It is accepted that the advances in resuscitation techniques, initiated and influenced the evolution of bioethics by bringing to the fore the questions of:
(i) just allocation of scarce medical resource, health care
(ii) the nature of “being”, and
(iii) the proper purpose of medicine.
The main issues that caused the emergence, or the study and introduction of bioethics was the introduction of modern technology in medicine in the form of respirators and artificial heart machines. The media attention to the Karen Ann Quinlan case made the issues public. The Karen Ann Quinlan case serves as a perfect example of these new issues. She was diagnosed with a persistent vegetative state, and her life was sustained with a respirator and
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This implies a downgrading of the importance of the human body.
The most important lesson learned from this case was the revising of medical treatment. Medicine should treat patients as autonomous subjects. Thus came about the development of autonomy based ethics principles. “Ethics needs principles – four can encompass the rest – and the respect for autonomy should be ‘first among equals”. (Gillon, 2003)
The limitations regarding, “the right to life” was a topical issue at the time of the Karen Quinlan case. The court ruled that the decision should be in the hands of ethics committees, another important realisation from the Quinlan case ruling. Many ethics committees were formed to make the decisions. Hospitals and all extended care facilities got an ethics committee. It was thought that they should be the decision making body in the future. However, it is now the opinion of experts that the authority of the ethics committees is limited. Any decision must belong to patients, and/ or their proxy. Out of this case there has also developed advanced health directives, which led to a society becoming aware of the need to create living wills as to what family members were to do or not to do in conditions of “extraordinary” medical care. The power of attorney also came to the forefront. Many people today would recognise the name of Terry Schiavo. Karen
The ethical principles for nurses to practice with beneficence and no maleficence. This legal battle between Terri Schiavo’s husband and her family was an ethical debate between continuing artificial life or remove her feeding tube by the request of her husband. Using the theories of utilitarianism and deontology can be applied or considered in making the most ethically correct resolution. The cases are very complex and raise many moral and ethical issues. The cases have brought awareness to society of “the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for health care, are a healthcare proxy clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions. Terri Schiavo should impress upon laypersons and professionals alike the uncertainty of the context in which issues of continuation and termination are argued ethically. Nobody knows what Mrs. Schiavo would have wanted. She left no advance directive and in its absence her husband says one thing and her parents
Autonomy includes three primary conditions: (1) liberty (independence from controlling influences), (2) agency (capacity for intentional action), and (3) understanding (through informed consent) (Beauchamp & Childress, 2009, p. 100). According to Beauchamp & Childress (2009) to respect autonomous agents, one must acknowledge their right to hold views, to make choices, and to take actions based on their personal values and beliefs (p. 103). Respect for autonomy implies thaturges caregivers to respect theassist a patient in achieving? Heed? the autonomous choices of their patients. From there, patients can act intentionally and with full understanding when evaluating medical treatment modalities. Autonomy also includes a set of rules, one of which requires that providers honor patient decision-making rights by providing the truth, also known as veracity (Beauchamp & Childress, 2009, p. 103). In this case, several facets of the principle of respecting autonomy, specifically veracity, informed
This assignment will discuss a case involving an individual known to me. It centres on the real and contentious issue of the “right to die”, specifically in the context of physician-assisted death. This issue is widely debated in the public eye for two reasons. The first considers under what conditions a person can choose when to die and the second considers if someone ever actually has a ‘right to die’. The following analysis will consider solutions to the ethical dilemma of physician-assisted death through the lens of three ethical theories. It will also take into account the potential influence of an individual’s religious beliefs
Aiding the death of infants is a much disputed controversy in healthcare. H. Tristram Engelhardt Jr. provides an ethical view that there is a moral duty not to treat an impaired infant when this will only prolong a painful life or would only lead to a painful death. It is these individuals, like Engelhardt, who must defend this position against groups who consider that we have the ability to prolong the lives of impaired infants, thus we are obligated to do so.
There are four principles of ethics: Respect for autonomy, Beneficence, Non maleficence and Justice. This four principles offers comprehensive thought of the ethical issues in clinical settings (Beauchamp and Childress 2001 cited in UK Clinical ethics Network 2011).
