Nereida Romero
Capella University
PHI-FPX3200: Ethics in Health Care
Dr. Kim Carter-Cram
August 14, 2024
Should We Withhold Life Support? The Mr. Martinez Case
End of life issues provide opportunities for healthcare professionals to utilize ethical theories and principles to make informed decisions on the best interventions. Martinez’s case provides insights into the need for healthcare professionals to accommodate patients’ decision to avoid a CPR. A DNR order clarifies a patient’s directives and stated preferences in end of life care (Porteri, 2018). Terminally ill patients understand the pain and suffering experienced in end of life years. The knowledge allows them to make decisions that would help alleviate emotional, physical, and psychological distress.
Significance of a Patient’s Directives
Oral and written advanced directives give patients the chance to express their values and preferences. The move allows individuals to describe their goals and treatment preferences during end of life care (Porteri, 2018). Martinez’s case provides insights into the need for healthcare professionals to promote the patient’s welfare based on clarified choices and wishes (Porteri, 2018). Martinez’s elderly state and chronic obstructive pulmonary disease reinforce the need for healthcare providers to appreciate the patient’s directives to avoid additional emotional, physical, and mental distress for the patient and family.
Quality of Life and Patient’s Preferences
Chronic obstructive pulmonary disease is a serious condition that exposes individuals to adverse outcomes including difficulties breathing. Martinez’s old age exposes him to multiple breathing-related complications, which reduce quality of life across the care continuum. Being on oxygen, fluids and antibiotic treatment already portrays the patient’s suffering, hence the need for the care team to acknowledge preferences that help alleviate pain. In this case, the healthcare provider should respect the decision to avoid a CPR as a means to fulfill the duty of care by alleviating suffering (Porteri, 2018). The written directive also enhances the need for the care team to adhere to the principles of beneficence and autonomy, which require them to act in the best interests of the patient. As such, preferences describe a patient’s awareness of complications and the role of informed decisions about their preferred treatment pathways.
Withholding Life Support
Withholding life support reveals refusal of treatments that would cause more pain and expose a patient to debilitating death. In this case, the health care team should acknowledge a patient’s preferences for a less painful death associated with the decision to withhold life support. In Martinez’s case, turning up the oxygen caused respiratory failure, terrible distress, and gasping in the bed. The outcomes worsened the patient’s physical, emotional, and mental state, which could limit him from experiencing a dignified death. While it is necessary to consider alternative solutions such as experimental drugs, healthcare professionals should consider demographic details such as age and the nature of a disease (Penders et al., 2019). The fact that significant improvements were unrealistic support the need for the care team to comply with advance directive to withhold life support. The written directive and availability on the charts ascertains the patient’s autonomy and informed consent, hence the need to alleviate suffering after exhausting all treatment options.
Conclusion
Advanced directives clarify a patient’s preferences and values. The oral or written consideration reveals the client’s awareness about complications associated with their condition and the desire for a less painful death. Thus, withholding life support is necessary to protect patients from additional distress as witnessed in Martinez’s case. The decision shows the care team’s commitment to respecting autonomy and beneficence principles.
References
Penders, Y., Bopp, M., Zellweger, U., & Bosshard, G. (2019). Continuing, withdrawing, and withholding medical treatment at the end of life and associated characteristics: A mortality follow-back study. Journal of General Internal Medicine, 35(1), 126-132. https://link.springer.com/content/pdf/10.1007/s11606-019-05344-5.pdf
Porteri, C. (2018). Advance directives as a tool to respect patients’ values and preferences: discussion on the case of Alzheimer’s disease. BMC Medical Ethics, 19(9), 1-8. https://bmcmedethics.biomedcentral.com/track/pdf/10.1186/s12910-018-0249-6.pdf