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An ethical argument for the Do-Not-Resuscitate Order
Mackenzie D. Burden
Rhodes State College
2-23-23
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Abstract
This essay is going to explore the moral and ethical dilemmas with the Do Not Resuscitate law.
(DNR). What is the Do not Resuscitate order? This is another word for “do not attempt.” It is stating that the patient is wishing for a natural death. For healthcare workers treating the patient, this means that the patient cannot receive cardiopulmonary resuscitation (CPR), if their heart stops beating or goes into cardiac arrest. It allows for a natural death for the patient. It is optional, but most patients who request a DNR are either terminally ill, having prolonged pain, or advanced age.
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Main Body
There are many legal implications
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One of the primary legal implications of DNR is respecting a patient’s autonomy. Legally, this shows that the patients have the right to refuse any type of treatment. There must also be some sort of informed consent. Informed consent means any patient must fully know all the risks and benefits. In this case, it would be talking about the risks and benefits of CPR. There also must be some type of legal documentation. It would be the Do-No- Resuscitate Order. This legal document will define and specifty the conditions in which CPR should be performed. They also could have signed another legal document known as a living will. A living will be a document that describes what you want done as treatment when you are incapacitated. It specifies the type and amount of medical care you wish to receive. If the living will be not signed by the patient incapacitated, it would then be the responsibility of spouses, and if not spouses, any other living family member.
Although there are many legal implications with DNR, there are also many moral dilemmas with this bioethical topic.
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The pros of this order are that the patient does not have to suffer, and they can be comfortable. The cons are that it can be seen as unethical, and it gives up any chance of revival and you cannot change your decision. In conclusion, the Do-Not- Resuscitate order is very important. It has a lot of moral dilemmas involved with it, as well as legal implications. It is a fatal bioethical topic. It is important to respect those wishes, and respect everyone’s decision in such a difficult time. I have learned multiple things about this topic, the big takeaway for me personally was the number of moral dilemmas involved. I was shocked at how many factors go into the order. My opinion has not changed on this topic. I still believe that the DNR order is moral, and I understand the suffering that the patients are going through. On the other hand, though, I do now understand why some people see it as an ethical issue.
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References
Ober, Vincent. (2005). “Legal Implications and Ethical Considerations of DNR Order”.
Fremgen, B. F. (2020). “Medical Law And Ethics.” Hoboken, Nj: Pearson Education.
Jones, A.L. (2011) “Use of Advance Directives in Long-Term Care Populations.”
Video:
Introduction People have moral and ethical values that assist them in making decisions about their healthcare on a daily basis. What if a person found out that they had a terminal illness and only had months to live? What if those few months would be filled with treatments, pain and suffering, tear filled family members, and high cost medical bills? Physician- assisted suicide remains a debated topic which causes physicians, nurses and those involved to take a look at what they value and what they are willing to do in order to carry out a patient’s wishes.
Oftentimes, grief can be a challenging thing to overcome as a healthcare provider. It not only stymies people from making sound decisions, but it can end up with blame focused in areas where it should not be. This is with particular regard to patient families. In the case of this 72-year-old patient, there are a number of issues in this situation that are both unethical and downright illegal, including the fact that the patient’s living will is not currently being respected. Legal/Ethical issue 1: The legality of the living will parameters Both the legal and ethical issues of this situation have the do with the legality of the living will.
John Henry Giles signed the DNR under the false belief that he was suffering from a condition called ALS which was diagnosed by Dr.Hamilton and agreed upon by Dr.Forman. It is understandable why he would not want to be resuscitated in the event that something would happen due to the miserable conditions and suffering that he would have faced as a result of the progression of this condition. The only problem was that Dr.House was the only one that disagreed with the ALS diagnosis but his argument was uncertain and unsupported. Due to the lack of testing requested by the patient and the undetermined cause of his illness the doctors that were assigned his case had to take a chance and prescribe John medications that they believed would help his
There was no consideration for the harm the patients received due to this unethical practice. The hospital was only worried about a potential $2 million dollar cost if they were cited for needing improvement (Chen, 2019). The more improvement a hospital is cited to need the less money they receive. There was no worry of the suffering the patient and the family would feel by ignoring a DNR order. Orders like this help a family from distress of not knowing what to do in these situations.
Running Header: Ethical Reasonings Ethical Reasonings for the Legalization of Physician Assisted Suicide The moral issue of whether or not Physician Assisted Suicide(PAS) should be allowed has been widely vocalized and debated throughout the world. Physician Assisted Suicide is an important issue because it concerns the fundamental morals of one 's life. There are a variety of opinions readily discussed about this issue. Most standpoints on this topic have to do with freedom.
