PHI FPX 3200 Assessment 3 Should We Withhold Life Support? The Mr. Martinez Case
Should We Withhold Life Support? The Mr. Martinez Case
The argument of whether or not to withdraw life support for Mr. Martinez is dependent on the observance of his previously expressed wishes through his Do Not Resuscitate (DNR) order, which demonstrates respect for his right to choose not to have life-sustaining measures, such as CPR, administered to him. The unsought rise in his oxygen level causing the respiratory failure complicates things, but the ethical principles driving the decision should be the three primary principles: autonomy, beneficence, and non-maleficence. Although life support might temporarily stabilize Mr. Martinez, his chronic condition may reduce the quality of his life. More importantly, while the medical team can’t directly reach his wife, her preferences announced earlier coincide with the DNR order; hence, respect for his autonomy, as well as the prevention of unnecessary suffering, is utmost. Finally, the ethical choice would be to respect the DNR and not do any aggressive life support interventions.
Mr. Martinez’s Case Description
Mr. Martinez is a 75-year-old patient diagnosed with chronic obstructive pulmonary disease (COPD) for whom a DNR was requested; he stated not to do CPR if at any point needed. A day before the incident, he was hospitalized with an upper respiratory infection for which he received antibiotics, fluids, and oxygen. He was improving well. However, an unintended rise in his oxygen levels caused respiratory failure, which resulted in significant distress for Mr. Martinez. When found by the therapist, he was gasping for air, and his medical team was divided about whether to treat him according to his wishes made earlier and then intended, but in a situation not originally planned.
Moral Issues Associated with Limiting Life Support
In analyzing the moral issues associated with withholding life support in Mr. Martinez’s case, the bottom line of the ethical concern seems to hover on respecting his autonomy by his Do Not Resuscitate (DNR) order. The DNR represents Mr. Martinez’s wishes to deny himself life-sustaining interventions, particularly CPR (Uzun et al., 2022). Although the unplanned increase in oxygen resulted in pulmonary arrest leading to life-threatening complications, it does not dismiss the ethical principle of respecting the previously taken decisions by the patient. The medical team is faced with a moral dilemma as to whether it should aim at saving lives at all costs or respect the autonomy of a patient who decided that he must not be subjected to interventions he refused earlier. Assuming that Mr. Martinez’s refusal of CPR was an informed, deliberate, value-based decision reflecting his opinions about the quality of life and his wishes regarding the end of life,
Quality of life is the other theme of great relevance in this analysis. If life-supportive interventions, including mechanical ventilation, are instituted for Mr. Martinez, his life might be prolonged, but at what cost-possibly a debilitated or miserable one resulting from his chronic respiratory condition (Keane et al., 2023). Beneficence (acting in the patient’s best interest) and non-maleficence (not harm) are tenets that may be violated if life-sustaining interventions are initiated. The assumption here is that prolonged life support might cause more harm than good, especially when the patient has expressed a preference for a natural death rather than prolonged suffering. The medical team must assess whether the benefits of extending life outweigh the potential harms of reduced quality of life or the emotional and physical burden on Mr. Martinez.
Finally, there is the matter of the role of the family in deciding what to do. The medical team cannot contact Mrs. Martinez personally, but one may surmise that the DNR order is consistent with the understanding that both husband and wife have of his wishes. Ethical respect for the values and insights that the family brings is an important element guiding decisions in these cases. An assumption here is that the family would probably have concurred with Mr. Martinez’s decision, given his attitude toward life support and end-of-life care. The moral concerns in limiting life support include respecting the patient’s autonomy, assessing both the harms and benefits of life-sustaining interventions, and examining the family’s perception of the patient’s wishes, all of which are consistent with the principles of autonomy, beneficence, and non-maleficence.
Assumptions
The analysis of limiting life support in the case of Mr. Martinez is predicated on certain key assumptions. The first assumption is that Mr. Martinez made an informed and voluntarily issued DNR order which takes account of his value judgments about quality of life and what he wants for end-of-life treatment (Green, 2021). It assumes that prolonging life support could do more harm than good, mainly because he suffers from a chronic condition and there may not be much living to be done outside of the hospital in his diminished state. Finally, it assumes that the family, and especially Mrs. Martinez, would concur with this decision since they all know what he wanted for himself at this phase of his care.
Ethical Principles When Considering Limiting Life Support
The limitations of life support for Mr. Martinez carry decisions that require sound ethical thinking based on the principles of autonomy, beneficence, and non-maleficence. The condition in effect would respect Mr. Martinez’s autonomy because it upholds his Do Not Resuscitate (DNR) order, which represents his rational decision to refuse life-sustaining treatment (Tsai & Lai, 2024). Beneficence requires action in the patient’s best interest; hence, preventing untimely suffering and acknowledging that life support may well diminish quality of life are considerations. Non-maleficence emphasizes the avoidance of harm, with prolonging life in such a fragile state perhaps causing more harm than good. Ignorance of these principles can have serious real-life outcomes, such as undue suffering, emotional anguish for the patient and family, and potential legal and ethical implications on the healthcare providers involved, including loss of public trust in the medical system and possible legal sanctions for not respecting a patient’s wishes.
Real-World Consequences of Ignoring Ethical Principles
Ethics in Mr. Martinez’s case could ignore some major real-world consequences both for the patient and the healthcare team. If his order DNR is not to be carried out, then the team could proceed with pushing for aggressive life support interventions, which might result in unnecessary physical suffering of Mr. Martinez, potentially prolonging his distress and thus damaging his quality of life (Kraus, 2020). Third, it violates his autonomy; hence the trust in the healthcare system may be eroded. Moreover, following a patient’s expressed wishes negates legal consequences in terms of lawsuit/s or professional disciplinary actions being taken upon healthcare professionals. Finally, it can bring further emotional distress to the family since it violates their perception of the patient’s desires, again bringing them additional misery and conflict.
