysis and recommendations that are consistent with biblical standards. The format and length are intended to simulate an actual consultation report that might appear in a clinical record and are not intended to be an exhaustive discussion of the issues raised. Case: Dorthea is a 69-year-old woman who was well and active until about five years ago when she developed diabetes. She was admitted to the hospital 18 months ago with recurrent fainting and was found to have an intermittent transient heart block1. She reluctantly consented to insertion of a permanent pacemaker. Three months ago her kidney function was found to be diminished to about 10% of normal, probably caused by her diabetes. It was expected that she would soon require dialysis. However, her kidney function has since improved so that dialysis will not likely be needed for some time. She has since said she would refuse dialysis even if it were needed, and she has refused treatment of her profound anemia. She did consent to a colonoscopy last month to see if she had cancer (malignant change was found in one small area, presumably cured)...
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...Physician Assisted Suicide Physician assisted suicide is a very controversial subject in today's society. Physician assisted suicide is when one voluntarily makes the decision to end life due to a terminal illness. In my opinion, physician assisted suicide is not ethical because; many people feel taking of a life is morally wrong, it shows no respect for humanity, and it takes ones dignity away. Physician assisted suicide and Euthanasia exist and neither are morally correct. Nothing about ending one's life is ethically right. An act as such would be considered an act od virtue ethics. "Virtue ethics is distinct from both utilitarianism and deontology. Rather than focusing on the consequences of the act we wish to evaluate or the rule that guides the action, we look at the character of the person performing the act."(Mosser, 2010) Each having the same outcome but still different, physician assisted suicide is when a physician gives the patient means to commit suicide but not administering it personally.Euthanasia is a lethal dosage of medicine administered by a physician. (Gula,1999a) This process is called death by mercy but some see it as murder. Death is a natural part of living. Death is something that occurs somewhere every second of the day, it should be from natural cause or accidental never should it be doctor promoted . When people become ill it is the physician they put trust in for the care they need to survive...
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...Simpson, RN Job Title: Hospice Nurse, Bayada Nursing (Oncology) Primary Questions I. What appears to be the greatest challenge facing individuals who work with grieving people? II. How do these individuals maintain their own mental health as they often are surrounded by issues revolving around death? III. How do you separate your professional duties from the personal aspects in your life? IV. As a Hospice Nurse, what are the obstacles that you are faced with while in a patients home with the family who wants privacy when they know it's their loved one end of life is near? Follow Up Questions I. In your career as a Hospice Nurse, were you in an ethical dilemma of following the physician's orders and the family asking you to do otherwise? If so, how did you handle this issue? II. How do you know when it's time to end an assignment? III. How you cope when your patient dies? Interview Summary I interviewed Michelle Simpson, an on call Oncologist Nurse who works with Bayada Nursing. She provides service to terminally patients who live at home where they receive specialized care toward the end of their life. As Michelle explained, hospice care is supposed to give the terminally ill individuals a pain free life each day with dignity. During the time she works with the patients, there is constant interaction with family members. There are heart wrenching moments when she goes into a home where there is only one care giver who...
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...Interview of a Hospice Chaplin The Duties of a Hospice Chaplin Michell McGill June 25, 2012 BSHS/302 Tami Frye Hospice Care and Hospice Counseling is a growing profession, which is being incorporated in many hospital and doctor’s offices today. Today there are many private companies who provide these services and they employ Chaplains to assist the patient and the families in making many decisions in reference to end of life wishes. There are many misconceptions as to the purpose of Hospices and the services they provide. The Hospice Chaplin can supply services such as emotional comfort, assist with reconciliation, assist with funeral/ memorial service and any other concerns the patients may have. My own misconception was a reason that I felt the need to research and find out more information. There are many ways to interview an agency, telephone calls, personal interview, and email or an investigative interview as a potential client. I choose an email interview because of the work schedule of the Chaplin and our inability to find a convient time for each of us to meet. . Interview of a Human Service Provider Person Interview (and organization) Kimberly Young-Hardin, MDiv, SCC – Providence Hospice Date of Interview Saturday June 25, 2012 Person Conducting the Interview Michell Walter McGill Hello, my name is Michell W...
