...Abstract Research into trends concerning medical futility reveal that aggressive treatment at the end of life is not equating to better outcomes (Colello 2008). In fact, not only is it providing no benefit, all too often it imposes unnecessary pain and suffering. In the case of patients who lack decision making capacity and do not have an advance directive, families are often approached by nursing staff and asked “Do you want us to do everything?” or if they would prefer a Do Not Resuscitate status (DNR), meaning CPR will not be initiated if breathing or the patient’s heart were to stop. This sends a confusing message to families, that there is something worthy of offering their loved ones; when the reality is, there is nothing worthwhile left to offer. More often than not, despite a grim prognosis for the patient and the possibility of being in a persistent vegetative state (PSV), families routinely choose this option, largely because an informative conversation has never taken place as to the implications of these decisions. This is an issue which can no longer be overlooked. It is costing our nation dearly, both ethically and fiscally. As Americans, it is high time that we come to terms with our mortality and accept the reality that death awaits us all. Denial will not make it less likely to occur. As such, in an effort to promote awareness of this issue and the detrimental impact it has on patients and society as a whole, the following will define and explain the various...
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...intent to refuse care. The state ruled that they had an interest in Cruzan’s life. o Principles established the right to refuse medical treatment is a liberty interest under the 14th Amendment The state has a valid interest in protecting all life A justification for a high standard of proof in evaluating the actually intention of a persistently vegetative patient. • Cruzan used Addington precedent which established clear and convincing evidence as a constitutional minimum for decisions to discontinue nutrition and hydration. Belmont Report principles (principles of bioethics ) o Beneficence –requires that the varied risks and benefits of an intervention be weighed.; the duty to do good o Non Maleficence- duty to do no harm o Autonomy -patients are able to exercise free will and free decisions o Justice- Freedom from discrimination; fairness in distribution of medical resources Medical Futility- o The concept that medical care should be deemed futile was one of the 3 fundamental principles that Hippocrates declared for the practice of medicine: to cure, relieve suffering and refuse to treat “those who are overmastered by their disease. o The AMA Code of ethics provides that the decisions should not be based on “futility” because there is no concrete definition for futility. o A quantitative assessment (standard) would invoked futility when a 1 percent or lower of success rate exists in intervening or performing a procedure. o A qualitative assessment suggests...
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...must ensure a health care ethic that respects the role of patients in decision making about treatment choices and other aspects of their care. Hospitals must be sensitive to cultural, racial, linguistic, religious, age, gender, and other differences as well as the needs of persons with disabilities (A patient’s bill of rights, 1992). To participate effectively in decision making, patients must be encouraged to take responsibility for requesting additional information or clarification about their health status or treatment when they do not fully understand information and instructions (A patient’s bill of rights, 1992). Three ethical considerations are autonomy, duty of care and risk-benefit. Ethical questions surround the concept of medical...
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...Legal Aspects of Life Support In "Legal Aspects of Withholding and Withdrawing Life Support from Critically Ill Patients in the United States and Providing Palliative Care to Them," authors John M. Luce and Ann Alpers, present this article to increase an understanding of the legal obligation of physicians and practitioners. Studies have shown that most patients, who die in intensive care units in the United States, deaths are related to the withholding and withdrawal of life support and also the administration of palliative care. The process through which various medical interventions are withheld or removed from patients with the expectation that the patient will die of an underlying illnesses is withholding and withdrawal of life support. The prevention or treatment of pain or providing comfort during suffering in terminally ill patients is palliative care. Physicians and practitioners are bound by ethical principles of autonomy, beneficence, and nonmaleficence. This means their actions are done for the benefit of others and they must do no harm. There are laws that govern the legal aspects and requirements of these practices in which physicians and other practitioners may not be familiar. The limitations of life sustaining treatments vary from each state and are based on statutory and case law. The Fourteenth Amendment to the Constitution protects a competent person’s right to proceed with treatment which includes nutrition and hydration. The legal aspect of...
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...decision making. This paper will discuss the legal, ethical, social, and personal factors that can impact our decision making process, with the focus on two specific case studies. American Nurses Association Code of Nursing Ethics Role in Practice The American Nursing Association (ANA) has created a set of ethical standards for the profession of nursing to abide by, which is entitled the ANA Nursing Code of Ethics. The ANA Code of Ethics states that collaboration is central to the care nurses deliver and to their ethical commitment to the patient (Garity, 2005). In the end-of-life case study, the nurse (she) has an unwritten obligation to the patient; the family appears to be in conflict with how to proceed with the patient's medical treatment. The medical team has an obligation to give the family all of their options and possible outcomes. If the family remains in conflict, it would then be appropriate for her to refer the family to the Patient’s Ethics Committee. Referring the family to the committee allows the family to make the final decision of what would be the most favorable outcome for the patient. The critical thinking exercise, however has more of an individual ethical dilemma. This includes the ethical principles of justice and veracity. She should reflect on her own values to determine what is ethically and...
