The subjects of withholding and withdrawing life-sustaining treatments are one of the most ethnically and morally complex issues in the healthcare industry. Advances in technology and medical sciences have raised several ethical dilemmas. The most common issues raised include the concept of the sanctity of life, the definition of “futile treatment”, and what “a patient’s best interest” constitutes.
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The case of Ms. Robaczynski involves a nurse who took upon herself to disconnect the life-sustaining support of a comatose patient. Regardless of how long the patient had to live, the nurse actively chose to disregard the principles meant to uphold the sanctity of life and as such was guilty of murder. The principles used in analyzing ethically sensitive issues include autonomy, distributive justice, non-maleficence, and beneficence.
Autonomy holds that every individual has a right to make decisions about their own bodies. Since Mr. Gessner did not sign any consent to withdraw treatment, the hospital was required to preserve his life to the best of their ability. By disconnecting the respirator, Ms. Robaczynski violated the patient’s autonomy.
Beneficence holds that all healthcare providers must act in a way that benefits others. Ms. Robaczynski chose to act because she felt “so helpless”. By switching off the respirator, she placed her own emotions before the welfare of the patient. She took action without considering the feelings of the patient’s friends and family. The nurse had no grounds to withdraw treatment since the patient’s death did not benefit anyone.
Non-maleficence holds that healthcare providers should always avoid causing harm to their patients. Mr. Gessner was almost dead and could not communicate his level of pain or discomfort. Ms. Robaczynski’s actions were therefore not helpful in any way that could be justified and resulted in the ultimate harm to the patient, death.
Justice requires healthcare providers to be fair when treating their patients and in the allocation of scarce medical resources. Healthcare providers should also be prepared to justify their decisions under all circumstances. Withdrawing treatment should only occur after consultations are carried out between all the parties connected to the patient. The nurse made her decision to disconnect the respirator based on an unjustifiable emotional response. She compounded this mistake by failing to seek consultations from her superiors and the patient’s family members. By stating that she only does this to GORKs, she raises questions as to her mental stability and shows a predilection to murder.
The question of whether to withhold or withdraw treatment usually follows a set of prescribed guidelines and involves various all parties connected to the particular case. Ms. Robazynski is clearly guilty of actively killing the patient as she chose to act according to her own wishes, disregarding proper medical procedures as well as the patient’s wishes.
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Had Mr. Gessner asked to be disconnected from the respirator, Ms. Robaczynski’s actions would still be regarded as active killing. While Mr. Gessner possesses autonomy, the decision to withdraw life-sustaining treatment can only be justifiable after careful deliberation of all the facts involved. When Mr. Gessner came to the hospital for the first time, he gave his doctors the power to do all they could to save his life. This empowered the doctors to participate in all medical-related decision-making processes including the withdrawal of life-sustaining treatments. If Mr. Gessner wanted his medical care to be withdrawn, appropriate medical personnel and immediate family members would have convened to analyze the situation and decide whether taking any action was justifiable.