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...Ethical theories serve as a significant foundation for understanding moral dilemmas that linger throughout society. Nevertheless, ethical dilemmas in the real world can become highly complex, causing the different ethical theories to disperse in interpretation. The complexity of these dilemmas is precisely exhibited in the medical world- a world that showcases the immense “grey” area of morality and ethics. In essence, the following case studies illustrate how these theories can be manipulated to either justify or condemn moral dilemmas that arise in the medical world. Case Study #1: “But, Doctor, Our Daughter Didn’t Want This!” In the state of Kansas, a married couple, Janet and Jack, experienced the merciless and brutal facet of life. The married couple was expecting a child and one day as they were driving home from an ob-gyn appointment, a distracted elderly driver ran a red light and crashed into their car. The accident resulted in the death...
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...the social work profession has embraced the challenge that comes from interaction with the dying process across multiple systems levels. A report from The Social Work in Hospice and Palliative Care Network stated the important role social work plays in end of life care: “Given the broad scope of practice and unique perspective, social workers bring to the field of palliative and end of life care, and to multidisciplinary teams their unique expertise in ethnic, cultural, and economic diversity; family dynamics; and social support networks. Their expertise in this field includes interventions for dealing with advanced chronic illness, trauma, grief, bereavement,...
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...any age is traumatic that includes nurses, physicians, for families, but caring for dying social workers, chaplains, child- children is especially challeng- life specialists, and volunteers. ing. As children and their fami- Among the ethical issues they withhold and/or withdraw medi- cal treatment, the implementa- tion of do-not-resuscitate orders, and allocation of resources. In all circumstances the key to achiev- ing the most positive outcome is to prevent ethical issues from Continued on the next page lies struggle to deal with their emotional stress, they can ben- e t from the presence of, and services provided by a trusted interdisciplinary healthcare team confront are what, when, and how much medical care a child should receive. In Katy’s...
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...Ethics Study Review 1) Write a paper (1,250-1,500 words) that describes how to use the method of ethical decision making: a) What are the dimensions of the ethical dilemma? b) What are the issues? c) Apply the four core ethical principles and the process of ethical decision making. There are many complex ethical issues that can affect patients and families in the health care setting. One of which is end of life care. Decision making in terminal care is a demanding and stressful duty for all involved that can take place in any setting in which patients die in hospitals, nursing homes, hospices, and at home. For people reaching and the end of life, continuing to suffer may appear worse than death. The suffering can be so great that the option of ending one’s life through either euthanasia or physician assisted suicide may appear to be a reasonable and merciful choice. “Euthanasia is an act where a third party, usually implied to be a physician, terminates the life of a person; either passively or actively. 14 Euthanasia is also defined as “the mercy killing of the hopelessly ill, injured or incapacitated.” (Athar, 2006). Active euthanasia requires performing some action that terminates the life of a person. An example of an active euthanasia intervention would be a situation where a physician would inject a patient with a lethal dose of a drug.14 In cases of voluntary, active euthanasia, a competent patient who wishes to avoid suffering and a slow dying process asks a...
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...years ago, and received a hip fracture. Her most recently bout was a very severe heart attack. The latest health concern came from her recent heart arrhythmia, and her heart not being able to pace itself, so a pace maker was implanted. The past 5 years have been very traumatic for Margie, and it seem as though she has lost her will to live. Her believe is that the only thing that is keeping her from “Going home” to her family in heaven is the pace maker. Mrs. Whitson is a person of faith and only wishes to stop the suffering she has to endure, considering her losses. I have spoken with the nursing home administrator, Cindy Mackin and Jane Robison. She has informed me of the conversations she has had with her doctor, a Dr.Vijay. The conversation between Cindy and Margie was quick, and dismissive. Cindy did remember that Margie can exercise her patients’ rights, under the HIPPA Act of 1996. She arranged a meeting with her doctor at the cardiology clinic. The meeting did not go well, the doctor insisted that he did not fill ethical about deactivating the pace maker, due to ethical he had. Dr. Vijay further explained to Margie, that the pacemaker is a crucial device that is sustaining her life....
