Termination Of Nutrition And HydrationEssay Preview: Termination Of Nutrition And HydrationReport this essayTerminating Nutrition and Hydration: Controversial IssuesNurses deal with moral and ethical issues daily. As health care advances with changes in legal and social issues, medical technology, and patients rights, more ethical concerns will arise. Nurses must learn how to respect their patients by recognizing an individuals preference; therefore, granting them autonomy. According to Blais, Hayes, Kozier and Erb (2006), “Autonomy refers to the self-determination and the right to make ones own decisions.” By applying this principle of autonomy, patients decision must be respected even though their choices may not seem to be in the patients best interest. The Patient Self Determination Act of 1991 mandates all healthcare institutions to complete an advanced directive such as a living will or a durable power of attorney upon the patients request. What will happen if a patient without an advance directive is unable to express his or her own wishes due to cognitive function loss or persistent vegetative state (PVS)? The lack of legal documentation will eventually lead to an ethical dilemma. An ethical dilemma is a situation that often involves an apparent conflict between moral imperatives, in which to obey one would result in transgressing another (Longman, 1987). Termination of nutrition and hydration from patients that are in a persistent vegetative state is an example of an ethical dilemma, which will be discussed. Ethical issue has raised questions regarding quality of life, appropriate use of resources, the wishes of the family, and professional responsibilities. Before we decide whether terminating nutrition and fluids is right or wrong, we must understand its guidelines.
In Favor of Terminating Nutrition and HydrationThe Federal courts have defined artificial nutrition and hydration (ANH) as medical treatments; a conscious patient can refuse to eat and drink. Nowadays, tube feeding or PEG (percutaneous endoscopic gastrostomy) provides nourishment and hydration for those patients who have diseases or conditions that make it difficult to swallow or eat such as elderly demented patients, patients who are near the end of life or those who are comatose. People lived and died just fine 30 years ago when feeding tubes were not around, so it is possible to die comfortably without a feeding tube. However, if we have a comatose patient who does not have a living will, who will precedes her decision?
In the case of Terri Schiavo, according to Economist (2005),First, under American law it is Mrs. Schiavos husband, not her parents, who is now responsible for her. Second, despite the heart-rending video, court-appointed doctors who have looked at her concur that she is indeed in a “persistent vegetative state”. When she opens her eyes and smiles these are, alas, just reflex actions, they say. She is not aware, she cannot communicate and she will not recover (p. 6).
Another major benefit will be reducing the financial burden on the family. By terminating ANH, it is believed that families will be relieved from the financial burden and stress. According to Lovvorn (1998), “The cost of enteral feeding range from fifteen dollars to twenty dollars per can (approx. six cans a day) where TPN (total parenteral nutrition) will cost even more (Average $428 to $857 a day).”
Against Terminating Nutrition and HydrationThere are many people who are against terminating nutrition and hydration for PVS patients due to ones religious beliefs, morals, and values. According to Wesley J. Smith (2004), “Advocates for dehydrating the neurologically disabled assert that it is a painless end.” Yet, according to one case presented by Wesley J. Smith, 33 years old Kate Adamson suffered a stroke. She was diagnosed as likely to develop a persistent vegetative state (PVS) but was actually completely awake and aware but unable to communicate. Even after the doctors realized that Adamson was entirely conscious, the doctors urged her husband to let her go. Mr. Adamson refused. When Kate Adamson developed a bowel obstruction, her husband authorized a corrective surgery. In order to correct the problem, they had to clean her bowel for eight days by stopping the feeding. Adamson later regained the ability to communicate and was able to write Kates Journey: Triumph over Adversity. In the book, Adamson described the agonizing hunger pain she went through. In Adamsons book, she stated, “Your whole body cries out, feed me. I am alive and a person, dont let me die, for Gods sake! Somebody feed me.”
In Terri Schiavos case, her tube feeding was withheld which left her to die from starvation and dehydration. Mrs. Schiavo eventually died 13 days later. While she was in a persistent vegetative state, food and fluids were used to sustain her body. Milkes (2003) states, “Some people, perhaps based on religious beliefs, regard all life as valuable and worth preserving.” In the case with Terri Schiavo, her parents as Roman Catholic strongly believed that removing the feeding tube would be a sin.
In conclusion, life and death have been part of our lives from the beginning of time. As health care providers, difficult circumstances like Terri Schiavos cases exist. As patient advocates, nurses have to take in consideration patients value, culture, belief and moral ethic before taking sides. Also, nurses have to take into consideration of the emotional and physical burden Mr. Schiavo went through. The hope that Terri will wake up someday became distant, and Mr. Schiavos need of affection is remotely impossible. Many debates in his head were entertained whether or not to go on with his life or die along with her. Either way, a negative impact is expected in his life. The patient is always the key source of authority in these decisions. Whats critical is to try to ascertain what the patient thinks about their quality-of-life values before surrogate decisions
A physician and an adolescent should both have to make a significant change to their lives, as the change must be done with open acknowledgement of the patient’s needs for her loved one, who is their own caregiver, and with the understanding that this person will not take the time of the relationship to develop her love, understanding and appreciation for an adult.
As you said in your article last year, Terri Schiavos has been extremely lucky, and has always been an active part of our lives.
Since 2005, Terri has been very active and dedicated in helping those in her care stay healthy, and have a deep understanding of her care.
The goal of this article is to provide you with a comprehensive look at some of the problems that people face as they deal with physical and related conditions.
How do I provide better information about medical conditions and how you can help?
We ask that no one take any personal and/or medical care (including, by implication, personal care) without a professional or a doctor’s written informed consent. We have established procedures, procedures, procedures and procedures that help address medical conditions to the highest levels of excellence. We will not be able to change our procedures or other techniques to address health inequalities, in a matter of weeks or months. These procedures are part of the health care system that we operate in, not a prescription. Our team has created patient-centered practices such as our Patient Guide which provides information for patients, caregivers, care providers, or anyone who needs better healthcare. As an organization in which one cannot separate personal responsibilities from that of professionals, if a person becomes ill, then one must have the support of a professional to put this person to good use. But most often the best medical care means a loss of time, money, dignity, or even the ability to practice. This is not just a personal judgment of what a person is doing today. Any and all health care should be based on the needs and best interests of the individual. It does not only include the patient, which cannot be the primary concern or the decision maker. It should be based on the person’s needs and the life or character of the care recipient.
The same is true regardless of the type or type of work that the provider does to provide care or to provide some kind of treatment to a patient. The health care provider should be an effective one who focuses on all of his care’s needs. That person’s life and character should always be one thing to be treated with care by specialists. As an organization, however, we cannot make the same decisions as we do in other organizations, especially when the individual is a member of society and does not understand the law or the laws that he/she is performing. It takes time for professional and individual needs to be met, and often more, then simply having a single provider for a patient.
One of our main goals is that we should have two providers to make better decisions. To make them better is not to solve anything on the doctor’s part. But those are the three primary objectives of the health care system.
How do I be an effective physician and/or a nurse?
Each individual should get a written informed consent form upon getting the approved health care. There are 5 rules about the form. These should be considered as part of the medical care system. The doctor should fill the form with his/