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...different definitions for the terms used in the discussion. Euthanasia could be defined narrowly or broadly. In the medical and legal field, when the term is used without qualification, euthanasia usually signifies “voluntary active euthanasia”. According to the Professional Code of Practice of the Medical Council of Hong Kong, euthanasia is defined as “direct intentional killing of a person as part of the medical care being offered”. Euthanasia is illegal throughout the world with the exception of Netherlands, Belgium and Luxembourg. However, in public debates and in bioethics literature, the term euthanasia often carries a broader meaning. Forgoing life-sustaining treatment (LST) is often considered as one form of euthanasia, labeled as “passive euthanasia”. Different ethicists define “passive euthanasia” differently. Some define the term as all forms of forgoing LST, while some define it as forgoing LST with the intention to shorten life. It should be noted that, legally and medically, forgoing LST is distinct from active euthanasia. The former, if carried out under appropriate circumstances (when it is the wish of a mentally competent patient or when the treatment is futile), is legally acceptable in most parts of the world including Hong Kong. To avoid any unnecessary confusing connotations, the term “passive euthanasia” is not recommended by the medical and legal field, and the term is not used...
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...participation by health care providers. 4. What is voluntary euthanasia? * The rational decision of a terminally ill person to end their life. * Requires a comprehension of the consequences of their decision. * A person must be able to make competent decisions about their own health care. 5. What is non-voluntary euthanasia? * The decision of someone other than the patient to end that patient’s life. * Usually as a result of the patient’s inability to speak for themselves. * May not be competent to make the decision, (i.e.) Alzheimer’s disease. 6. What is the difference between ordinary treatment and extraordinary treatment? * Ordinary treatment is the application of established and standard medical procedures to sustain life. * Usually offers hope of a cure. * Not typically very expensive. * Treatments should be available to everyone. * Extraordinary treatment is the use of experimental medications and procedures to cure or extend the life of terminally ill patients. *...
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...| | |Euthanasia | |Pros and Cons of Euthanasia | | | |Lisa Rohn | |10/20/2010 | |Euthanasia is a highly controversial topic among many political and religious groups. The purpose of this project is to detail the facts of | |Euthanasia and to list the pros and cons surrounding the topic. Euthanasia is prohibited in the United States. However I will show that | |patients practice forms of this “mercy killing” legally each day while exercising their right to die. This project will list guidelines in | |which Euthanasia should be legalized and give arguments as to why the decision should be the sole right of the suffering individual. | Imagine that your mother...
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...to be a suitable contender for euthanasia? Is the judiciary ignoring this since Euthanasia is an issue faced by a minority? SOME FAMOUS VOICES ON EUTHNASIA: 1. Mr. Ravi B Naik, former High Court Judge and Senior Advocate: (deccanherald.com) “When it is not possible for man to give life, who is he to take it away? We should leave death in the hands of God who gave life. There is no law that allows killing by force till a man dies naturally, nor should there be one. In a situation where it is ‘impossible to live’, people die naturally. When they don’t die, doesn’t it mean they can live? It is meaningless to ask them to die without allowing them to live.” 2. Dr Vasantha Muthuswamy, former Deputy Director General, Indian Council of Medical Research, who is regarded as ‘Queen of bioethics’: (deccanherald.com) "I am against active euthanasia. In our country, it is very difficult to implement it. We are always worried about its misuse, if...
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...From Medscape Nurses Medication Error Prevention for Healthcare Providers Faculty and Disclosures CE Information There are between 44,000 and 98,000 individuals who die every year in hospitals due to preventable medical errors.[1] It has also been reported that this is only part of the problem, as thousands of other patients are adversely affected by medical errors or barely avoid injuries that are nonfatal.[2] These medical errors not only cost the loss of lives, but carry a financial burden that is estimated to be in a range of $17 billion to $29 billion annually. Additionally, there is physical and psychological pain and suffering related to these errors.[1] Another consequence is that medical errors diminish trust and satisfaction in the healthcare system and in healthcare professionals.[1] Ginette A. Pepper, PhD, RN, FAAN, a Professor and Helen Lowe Bamberger Colby Presidential Endowed Chair and Associate Dean for Research, University of Utah College of Nursing, Salt Lake City, spoke on medication safety for the geriatric nurse practitioner (GNP).[3] Dr. Pepper was trained as a pharmacologist with a nursing focus. She was one of the first NPs to add "geriatric" to her title as well as one of the first NPs to have prescriptive authority. Safety Principles and the Medication Use Process Dr. Pepper noted that safety issues are of the utmost importance for all healthcare providers.[3] Nursing as a profession has a long history of regarding patient safety as a primary...
