End Of Life

By Author: Sherry Roberts
Total Articles: 81
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Introduction
End of life decisions are very sensitive as they involve determining when to die. Individuals can write out a will that dictates how they should be taken care of in case they find themselves in a medical condition that impairs their decision making ability. However, when an accident or medical emergency occurs, the people in the patient life can influence decisions relating to continued medical care and treatment and end-of-life decisions. Cynthia’s case highlights the dilemma of listening to the spouse or the patient’s parents on matters of end-of-life.
Discussion
The risks involved in Cynthia’s case included exposing her to prolonged pain and suffering without any hope of recovery or switching off her life support thus denying her a chance of making a recovery. There are several implications with the risks involved. First, it would be unethical to prolong a patient’s life when there is no hope for recovery. Cynthia had been in a coma for three years and was unable to speak, eat or move. In short, Cynthia was trapped in her body, a situation that she had mentioned not to be put ...
... through if it ever happens. However, the husband claims that the wife said she did not want to be sustained by artificial means could be the cries of a spouse who did not want to see his wife in a helpless state. The second ethical implication would be ignoring the decision of Cynthia’s parents and maybe Cynthia had a chance of making a full recovery. However, Cynthia had been in a coma for three years and had not recorded any improvements (Landau, 2010). The accident resulted in severe brain damage and Cynthia was in a persistent vegetative state. Patients considered as being in a persistent vegetative state are unlikely to make a full recovery especially if they are unconscious for over three months.
Cynthia’s case and subsequent medical decision was sensitive because of the persons who were invested in the outcome. First, the healthcare professionals are tasked with the responsibility of providing quality and professional care to patients (Sinuff, & Heyland, 2015). The expectation of the healthcare professionals is to ensure that the patient makes a full recovery. Second, the spouse is invested in the outcome as he does not want to see his wife in a prolonged state of artificial support without hope of recovery. The third person invested in the outcome is the patient’s seven-year old son. For three years, he has watched his mother in the helpless state but he continues to expect her (the patient/mother) to wake up and make a full recovery. The fourth group invested in the outcome is the parents and the sisters. Their interest is to see they daughter/sister alive and thus they hold onto the hope that she will make a full recovery irrespective of the three years of no change.
In Cynthia’s scenario, the best approach on end-of life matters would have been to listen and adhere to the wishes of the spouse. The spouse indicated that 3 months prior to the accident, she had indicated that she would not have wished to be supported through artificial means. As the spouse, the husband had the legal right to decision on the medical procedures Cynthia should or should not undergo. Cynthia’s wishes coupled with the obvious indication that she is unlikely to make a full recovery should have formed the basis for ending Cynthia’s life. The doctors could have resolved the family standoff by highlighting that Cynthia was in a persistent vegetative states and unlikely to come from it (Cohen, & Fried, 2015). Moreover, the family indicated that Cynthia wanted “to be let go with dignity” and after three years of no improvement maybe it was time to let go. Cynthia’s husband’s claims of his wife’s wishes were initially verbal but he later found an old-not from Cynthia that highlighted her desire not to be supported by artificial means. The husband’s decision to remove the feeding tubes would, therefore, have been validated. According to Lang, (2004), the most frequent hierarchy when it comes to matter of end of life decision is the spouse, the adult children and then the patient parents. The doctors should have, therefore, listened and adhered to Robert’s wishes on turning off the machines.
Conclusion
End of life decisions must be respected especially if the patient made the decision before the occurrence of an injury or accident. Concerning Cynthia’s case , the doctor’s failed Cynthia by failing to execute her wishes as told by the husband. Robert, as the spouse had the right to announce and ensure the execution of his wife’s wishes. Unfortunately, the doctors chose to listen to Cynthia’s mother and her sisters. In the end, she did in pain after experiencing an infection. In short, she did not die with dignity as she wished due to the doctor’s decision to ignore her wishes. Her husband, therefore, has every right to sue the state and the hospital for going against his wife’s wishes. Cynthia would not have acquired the infection that eventually resulted to her death. She died from an infection that she would not have acquired if her wishes had been granted.

References
Cohen, A. B., & Fried, T. (2015). Guardianship and end-of-life decision making. JAMA internal medicine, 175(10), 1687-1691
Landau, E. (2010). Who will make your life-or-death decision. CNN Health
Lang, F. (2004). Making decisions with families at the end of life. American family physician. Vol. 70(4):719-723
Sinuff, T., & Heyland, D. K. (2015). Improving end-of-life communication and decision making: the development of a conceptual framework and quality indicators. Journal of pain and symptom management, 49(6), 1070-1080

Sherry Roberts is the author of this paper. A senior editor at Melda Research in online nursing papers. If you need a similar paper you can place your order for a custom research paper from legitimate research paper writing service services.