Mr. G, in his 60s, was lying on the cardiovascular surgical ICU bed with a flat affect, rarely responsive to his environment. His fingers and toes were necrotic and black. His tracheostomy was connected to the ventilator. His heart and blood pressure were dependent on multiple vasoactive drugs at the maximum dosage. He was also receiving nutritional support via a PEG-J tube. Despite all these life-sustaining treatments, his condition continued to deteriorate. Mr. G’s prognosis was grim, and the cardiac medical team recommended palliative care. However, his family insisted on maintaining current treatments. Is it ethical to withdraw the aggressive and life-sustaining treatments and transition the patient to palliative care?
The term futile “refers …show more content…
The principle of nonmaleficence addresses the first part of Hippocratic ethical dictum while the principle of beneficence reflects the second part. The principle of beneficence also takes into account the patient’s quality of life and weighs the benefits, costs, and risks of interventions. While the life-sustaining interventions prolonged Mr.G’s life, it did not palliate his suffering or enabled him to have the fullest possible end-of-life experience. The burdens of these interventions include pain, monetary cost, ICU dependence, a decrease in quality of life, disfigurement, and loss of independence. Transitioning the patient to palliative care will provide more focus on patient’s comfort, symptoms relief, and quality of life. Therefore, continuing these interventions violates the principles of beneficence and …show more content…
Therefore, it is important for nurses to promote ethical practice by taking ethic-related courses, participate in ethics committees, and seek ethics consultation as needed (Scanlon, 2003). Nurses should educate patients about advance directives and living wills and encourage them to discuss their preferences with their family members. Aside from participating in family meetings, nurses can involve palliative care specialists in patient care. Last, but not least, nurses play an important role in advocating for patients, building rapport, and communicating with the patients, their families, and the medical
The term futile “refers …show more content…
The principle of nonmaleficence addresses the first part of Hippocratic ethical dictum while the principle of beneficence reflects the second part. The principle of beneficence also takes into account the patient’s quality of life and weighs the benefits, costs, and risks of interventions. While the life-sustaining interventions prolonged Mr.G’s life, it did not palliate his suffering or enabled him to have the fullest possible end-of-life experience. The burdens of these interventions include pain, monetary cost, ICU dependence, a decrease in quality of life, disfigurement, and loss of independence. Transitioning the patient to palliative care will provide more focus on patient’s comfort, symptoms relief, and quality of life. Therefore, continuing these interventions violates the principles of beneficence and …show more content…
Therefore, it is important for nurses to promote ethical practice by taking ethic-related courses, participate in ethics committees, and seek ethics consultation as needed (Scanlon, 2003). Nurses should educate patients about advance directives and living wills and encourage them to discuss their preferences with their family members. Aside from participating in family meetings, nurses can involve palliative care specialists in patient care. Last, but not least, nurses play an important role in advocating for patients, building rapport, and communicating with the patients, their families, and the medical