Ethical and Legal Dimension
Alex, 68 years old man was admitted to the Neurological Intensive Care Unit due to cerebral hemorrhage leading to severe brain damage and ventilator dependent. Two years prior to this event, Alex and his wife, Jessica, had come up with living wills through the help of an attorney. He was diagnosed by his treating medical practitioner as being in the permanent unconscious state or condition. Alex’s living will categorically specific that Alex cannot use ventilator support in the course of permanent unconscious state or terminal condition. Jessica is the legal next of kin and the only individual with the surrogate consent to make a decision. When the living will was discussed with her, she insisted that he had not even intended for the document to be applied in a situation like that. The physician told her that the patient would on receive any form of meaningful brain function but she holds that the living will was not applicable because his state was not imminently terminal (Kelly et al. 2020). Jessica also argued that she did not consider her husband to remain in a permanent state of unconscious. The first son of the family disagreed with the mother’s decision in relation to the termination of the life of their father. The treatment staff on the other hand gave Jessica more than two weeks to watch the deteriorating health of her husband and come up with the decision. After the end of two weeks still, Jessica was adamant with her decision and did not authorize the withdrawal of life support measures, as the patient highlighted in his living will.
Be ore the physician delivers the care ethical as well as legal standards requires that the patient provides informed consent. If the patient is not in a position to provide consent then the legally authorized surrogate decision-maker comes up with the decision. There are two standards that the participants in this scenario filed to uphold (Kelly et al. 2020). The facility failed to uphold the patient’s will that he did not want ventilator support or artificial life support in the case of a terminal condition. The son and the hospital also failed to listen to surrogate decision-makers and more so acted without any consideration of the will of the patient. Also, the wife as a surrogate decision-maker, she failed to understand and hold on to the patient’s living will and acted without consideration of the patient’s welfare.
In normal cases, the patient has the right to come up with the decision on what would happen in case of a terminal condition. This is what Alex did and this means that he actively participated in his health. The right was also practiced through writing and living behind the living will with his beloved wife. In his living will he states that he does not require ventilator support nor artificial life support in the course of terminal condition that is permanent (Jones, Gastmans, & MacKellar, 2017). In regard to the ethical decision making as the care provider, the patient has the right not to be placed in the ventilator support or artificial life support as it is clearly illustrated under his living will. Human being has dignity revolving around their human nature per se or based on their capability to choose freely what they do with their lives (Macpherson, Roqué, & Segarra, 2020). Therefore in this case the greatest ethical action is to respect and protect the moral rights of those that are affected. Given the basis of the dignity, the patient’s right must be treated as the ends and not as the means to other people’s ends. In this case, the patient should not be put on the ventilator or any artificial life support machine.
The wife was the legal next of kin thus acting as the surrogate decision-maker. She made the decision not to withdraw life support machines, therefore, going against the patient’s living will. She argued that the living will was not in relation to the patient’s present terminal condition and if he was able, he would concur with her. The interlocking relationships of the community are the foundation of the ethical reasoning and more so, compassion, as well as respect for all other oftentimes the vulnerable, are needed for such like reasoning (Jones, Gastmans, & MacKellar, 2017). In this case, as the care provider, I would concur with the wife to delay pulling down artificial life support until she comes in terms of doing so.
As a health service provider, I would agree with the surrogate decision maker’s decision and delay pulling the life support until he decided otherwise. Based on the common good approach, the interaction of the given society must be the foundation of ethical reasoning and compassion for everyone more so, those who are vulnerable to you.
The wife disagrees with most of the ideal virtues which should provide the full development of humanity when making the decision to place the patient in the artificial life support. She comes up with this decision knowing that the patient will never recover and regain mental functionality (Jones, Gastmans, & MacKellar, 2017). In relation to virtue approach, the ethical action is supposed to be consistent with the special ideal virtues which provide for the full development of the humanity as the medical provider, it is ethical not to place the patient on life support.
If the ethical standards did not exist, there would be wrinkles whereby every individual is not aware of the roles and the responsibility to play. Ethical standards, allows the person to have a clear conscience that they have done the right thing (Castelli Dransart et al. 2017). The decision-maker has all the rights to allow the patient to stay on life support machine as long as she likes. Ethical standards equipped the physician to make an informed decision since they acknowledge their roles through the logical conclusions being made. Any lack of ethical standards results in disrespect of the patient. The patient’s living will in this would not have been put into consideration.
Conclusion
Conclusively, through the help of ethical standards set in healthcare, the issue can be handled to reduce confusion among stakeholders involved in this scenario. Based on the Virtue approach which states that ethical actions ought to be consistent with certain ideal virtues that provide for the full development of our humanity as a health care provider, I feel that it is ethical not to put the patient on life support.
References
Castelli Dransart, D. A., Scozzari, E., & Voélin, S. (2017). Stances on assisted suicide by health and social care professionals working with older persons in Switzerland. Ethics & Behavior, 27(7), 599-614.
Jones, D. A., Gastmans, C., & MacKellar, C. (Eds.). (2017). Euthanasia and assisted suicide: lessons from Belgium (Vol. 42). Cambridge University Press.
Kelly, B., Handley, T., Kissane, D., Vamos, M., & Attia, J. (2020). “An indelible mark” the response to participation in euthanasia and physician-assisted suicide among doctors: A review of research findings. Palliative & Supportive Care, 18(1), 82-88.
Macpherson, I., Roqué, M. V., & Segarra, I. (2020). Moral dilemmas involving anthropological and ethical dimensions in the healthcare curriculum. Nursing Ethics, 0969733020914382.