Ethical Dilemmas In The Medical Field

In the medical field, many cases of legal and ethical dilemmas arise on a daily basis. In such cases, the role of the physician is to provide competent medical treatment at the discretion of the patient and their families. In many of these cases, although the physician believes they are doing the right thing, we often have our own opinions. Among these cases, are two unique dilemmas to be discussed in great detail before obtaining an ethical decision. The first case is of a 47 year old male who suffers a brain aneurysm and is comatose. After three years of the patient being in a persistent vegetative state, his wife chooses to remove the feeding tube which supplies her husband’s nutrition and fluids. The next case is of a baby born with down …show more content…
Among the two cases discussed there are two options to decide between. In the case of the 47 year old man the options are straightforward, however, difficult to decide in the perspective of the physician. On the one hand the physician can choose to remove the feeding tube from the comatose patient leaving him to die of starvation and dehydration. On the other hand, the physician could choose to forgo removing the feeding tube and cause more distress upon the patient’s wife, but spare the life of the patient. If the physician were to choose to remove the feeding tube he would ultimately give up any hope of the patient potentially waking up from his comatose state. There are many who also argue that a feeding tube is rather uncomfortable for a patient. However, those who are comatose “are not conscious of hunger or thirst. Feeding tubes have the potential to preserve the patient’s level of consciousness and thus prolong the agony of the underlying disease or of the dying process. This may be considerably more painful than any associated with starvation and dehydration” (Dunlop, 2006). Further, this case in particular presents the topic of deontological ethics or duty based ethics. Deontological ethics focuses on one’s duties to others and others’ rights (Pozgar, 2016, p. 11). In this dilemma the physician has a duty to the patient to do …show more content…
Despite the child having down syndrome, if the parents were to follow through with surgery the child would have a normal life after healing. However, if the parents chose to forgo surgery the child would ultimately die of starvation. Although the parents may feel they are sparing their child the repercussions of surgery, I believe they are making the child suffer more by forcing the child to die of starvation. This child is unable to make the decision for themself because they are too young. In terms of the physician’s decision, the decision truly comes down to their opinion of whether the patient’s parents are making the most appropriate decision for their child. Under the physician’s code of ethics “if there is no reasonable basis on which to interpret how a patient would have decided the decision should be based on the best interests of the patient, or the outcome that would best promote the patient’s well-being” (AMA, 2016, opinion 8.081). In other words, if the physician believes the decision being made by the surrogate decision makers is not in the best interest of the patient, then the physician has the right to provide the best means of treatment regardless of the parent’s decision. In a similar case, a child with down syndrome was also denied the surgery he needed to survive by his parents. Due to the denial of the surgery many believed that the child’s parents were attempting to avoid