Term Paper: Nutrition: Ethical or Unethical?

Pages: 6 (2403 words)  ·  Bibliography Sources: 0  ·  Level: College Senior  ·  Topic: Health - Nursing  ·  Buy This Paper

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[. . .] They make no secret of their differences of opinion. Consider, however, that there are some 18,000 consultants and 30,000 general practitioners in this country. Inevitably, they will represent a vast cross-section of views about non-resuscitation. Religious convictions may play a part in the decisions taken by some, particularly in matters concerning the sanctity of life. The Roman Catholic Church and orthodox Jews oppose the withdrawal of lifesupport. Others may refuse cardiopulmonary resuscitation to elderly patients for fear of causing indignity, or because they have become highly dependent on others. On the other hand, some say that loss of dignity arises from the way we care for our sufferers not from the illness itself and that the provision of a better environment for elderly patients suffering dementia would prevent the question from arising. For others the patient's social environment is a factor to be taken into account in making the decision, as is the issue of NHS resources. Some would offer haemodialysis to married women with children in preference to a labourer of no fixed abode, but not to those who are under five, or over fifty, or over sixty-five, or too intelligent, or too unintelligent. The literature indicates that a range of highly intuitive factors are used to guide the profession. Inevitably, there will be considerable inconsistency, both between different nurses and in the same nurse from time to time, as to the precise circumstances in which they will be thought appropriate. So long as reasonable nurses can be found to support them, the House of Lords has laid down no standard of its own by which the lawfulness of these differences can be judged.

Solution

There is another concern. To what extent can the profession be the sure that its intuition as to propriety of a DNR is grounded on an accurate assessment of the patient's circumstances? After all, hasty or ill-informed decisions may not be reversible.

One wonders why more specific guidelines are not suggested. Certainly, one cannot be specific about individual cases in which a DNR would be appropriate. Patients and the conditions they present are different. But it would be possible to indicate the considerations which ought to be taken into account in arriving at such a decision. How often should the DNR be reviewed? Ought relatives to be informed unless the patient wishes otherwise? (They may be able to inform nurses of the patient's own wishes.) To what extent should nurses with day-to-day experience of caring for the patient be involved? How should the patient him or herself be approached about the matter and to what extent should nonclinical matters be considered relevant to the decision? I feel that the fate of a patient lies outside of the decisions of courts and nurses. The family is the most important factor in judging whether or not a patient should receive care or not. Hence, if one is going to decide to withhold a form of care, the decision should rest with the family because they are the ones who know the suffering person the best. They are also the ones who will suffer the most as a result of the death. However, if the patient is coherent enough to make the decision by himself or herself, and is terminally ill, then the patient should be able to decide the outcome of his or her life. It is important that we give suffering people with nothing to look forward to but death some sort of option to provide them with dignity.

Therefore, I feel the two most viable solutions are to either consult with the patient or with the family. However, I feel the patient must be terminally ill or in a vegetated state in order to qualify for a faster death. This should not be done to people who still have life to live and can be accommodated.

For the moment the common law generously permits nurses to make choices on the basis of considerations which are not strictly clinical. Recall too that health service managers also influence practice in this area. It must be said, however, that the grounds for exercising so little supervision over this area are so insubstantial, so unpersuasive, that the matter is bound to be challenged in the future. Both as to matters of substance and procedure, the grounds on which these questions are decided must be subjected to closer examination.

Schroeter, Kathryn. "A Study of Proactive Ethics..." Internet. Available online. http://www.findarticles.com/cf_0/m0FSL/4_71/64424060/p1/article.jhtml?term=withholding+care+to+terminally+ill+patients

Issue: April, 2000 AORL Journal Online

Whitten, James. "Ten Commandments for the care of terminally ill patients." Internet. Available Online. http://www.findarticles.com/cf_0/m3225/n5_v57/20460455/p1/article.jhtml?term=withholding+care+to+terminally+ill+patients

Issue: March 1, 1998 American Family Physician

Ackermann, Richard. Internet. Available Online. http://www.findarticles.com/cf_0/m3225/7_62/65864094/p1/article.jhtml?term=withholding+care+to+terminally+ill+patients

Issue: Oct 1, 2000 American Family Physician

Trotto, Nancy. "The role of lifeprolonging technology. http://www.findarticles.com/cf_0/m3233/21_34/67503384/p1/article.jhtml?term=withholding+care+to+terminally+ill+patients

Issue: Nov 15, 2000 Journal of Patient Care

Ferrell, Betty. "End-of-life care..." Internet. Available Online. http://www.findarticles.com/cf_0/m3231/7_30/63583997/p1/article.jhtml?term=withholding+care+to+terminally+ill+patients

Issue: July, 2000 Nursing Library.

Huffman, Grace. "Artificial Nutritional Support..." Internet. Available Online. http://www.findarticles.com/cf_0/m3231/7_30/63583997/p1/article.jhtml?term=withholding+care+to+terminally+ill+patients

Issue: July 1, 2001 American Family Physician. [END OF PREVIEW]

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