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...Administrative Ethics Paper HCS 335/Ethics: Health Care and Social Responsibility June 10, 2012 Administrative Ethics Biomedical ethical issues are seen frequently in the news and are in constant scrutiny. The demand for social responsibility is high and available resources are limited. Healthcare leaders are faced with numerous administrative issues regarding patient privacy, research, confidentiality, and terminal illness. Much debate has surrounded medical spending on the terminally ill, such as the cost and allocation of resources toward end-of-life care. Choosing between prolonged life and quality of life are two seemingly difficult decisions to make. Nonetheless, it is difficult to base one’s opinion until cancer has taken over one’s life. A close look at administrative issues surrounding end-of-life care will demonstrate the impact on a population, ethical and legal implications, potential solutions to the problem, and managerial responsibilities. Impact of Ethical Issue on the Population The Northern Mariana Islands (NMI) is a part of the United States territory since its establishment of commonwealth in political union and is home to approximately 44,000 people (Central Intelligence Agency, 2012). Because of the increase in chronic diseases and lack of available resources, several residents are referred to go off the island to seek health care in Guam and Hawaii (Doty, 2012). However, the medical referral program has a crucial problem with financing...
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...popular health organization in Northern California. Sutter health as it is known today was created in 1996 through the merger of its Sacramento based organization and the Bay Area based Health care System. In part it was created due to many physicians and small clinics and hospitals needing to close their doors due to rising costs and the difficulty of health payments. Sutter Health’s organization is a vast network of health care providers ranging from family health to even transplants. As a not for profit, the monies coming in from health payments and charitable donations are in turn used back into the community. Although Sutter Health organization has many hospitals, clinics and other organizations affiliated with the Sutter name, its home office is located where it has become what it is today and that is in...
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...essay we will explore the facts on Euthanasia: Assisted Suicide, my view, the world view and its progress. Before I begin, however, let me note what I will not try to do. I will not try to show you that Physician Assisted Suicide is a fully justifiable course of action what I will do is give you facts and statistics of this rapidly growing controversial issue.. What I will show you is the compatibility to the commitment to good end-of-life care. One of the most important public policy debates today surrounds the issues of euthanasia and assisted suicide. The outcome of that debate to whether or not it should be made available will profoundly affect family relationships, interaction between doctors and patients, and concepts of basic ethical behavior. Although not accepted widespread, the thought and ease of relocation to a place where it is available is an option many people are considering. By definition Physician-Assisted Suicide is defined as a physician providing medications or other interventions to a patient with understanding that the patient intends to use them to commit suicide. In contrast to Euthanasia defined as, intentionally administering medications...
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...Advance Directives—research and discuss the legal and ethical basis for Advance Directives such as the Living Will and Durable Power of Attorney for Healthcare. Why are these documents so valuable in healthcare situations? What legal authority do these documents provide for decision making by family and/or healthcare providers? Briefly discuss a situation in which a Living Will might apply and would be of benefit to those involved. Once you have researched and discussed Advance Directives, draft a sample Living Will, indicating the type of content that should be found in such a document. Some students take this opportunity to prepare their own actual Living Will, and that certainly is encouraged. What Are Advance Directives? Advance directives are a written statement, made in advance by a legally competent adult, that appoint someone to make healthcare decisions if a person becomes incapable of making decisions and unable to communicate his or her wishes. Advance directives also provide instructions which define the type of treatment or care a person would want or not want under particular conditions. Doctors, other members of the healthcare team, family members and/or appointed “agents” use these documents to ensure that a person’s preferences are honored in a critical healthcare situation (National Hospice and Palliative Care Organization, 2008). Legal and Ethical Principles Legal Basis It is an accepted legal theory that a legitimately competent person is empowered to...
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...Purpose and Scope The purpose is to determine if actions taken by medical staff at Memorial Medical Center during Hurricane Katrina were ethical. The scope will focus on Dr. Anna Pou’s triage system and its impact on Emmett Everett, a patient at Memorial who lost his life during the events that unfolded between August 29, 2005 and September 1, 2005. Organizational Description Memorial Medical Center was built in the French Quarter of New Orleans in 1926. Due to its location, it served a diverse clientele and traditionally served as a shelter when hurricanes threatened the city. The hospital held around 2,000 people when Katrina hit on August 29th, 2005, which included more than 600 workers and 200 patients. The organization had eight...
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