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...standard in place that must be followed. These are nonnegotiable, ethical standards, obligations and duties that every individual swears to when entering the nursing profession. These standards are all found within the American Nurses Association’s code of Nursing Ethics and Conduct. Whether dealing with patients and families during end of life decision making or dealing with nursing negligence within the court of law, the first provision in the code of ethics is the most imperative to remember. Nurses are always obligated to their patient’s best interest, therefore making them an unrelenting patient advocate. Many provisions are pointed out within the Nursing Code of Ethics. In the situation of dealing with Marianne’s family and medical treatments, there are many important things to consider. “The nurse respects the worth, dignity, and rights of all human beings irrespective of the nature of the health problem. The worth of the person is not affected by disease, disability, functional status, or proximity to death. This...
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...interesting details concerning it. I have always felt that marijuana should be legalized, or at the very least, people with serious medical conditions should have access to it. And marijuana doesn’t even have to be legalized in my opinion, but it should definitely be decriminalized. I don’t think anyone who wants to smoke a plant that they grow themselves should have to suffer consequences, considering they are responsible in their recreational smoking. I do feel that if it were legalized, that there should be an acceptable age limit to buy and/or consume marijuana, comparable to that of alcohol. There are beneficial as well as harmful effects concerning marijuana, but that goes for a lot of things people do in everyday life. And I feel that a lot of time has been spent shining the spotlight on the harmful effects of marijuana, while little research has been done or even allowed, on the benefits of marijuana. While preparing for the debate, I encountered many sources on each end of the spectrum; including some in the middle. Many of the sources I looked at seemed rather credible, but others were most definitely biased. One example of a blatantly biased comment was, "Most pot smokers drink alcohol heavily, and may become so confused that they take cocaine or heroin.” (medicalmarijuana.procon.org). Another interesting bit of information I found was, “Medical marijuana is now a serious $1.7 billion dollar market, according to a new report released this month by an independent financial...
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...promote new products and new services the ways that this can be done would be through electronic medical records, or any form of a web-based communique. Some types of communications can also make the patient feel safer and also help the organization save time and money. Electronic medical records give the patient some benefits that are to the advantage of them as well as the provider. It allows the patient to keep their medical records up to date and accurate so that way there are no problems with such things as allergies, surgeries, or medications that are being taken. This is a way for the patient to keep accurate records of their medical history as well as keeping the provider updated at all times (Brooks, R., Grotz, C.). This an effective means of communication between the patient and provider by allowing the provider to give access to some of their records that will allow the patient to adjust certain things in their lifestyle or medications without going in to see the provider for something that would not require an office visit. This type of communication can allow the provider to keep a better watch on the consumer’s progress that will allow the provider to release some test and results to the consumer and the provider can also let the consumer know exactly what the their instructions are without being misinterpreted (Brooks, R., Grotz, C.). Electronic Medical Records is a form of communication that is developed to make health care records easier to update...
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...Prescription Drugs In this society, most Americans use some type of prescription drug. According to this week chapter reading: “More than 80 % of U.S. adults use some form of medication, with 50 % taking a drug prescribed by a doctor. The average American fills 11 prescriptions per year spending approximately $ 771 annually (Gentzen, p. 245, 2007).” This is a true statement because I am one of those Americans who depend on prescription drugs. I have a seizure disorder that doctors have not found what cause me to have seizure. Without medication, I can have a seizure. So now I have become what society has called “addicted” to prescription drugs, when I go too long without medication, I can have a seizure at any given time. So I am glad that my team has chosen this topic to discuss. We talk about The History of Prescription Drugs, Drugs Addicts, and The steps that we believe that could be used to make a change to the present system. Prescription drugs are medicine regulated by legislation to require a prescription before it can be obtained. The term prescription drug is used separate from over-the-counter drugs that can be purchased without a prescription. In the United States, the Federal Food, Drug and Cosmetic Act determines what requires a prescription. When obtaining a prescription, a person will also receive a pamphlet explaining the drug and helpful information about the effect of the drug and how it affects the body. It also describes side effects...
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...definitions of euthanasia: "A gentle and easy death...[T]he means of bringing about a gentle and easy death... However, in today’s society term euthanasia includes both voluntary and involuntary termination of life. Euthanasia has many meanings. Except for involuntary euthanasia, all these terms are closely related because the victim requests the action. The only difference is who is actually committing the act, Voluntary euthanasia is a help to mentally competent person to die through the assistance of others and can be divided in two categories. Passive Euthanasia means causing the death of a person by withdrawing some form of support and letting nature take its course. For example: removing life support, stopping medical procedures, stopping food and water and allowing the person to dehydrate or starve to death, and not delivering CPR. Active Euthanasia involves causing the death of a person through a direct action, in response to a request from that person. For many people, euthanasia is a preferable option compare to loss of independence and unbearable suffering. Background Euthanasia has always been a highly controversial topic. In...
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