With our framework of ethicaltheories and principles in hand, we begin our look at some of the critical ethical issues in our contemporary world, starting with end-of-life issues. This assessment covers ethical questions related to end-of-life care. Passive euthanasia is the removal or refusal of life-sustaining treatment. Examples of passive euthanasia include removal of a feeding tube or a ventilator, or forgoing a life-prolonging surgery. Passive euthanasia is legal in all 50 states, and the principle of autonomy gives informed patients the right to refuse any and all treatments. Patients who are unable to make such decisions in the moment (because they are unconscious, for example) might have made their intentions clear beforehand with an advance directive or similar document. Things become more complicated, however, when a patient who is unable to make treatment choices has not made his or her wishes clear, either formally in a written document, or informally in conversations with family members or friends. Another problem concerns cases in which there is disagreement about whether the treatment is sustaining the life of a person in the full sense or merely as a body that, because of severe and irreversible brain trauma, is no longer truly a living person.

Active euthanasia, or assisted suicide, introduces further difficult moral questions. A patient who has a terminal illness and who has refused treatments that would merely prolong a potentially very painful and debilitating death might want the process of dying to be hastened and made less painful. The patient might want to take his or her own life before the disease reaches its horrible final stages. Should patients be legally allowed to have help in this endeavor? If suicide itself is not morally wrong, at least in cases like these, is it wrong for another person to directly help bring about the patient's death? Is it wrong for doctors, a role we naturally associate with healing and the promotion of life, to use their medical expertise to deliberately end a patient's life if the patient wants this?

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Articulate ethical issues in health care.
  • Articulate the moral issues associated with limiting life support.

• Competency 2: Apply sound ethical thinking related to a health care issue.
  • Demonstrate sound ethical thinking and relevant ethical principles when considering limiting life support.
  • Explain important considerations that arise when contemplating limiting life support.

• Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
  • Exhibit proficiency in clear and effective academic writing skills.

Preparation

Case Study: Mr. Martinez-Mr. Martinez was a seventy-five-year-old chronic obstructive pulmonary disease patient. He was in the hospital because of an upper respiratory tract infection. He and his wife had requested that CPR not be performed should he require it. A DNR order was written in the charts. In his room on the third floor, he was being maintained with antibiotics, fluids, and oxygen and seemed to be doing better. However, Mr. Martinez's oxygen was inadvertently turned up, and this caused him to go into respiratory failure. When found by the therapist, he was in terrible distress and lay gasping in his bed.

This media piece provides the context for this assessment; make sure you have reviewed the case study thoroughly.

Additionally, it may be useful to think through the following issues as they relate to Mr. Martinez's case:

• Should Mr. Martinez be transferred to intensive care, where his respiratory failure can be treated by a ventilator, and by CPR if necessary, and his oxygen level can be monitored?
  • What are the key ethical issues or models at play in this case study?
  • What are the key end-of-life issues at play in this case study?
  • How can an understanding of models and best-practice help to guide health care practitioners to make ethical and legal decisions?

Answer rating: 100% (QA)

The transfer of Mr Martinez to the ICU or should have performed CPR depends on the situation of the Mr Martinez and his decision of the family They ha... View the full answer