Ethical Dilemmas

Patient values and preferences and the concerns and values of family must be taken into account when faced with difficult clinical situations. Although my mother is mentally incompetent and doesn’t understand the implications of stopping dialysis, she has indicated that she refuses potentially life-sustaining dialysis by way of displaying behavioral resistance. Many patients with dementia usually state their care preferences before they become too impaired to make care decisions. In her illness, my mother also seems to have an opportunity to state her wishes verbally or she seems to have a living will. Therefore, in this situation, my family should make a practical decision considering all things such as her care preferences, quality of life, …show more content…
Her primary doctor will seek to maximize benefit and avoid harm based on the principle of beneficence and nonmaleficence. My mother has a severe, irreversible illness with poor prognosis, and most of all, continued dialysis is causing her a high level of pain, which can worsen her quality of life. Aggressive medical care is able to extend her life, but it can damage her quality of life causing pain to her and my family. At this point, identifying goals of care in an effort to optimize her quality of care and avoid her suffering is important for decision-making. In that case, a palliative care should be considered. The doctor’s recommendation doesn’t mean he lets his patient die because he will make a decision based on his accumulated skills, knowledge, and lawfulness of dialysis withdrawal. In respecting autonomy, her lack of awareness of her illness and communication problems make our decision difficult. Furthermore, perceptions of “quality” may vary from one person to the next. In this regard, my family should use my mother’s expressed wishes that were made through her life, values, and preferences as a guide to what best defines quality of life for …show more content…
It can cost a fortune to care for a patient with chronic diseases, and this will be a burden for every family after her death. The diseases my mother has is not welcome to the hospital settings because the hospitals mainly focus on advanced care not on spiritual, emotional care for my mother. Many hospitals tend to avoid costly chronic procedures like dialysis and limiting hospital admission. In strictly economic terms, a decision to pursue palliative care would be considered as cost saving. When we face this ethical issue, ethical decision making is challenging because we are closely connected with my mother emotionally and want to see her prolong life as long as possible. In this regard, my family can get some help from healthcare professionals who have good professional knowledge to make a practical decision about what is best for my