Langendoen and Bartels also express the need for goal-driven decision making asserting that, if the goal is strictly patient comfort, then pressers should be discontinued, however, if the patient’s goal is to maintain alertness and the ability to communicate, then many measures may benefit the patient and should be continued (Langendoen and Bartels, 576). It is also important to revisit and reevaluate a patient’s needs on a regular basis as their care progresses.
Some people may argue that because a physician or healthcare provider is deliberately stopping treatment, that the resulting death is therefore just as deliberate and just as morally inexcusable as actively euthanizing a patient. Still, the idea of “letting” someone die “naturally” is considered to be much more permissible by many healthcare professionals. A patient can refuse a treatment and therefore, if the discontinuation of that treatment results in death, it is still for the patient to decide. On the other hand, a patient cannot demand a treatment, and if a patient requests active euthanasia, it is for the doctor to decide whether or not to provide that treatment. In this case, the decision falls on the doctor and the resulting death would then also fall on him/her. A common argument against euthanasia is the “killing in the baths” argument provided by James Rachels. In this comparison, one man actively drowns a child in a bathtub, while the other only lets the child drown in the tub. Rachels argues that while one is clearly worse than the other and against the law, both are morally wrong to commit (Rachels, 3-4). The issue with this comparison however, is that it fails to take into account the wishes of the patient, and the patient’s goals. A physician supporting the euthanization of a patient is rarely motivated by malice, but by compassion and the desire to end suffering. The comparison also draws attention to an interesting sociological principle: the value of youth in contemporary cultures. Rachels’ use of a child highlights compared to the reality that many of the people facing end-of-life care are elderly highlights a distinction between the two populations. As a society, we are much quicker to side with the life of a young child over an older adult. This idea may lead toward a utilitarian view that permeates our culture in which younger generations have the greatest potential to benefit society. In the studies reviewed, there were no significant differences between the hospital stay of adults and children (Langendoen and Bartels, 572). However, elderly patients typically were more likely to discontinue certain treatments than younger patients (Langendoen and Bartels, 574). The decision to undergo more aggressive treatments may be attributable to general trends in health. A younger person is generally healthier than an older person and may respond better to aggressive treatments that would only burden an older patient who is on the decline. Still, the idea that one population holds greater value than another should not be the basis for clinical decision making, and younger patients should not take precedence over older patients for the sole purpose of their youth. It is crucial to understand that the decision to withdraw treatment is not one that is made lightly. One study found that the decision to withdraw treatment took about 24 days on average, with an average total hospital stay of 28.4 days (Langendoen and Bartels, 572). During the time leading up to the decision, each party works tirelessly to determine if the withdrawal of treatment is truly …show more content…
Each party must understand one another and be absent of coercion. In this way, the decision to withdraw care can be made without doubt or guilt by any party. That’s not to say that the decision will be any easier. Patients and their family members will continue to experience anxiety and may even fall into depression. We cannot forget however, that prolonging treatment will not prevent these disasters, but only delay them.
In choosing to withdraw end of life care, we can provide an environment in which patients can die peacefully and on their own terms. It gives the family the chance to say goodbye and avoid watching as their loved one dies a much slower and more painful death. It provides much needed closure and the chance for life to continue and to be
Some people may argue that because a physician or healthcare provider is deliberately stopping treatment, that the resulting death is therefore just as deliberate and just as morally inexcusable as actively euthanizing a patient. Still, the idea of “letting” someone die “naturally” is considered to be much more permissible by many healthcare professionals. A patient can refuse a treatment and therefore, if the discontinuation of that treatment results in death, it is still for the patient to decide. On the other hand, a patient cannot demand a treatment, and if a patient requests active euthanasia, it is for the doctor to decide whether or not to provide that treatment. In this case, the decision falls on the doctor and the resulting death would then also fall on him/her. A common argument against euthanasia is the “killing in the baths” argument provided by James Rachels. In this comparison, one man actively drowns a child in a bathtub, while the other only lets the child drown in the tub. Rachels argues that while one is clearly worse than the other and against the law, both are morally wrong to commit (Rachels, 3-4). The issue with this comparison however, is that it fails to take into account the wishes of the patient, and the patient’s goals. A physician supporting the euthanization of a patient is rarely motivated by malice, but by compassion and the desire to end suffering. The comparison also draws attention to an interesting sociological principle: the value of youth in contemporary cultures. Rachels’ use of a child highlights compared to the reality that many of the people facing end-of-life care are elderly highlights a distinction between the two populations. As a society, we are much quicker to side with the life of a young child over an older adult. This idea may lead toward a utilitarian view that permeates our culture in which younger generations have the greatest potential to benefit society. In the studies reviewed, there were no significant differences between the hospital stay of adults and children (Langendoen and Bartels, 572). However, elderly patients typically were more likely to discontinue certain treatments than younger patients (Langendoen and Bartels, 574). The decision to undergo more aggressive treatments may be attributable to general trends in health. A younger person is generally healthier than an older person and may respond better to aggressive treatments that would only burden an older patient who is on the decline. Still, the idea that one population holds greater value than another should not be the basis for clinical decision making, and younger patients should not take precedence over older patients for the sole purpose of their youth. It is crucial to understand that the decision to withdraw treatment is not one that is made lightly. One study found that the decision to withdraw treatment took about 24 days on average, with an average total hospital stay of 28.4 days (Langendoen and Bartels, 572). During the time leading up to the decision, each party works tirelessly to determine if the withdrawal of treatment is truly …show more content…
Each party must understand one another and be absent of coercion. In this way, the decision to withdraw care can be made without doubt or guilt by any party. That’s not to say that the decision will be any easier. Patients and their family members will continue to experience anxiety and may even fall into depression. We cannot forget however, that prolonging treatment will not prevent these disasters, but only delay them.
In choosing to withdraw end of life care, we can provide an environment in which patients can die peacefully and on their own terms. It gives the family the chance to say goodbye and avoid watching as their loved one dies a much slower and more painful death. It provides much needed closure and the chance for life to continue and to be