This problem first began to surface in the 1980s when the court had to face Cruzan v. Director, Missouri Department of Health. In this case the court had to decide by “clear and convincing evidence” that the comatose patient’s (Nancy Beth Cruzan) desire to terminate her life before the courts would allow her family’s wish of disconnecting her feeding tube be carried out. Unfortunately eight of nine judges said no to the proposition and concluded that the right
Although all the clinical practitioners were not required to study medical ethics at that time, AMA still believed that the clinical practitioners would be able to make good moral judgements in bioethical dilemmas. The AMA’s laissez-faire approach worked fine until the emergence of the morally disruptive technologies, such as the dialysis machine, ventilator etc. These new innovations in medicine were morally disruptive because they challenged the previous definitions of life and death. For example, the invention of a ventilator destroys the previous definition of death. With the use of a ventilator, a patient whose heart stopped beating could still live because the ventilator would provide the pulmonary function to him/her. This not only led to the reconsideration of the definition of death, but also raised the moral issues of whether or not they should discontinue the life support of the ventilator-dependent patients. In addition, there was an outbreak of research ethics scandals, in which the clinical researchers continued to do research on
What is bioethics? According to Michigan State University, School of Medicine, it is defined as an activity that is shared, reflective, examination of ethical issues in healthcare, health science and health policy. It is the discussion of the information that should be given to the patient and the patients right to refuse or accept that information. It involves doctors and patients but scientists and politicians and the general public. It has brought significant change but also raises new questions. In any event the topic of discussion and the purpose of this term paper is to explore biology and the ethics of this natural science. The topic of this paper is Physician Assisted Suicide; it has been widely debated amongst doctors, patients, politicians and law makers. The question that will be explored is the fact of if this is wrong or right to do. The purpose of physician assisted suicide, as well as how humans manipulated this phenomenon, and the controversy of this topic, amongst other prevalent information will be discussed. There will be some court cases that will be mentioned to prove when it should be used and when it should not be used. I will attempt to provide my position to this topic, although it may be hard to do so. Laws in which PAS can be done will be mentioned as well as other alternatives to it. I hope and pray this is sufficient.
This edition consists of nine chapters divided into three parts, as well as an appendix of ten biomedical ethics cases. In Part I, chapter 1, entitled "Moral Norms," introduces the decision-making framework with attention to specifying and balancing principles and rules for moral deliberation and decision-making. Chapter 2, entitled "Moral Character," elaborates on moral virtues and ideals as an often-neglected area in biomedical ethics. In Part II, chapters 3 through 6 present the four basic groups of principles, and chapter 7, "Professional-Patient Relationships," examines the moral rules of veracity,
This question has major impact on many people’s lives, their deaths, and their quality of life. Many other questions can be asked in conjunction with this question. How would you like to be kept on life support? Would you want a doctor to make the decision of ‘life or death’? The questions just keep on coming, and every time we seem to find ourselves divided. This issue is relevant because of the recent media coverage over Terri Schiavo’s right to live or die and the fact that any of us could be in her situation. In the case of Quinlan1., the court asked, "If the patient could wake up for 15 minutes and understand his or her condition fully, and
In the following paragraphs, I will use ethical principles to solve the problem of allocating ventilators during a mass casualty event. I will reference the article, “Principles of allocation of scare medical interventions” and “Ethical Principles in the Allocation of Human Organs” as references to discuss bioethical principles. Many of these principles will conflict with each other, so I will discuss which actions are more “ethical”, after the four principles of bioethics are considered. For the purposes of this paper, I will be using a utilitarian approach that states allocation should result in the greatest overall good for the greatest number of people, which goes hand in hand with the principle of beneficence and non-maleficence. Being that utilitarianism is a form of consequentialism, it is also important to look at the consequences of allocation, or what some will consider the flaws of utilitarianism. To put it simply, not everyone can be
The case of Karen Ann Quinlan led to four basic approaches to this ethical problem; advance directives or other clear evidence of the patients wishes while competent, surrogate decision making (power of attorney), and action in the patients best interest. Each solution has deficiencies both in theory and practice, but there can be no debate that their application has changed the landscape of medical ethics.
Medical technology is far more advanced today then years of past. With the new and rapid expansions in knowledge and drug pharmacology the power of life and death lays in closer proximity than ever. With this comes the medical means to treat and diminish the anguish of people afflicted with sicknesses that were once incurable or agonizing. However, we are also in a time where medical technology has given us the power to sustain lives or prolong the death of patients whose physical and mental capabilities that cannot be restored. Patients, whose deteriorating conditions that cannot be overturned or even treated now have to suffer in pain that cannot be eliminated, only controlled. As medical professional fight to yank
Autonomy can override beneficence when life-support is withdrawn (Prozgar, 2010). In addition, when a physician takes the position of withdrawing life-supporting equipment, the principle of non-maleficence is severed. Since helping patients die violates the physician’s virtue of duty to save lives,” distributed justice is served by releasing a room in the intensive care unit for a patient who has a higher chance of resolving their medical problems (Pozgar, G. 2010). There are so many inflict fuzzy gray areas and ideas about conflicting DNR policies that political disputes had to go to the courts to sort out the issues legally.
There are four basic ethical and bioethical principles that have a strong influence in the practice of medicine, predominantly medicine that deals with those who are dying. The first is beneficence, which directs the physician and health care worker to take positive actions, specifically by restoring health and relieving suffering (Bongard et al., 2008). Then there is nonmaleficence. Goldman and Schafer (2012) add that nonmaleficence is the idea that people should not be harmed or injured knowingly. The third ethical principle is autonomy,