There are many ethical and practical concerns that must be taken into account when considering whether to end a person's life, including questions of autonomy, dignity, and pain management. Simply asserting that some individuals have a duty to die is not enough to address these complex issues, and it fails to take into account the potential for unintended
Advance directives help inform health care providers with the patient’s wishes on how they would like to be treated medically. Advance directives allow a patient to be in control of their treatment plan as well as end of life choices. Therefore, when the time comes, and the patient is no longer able to make these decisions, there is a legal document that has been put in place to carry out the patient’s wishes. Advance directives are critical documents that are often ignored because of the uncomfortableness the subject of end of life care brings up. Advance directives are most common in the geriatric population since people often associate advance directives primarily with end of life decisions.
It is advised to communicate with the doctor so it can decrease the possibility that the health care decisions are not fully relied on the physician’s judgment call. There has been statistical evidence from surveys and numerous cases reported that physicians were falsely accused of showing acts of murder in the EOL care, which is another term for life support. Although that is not the case because JoAnn reports that “improving the quality of EOL care are failure to prepare an advance directive and disregard of an existing advance directive.” Overall, both the doctor and patient must make a reliability form before so the patient, at the moment who cannot make the decision, since they are unable because of their unresponsive condition. The will should describe how the patient wants to be treated but it has to be updated to specify the type of treatments that is
The right to die, or euthanasia, is when a person makes a request to be helped to die. Mainly for terminally ill patients who want a good death without pain. (Manning, 1998) The patient self-administers the lethal dose prescribed by a physician. (Foley and Hendin, 2002)
The debate over whether or not physician-assisted suicide should be a legal option for dying patients has long been a topic for discussion amongst members of the medical community. There are pros and cons for each argument, however, at the center of this debate is the consideration of patient advocacy and well-being. Although every health care profession centers their profession around providing the best ethical care for the patient, the most important value to consider are the decisions the patient makes for themselves. Currently, patients are given many safeguards such as living wills, a durable power of attorney, and the option for do not resuscitate that act as guidelines for end of life treatment. Physician-assisted suicide
The Death with Dignity Act (DWDA), which allows terminally-ill patients to request physician-assisted suicide, was first introduced in Oregon in 1997. The basic premise of the law is that terminally ill patients, with no outside help, should be able to choose the right to end their life. Since then a few more states have the DWDA or an similar law in their state; an ongoing debate is going on to make the act legal across the nation. The Death with Dignity act allows the individual’s request to die to be acknowledged by the state. Though various of groups and people have spoken against this act, Oregon, with close to two decades of experience with the law, has shown that it can work well even when faced with backlash from the public because
Terminally-ill patients and their families are forced to make some of the toughest decisions anyone will ever have to consider. When it comes to end-of-life decisions, there are two main options that will help prevent unnecessary suffering. The use of a widely-accepted practice, a “do not resuscitate" order, which is a legal order to withhold life-saving interventions in the event of cardiopulmonary arrest. And an alternative option, which has been highly controversial and heavily debated over the past twenty years, is the “physician-assisted suicide” or “aid-in-dying” as it is referred to by supporters. As of 2015, California is the fifth US state to allow physician-assisted suicide after Vermont, Washington, Oregon, and Montana.
However, there is hope of a peaceful death for these patients that exists in a controversial law being considered by many states throughout the country. It is known as the Death with Dignity Act. This law gives terminally ill patients the option of ending their own life in a painless manner at a time and place of their choosing by
It is recognizable that assisted suicide goes against human nature. Physician assisted suicide is judged morally wrong because every human is inclined to continue living. In the event that a terminally ill patient cannot be cured, palliative sedation is an option. According Boudreau, “we believe that the art of healing should always remain at the core of medical practice…sedation is morally acceptable to avoid severe pain…sedation achieves a humane and compassionate period for the patient, caregivers, and family without precipitating important concerns about slippery slopes”. Healthcare facilities have to comply with the rules and regulations.
The dying patient no longer has quality of life, they have lost their independence, are lonely, are forced to endure inevitable pain, are publicly humiliated, are suffering immensely, and are forced to watch their loved ones grieve because of them. It is an innate Constitutional Right to choose how to die, since we all will die. There comes a point when the poking and prodding becomes too much, when the patient wants to just die in silence in the loving arms of their