Abbas Aslam

Biomedical Ethics

Due: June 18, 2023

This case study delves into the ethical dilemma surrounding the withdrawal of treatment in critical care for Danny, a chronic obstructive pulmonary disease (COPD) and prostatic cancer patient currently on ventilated life support . The core issue lies in conflicting preferences, as Danny desires to withdraw life-support while his family objects and wants to continue treatment. The study thoroughly examines this predicament through an analysis of ethical principles, philosophical theories, and nursing codes of ethics to navigate the decision-making process. In the end, the healthcare professionals honor Danny’s decision, while upholding effective communication with the family and fostering collaboration among other healthcare providers to ensure optimal care (Lyu & Zhang, 2018)

In this case study, the ethical dilemma primarily revolves around the conflicting principles of autonomy and beneficence. Autonomy refers to the right of individuals to make decisions about their healthcare and the right to have those decisions respected. In this case, Danny wishes to withdraw life-support, exercising his autonomy. His wife and adult children, however, oppose this decision, raising the question of whose autonomy should take precedence (Lyu & Zhang, 2018). Beneficence is the ethical principle that promotes actions aimed at benefiting the patient and maximizing their well-being. In critical care settings, the withdrawal of treatment may be considered when it is deemed futile or when prolonging treatment would only lead to suffering without meaningful recovery. In this case, it is the responsibility of the healthcare professionals to assess the potential benefits and burdens of continued treatment against the patient’s wishes and the family’s objections.

I support the healthcare professionals’ decision to withdraw Danny from life-support as they are making a difficult yet carefully calculated decision that ensures the best outcome for the patient while respecting their wishes and best interests. The study highlights the complexities of decision-making, especially when it involves multiple stakeholders, legal considerations, and ethical principles such as autonomy and beneficence. It emphasizes the importance of clear communication, empathy, and collaborative decision-making which honors the wishes of the patient while also being considerate and compassionate towards the patient’s loved ones. In this situation, it was important for healthcare professionals to maintain a careful balance between respecting Danny’s autonomy and considering the principle of beneficence.

To ensure there is communication between the healthcare professionals and the patient’s loved ones, they must provide clear information about the prognosis and potential outcomes. This includes engaging in shared decision-making with the patient and family and conveying to the family that Danny’s cancer also means that intensive care is “extended life or postponed death” (Lyu & Zhang, 2018). Additionally, the study highlights Danny’s expression of pain and difficulty breathing despite sedation medications, as well as his preference to pass away peacefully rather than endure prolonged suffering caused by cancer. (Lyu & Zhang, 2018). By considering Danny’s expressed wishes and the reality of his medical condition, the healthcare professionals are striking a balance between respecting his autonomy and adhering to the principle of beneficence. Their decision reflects a compassionate patient-centered approach that prioritizes the patient’s well-being and alleviates his suffering. Ethical decisions like these are not easy to make and require thought, weighing all the applicable core values that align with PA’s and their practice. After measuring how beneficence and autonomy relate to the above case, I agree with the medical professionals’ decision to honor Danny in his final moments.

References:

Lyu, C., & Zhang, L. (2018). Who decides in withdrawal of treatment in a critical care setting? A case study on ethical dilemma. International journal of nursing sciences, 5(3), 310–314. https://doi.org/10.1016/j.ijnss.2018.06.004