"Caring a Patient With Terminal Illness" is an excellent example of a paper on medical ethics. It’ s the authorship of Katy Butler that presents one of the most modern times difficulties that families and health caregivers endure when monitoring patients with a terminal illness. At the heart of the problems is the ethical issues that families and health caregivers come across. Katy Butler uses a family with one of the members being terminally ill who are on a pacemaker to bring a broader picture of how it can be.
Additionally, it’ s a family that has a history of a terminal illness. It is like they have adapted to this kind of life. The grandfather of the narrator was also a patient that died after years of close monitoring. The narrator is now taking care of their father, Jeffrey, and professor, who is suffering from heart problems co-morbid with dementia. Jeffrey has a pacemaker and he is constantly being help performing basic daily activities such as going to empty bowels. The mother of the narrator is the primary caregiver who adapts to that way of life.
At moments she sees that her husband is suffering and would even wish the pacemaker to stop to relieve him of the suffering. To the very last moments and with encounters with doctors and nurses, Katy Butler has brought to light the experience people caring for a patient with a terminal illness go through with the ethical issue of the core of the experience. In the article, the ethical issue that needs to be addressed is whether the artificial pacemaker should be preserved at the request of the patients and family members.
It has been seen in the case by Katy Butler the health caregiver has been in a position where the preference of the patient or the family member has been requiring them to switch off the pacemakers. There are two ethical codes that are provided by the American Nursing Association (ANA) which are opposing. One of the ethical code is respect for inherent integrity and patient autonomy. The patient can request the health caregiver to disconnect the artificial pacemaker. With the provision of the ANA, on one hand, advocating for the respect of patient autonomy and the other hand opposing provisions of observing beneficence, put the health caregiver in a dilemma on which provision of ANA to apply.
Respecting the autonomy of patients means removing the artificial pacemaker and hence life while applying a second provision will mean that the pacemaker should be preserved. The ethical dilemma that faces the health caregivers as presented by Katy Butler can be addressed through the application of well-researched work of Bronner (1999) and Fowler, M. D. M., & American Nurses Association.
(2008). That has attempted to come with evidence-based approaches in such situations. The two have arguments that take on the dilemma with the purpose of preserving the artificial pacemaker. According to Fowler & American Nurses Association. (2008), he argues that the sole purpose that the health care services came into being was to reduce mortality and morbidity that is associated with illness. The artificial pacemaker is for the therapeutic purpose and hence reducing mortality. For the patient that needs it removed, will be compromising the sole purpose that the health caregiver is meant for.
Removing the pacemaker translate to increased mortality that the health caregiver is meant to reduce. Following the viewpoint of this argument, therefore means that the pacemaker should be preserved and save the life that the health caregiver is meant for. Therefore, the request of the patient and family member taking care of the patient should be scaled with the purpose that the health caregiver is meant for. If the request goes against the purpose, then the health care worker has the latitude to disregard their request and reduce the mortality and morbidity of the patient.
To that effect, beneficence must transcend the patient autonomy that will compromise the purpose of the health caregiver. Another viewpoint of tackling the dilemma is through putting the research of Bronner (1999) into perspective. According to Kristen, argues that health care workers should learn what the request of the patient means before granting the patient autonomy. A patient that requests the pacemaker to be removed could be having intense pain of which he or she is associating with the artificial pacemaker.
The health caregiver should therefore address the underlying issues other than respecting the autonomy of the patient which is poorly interpreted. Following the knowledge of the underlying cause of the patient's request, for example, if it's pain, then the pain should be dealt with and settle the fear of the patient. Respecting patient autonomy does not mean addressing the need in a patient way but in a meaningful way. Basing on this approach, beneficence overrides the mistaken request of the patient. Beneficence should be upheld in the event the life of the patient is threatened.
In this case, the patient request to remove the artificial pacemaker is a threat to life therefore not granted. The health professional should be guided by the principle rather than the emotion or the second party influence of others. The understanding of the respect and need for beneficence is the first step in ensuring that every action that is taken is correct and free of any malice. The patient’ s preference can be some time against ethics hence health care workers should remain put on the principles.
The beneficence and respect for the patient should be above everything when dealing with patients.
Butler, Katy. (2010). What Broke My Father’s Heart: The New York Times Available at http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=all&_r=0
Bronner, Kristen. (1999). Preference-sensitive care: Center for the Evaluative Clinical Sciences. Chicago: Dartmouth atlas of health care
Fowler, M. D. M., & American Nurses Association. (2008). Guide to the code of ethics for nurses: Interpretation and application. Silver Spring, MD: American Nurses Association