Case Facts and Ethical Consideration:
Case 4 focuses on care decisions pertaining to 41-year-old firefighter Mr. Worther, who was brought into the emergency burns center under the care of Dr. Sachem after responding to a house fire call. He was trapped under a fallen beam and exposed to the flames for 3 minutes before being rescued. Though his left hand, shoulder, and faced were spared, it was calculated that full-thickness burns covered 85% of Mr. Worther’s body and significant smoke inhalation was suspected. Dr. Sachem remembers a case from her residency when the emergency team failed to sufficiently replenish the fluids of a burn victim who later died on life support. …show more content…
Sachem must decide whether to respect autonomy and the decision of Mr. Worther to be ushered towards a peaceful death or to follow beneficence and provide any treatment necessary towards the prospect of recovery. Ignoring the patient’s request would defy autonomy that may ultimately dissolve trust in medical service. Alternatively, withholding treatment based on the patient’s request alone defies beneficence and the physician’s duty to care because he cannot take steps to improve the situation of the patient if he is no longer alive. Non-maleficence becomes involved because the doctor must determine whether potential treatments would yield any benefit or would just condemn the patient to suffering before an inevitable death as was the case in her residency. Ethical considerations pertaining to euthanasia become prominent if death is decided to be the lesser harm. Therefore, some key ethical questions include: Does the extent of the injury play a role in the decision? Is the patient able to make autonomous decisions? And, should Dr. Sachem choose to treat or euthanize the …show more content…
Worther becomes receptive to treatment, Dr. Sachem should proceed with beneficence to replenish fluids using the Parkland or other formula, provide pulmonary care for smoke inhalation, and attend to the wounded femur (Greenhalgh, 2017). If the patient persists in his decision to be euthanized, then the doctor should honour this as well. The practice may be ethically justifiable based on several arguments. For one, the doctor would respect patient autonomy. Competent patients should have the right to determine the timing and course of their death in a medical context. This also consistent with respecting individual liberty and patient dignity (Starks, 2013). Further, if terminally ill patients that are dependent on life support have a right to refuse further treatment that prolongs their life then the principle of justice would indicate that other patients in suffering should be permitted to have an assisted death. Moreover, if the patient has competently decided that assisted suicide is desirable, they have decided that death is a lesser evil than their continued existence and so the physician should have no moral objection to euthanasia (Sikkema, 2017). Moreover, there are many other methods of suicide that are arguably more dangerous than controlled physician assisted suicide (Starks, 2013). Finally, in cases where it may not be possible to relieve pain and suffering, an assisted death is seemingly the compassionate and humane response. Thus, if the patient