Do Not Resuscitate Week 10 Assignment

docx

School

Capella University *

*We aren’t endorsed by this school

Course

3200

Subject

Philosophy

Date

Feb 20, 2024

Type

docx

Pages

Uploaded by AmbassadorAtomAlbatross37

Do Not Resuscitate 1 Do Not Resuscitate Goua Hang Capella University PHI3200: Ethics in Health Care Kim Carter-Cram December 17, 2023

Do Not Resuscitate 2 Do Not Resuscitate There are two most important parts of life: One is when we are born, and the other is when we are at the end of our life, whether because of an illness, injury, or old age. When we reach this part of life, we sometimes can’t decide whether we receive care or treatment. It often falls to those who care for us, our family members, and our physicians. Not everyone knows what a do-not-resuscitate (DNR) order is or has a DNR order documented in their medical charts in case such circumstances occur. A DNR order is the right to refuse CPR (cardiopulmonary resuscitation), artificial intervention, and defibrillator. In a study of “ 19,007 ICU patients, 1,239 patients (6.5%) had a do-not-resuscitate order on the first day of ICU admission and survived 48 hours in the ICU” (Fuchs L, Anstey M, Feng M, Toledano R, Kogan S, Howell MD, Clardy P, Celi L, Talmor D, Novack V, 2017). Patients' wishes are part of their lives and should be respected as an individual’s sense of autonomy. Sometimes, we either can’t make that decision, or we are incapable of making such a decision, leaving our family and physicians with a decision on our behalf. When no DNR order is present, it becomes a hard choice, leaving our lives in the hands of others, hoping they know what we want. Sometimes, a physician must make a choice, and it becomes difficult for a physician to choose between doing no harm, which is nonmaleficence, and doing good and practicing beneficence. Do they withdraw treatment, or do they withhold treatment? Is it wrong to withdraw treatment, or is it better to not offer it in the first place? These questions should be answered and made knowledgeable to the family or caretaker of the individual. We should be treated justly in our hospitalization and receive that to which we are entitled, and our rights should be recognized

Do Not Resuscitate 3 and protected. These problems occur when a person gets admitted to a hospital for end-of-life care. This end-of-life decision affects family members, doctors, and nurses, especially when a DNR is absent. In some rare cases, the court decides when no known next of kin, relative, or someone close is available. There is a hierarchy known as a surrogate decisionmaker, starting from a legally appointed guardian to a spouse, adult children, parents, adult siblings, and lastly, court decision-making. This, of course, varies by state but should follow a similar hierarchy. Sometimes, the decision-making member is too emotionally affected and cannot make a sound decision, and we put their decision into question and must override this person’s wishes. This problem is not limited to a certain group or community but is more of a national problem that every family faces. The stakeholders are anyone in the position of deciding for the patient, whether that is the patient, family member, physician, or court. Whoever it may be, the final decision falls on that stakeholder and becomes their responsibility. It is a problem, as mentioned before. If the patient is not making the DNR order, it can become an ethical issue when it violates the patient’s autonomy. When the DNR order falls into the court’s hands, there is only a limited amount that the court can do on behalf of the patient. According to J. Randall Curtis, Erin K. Kross, and Renee D. Stapleton (2020), depending on state regulations, patients with chronic life-limiting illnesses should be offered the option to complete a physician order for life-sustaining treatment form, especially if they do not want to receive cardiopulmonary resuscitation (CPR) or mechanical ventilation. Two intended purposes of a DNR were to support the patient’s autonomy and to prevent non-beneficial interventions; failing to fulfill those purposes can lead to serious ethical issues. An important component is to

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

Do Not Resuscitate 4 be clear on the policy of a DNR order. Patients and their families must understand that a DNR does not mean that all medical care is withheld from the patient but rather only pertains to CPR, artificial ventilation, and defibrillation. Other treatment such as pain management, palliative care, antibiotics, or other treatment aimed at comforting the patient is continued per the patient’s request. A legal aspect of a DNR order should involve intricate documentation and communication. Accurate communication with healthcare providers and punctiliously documenting a DNR in the patient’s medical records is paramount. Everywhere in the world, people face the same issues with end-of-life care. DNR affects not only our nation but all nations. One solution to the problem is clarifying and informing the patient and the family what a DNR order is and what is expected when ordering a DNR order. Patients should be aware and capable of making decisions instead of waiting until they become incapable. Respecting the patient’s autonomy is crucial. This will help ensure that everyone is on the same page and that patients and their families will not be left without 100% knowledge of what a DNR order is and what it pertains to. A study showed “that out of 500 patients who suffered from cardiac arrest, 76% of those patients were incapacitated to make decisions at the time a DNR order was discussed” ( Yuen JK, Reid MC, and Fetters MD. 2011) . The Joint Commission’s policy does not provide a clear and concise guideline for DNR discussion (2011). Having a standard policy and procedure across all hospitals is essential. The best way to make this a solution rather than a problem is by making DNR orders a more common subject and revising the policies behind a DNR order. Physicians, nurses, and hospital staff should raise awareness about DNR orders. Yuen, Reid, and Fetters (2011), state that in 1991, the passage of the Patient Self-Determination

Do Not Resuscitate 5 Act (PSDA) required all healthcare institutions to inform patients about their right to complete an advance directive, including their right to refuse life-sustaining interventions such as CPR. In an analysis, only 4% of medical residents discussed the chances of survival after CPR, and rather than clarifying the topic, it was discussed vaguely. The more we make it known to the public and around hospitals, the more aware people will be. We can use pamphlets and signs, make commercials about it, and promote it more on TV shows like The Good Doctor or ER. Like anything else, people will become aware if it gets put into the world enough. The more people know about DNR orders, the more capable they can make sound decisions on how they want to continue care during this last phase of their lives.

Do Not Resuscitate 6 References Yuen, J. K., Reid, M. C., & Fetters, M. D. (2011). Hospital do-not-resuscitate orders: why they have failed and how to fix them. Journal of general internal medicine , 26 (7), 791–797. https://doi.org/10.1007/s11606-011-1632-x Fuchs, L., Anstey, M., Feng, M., Toledano, R., Kogan, S., Howell, M. D., Clardy, P., Celi, L., Talmor, D., & Novack, V. (2017). Quantifying the Mortality Impact of Do-Not-Resuscitate Orders in the ICU. Critical care medicine , 45 (6), 1019–1027. https://doi.org/10.1097/CCM.0000000000002312 Curtis, J. R., Kross, E. K., & Stapleton, R. D. (2020). The Importance of Addressing Advance Care Planning and Decisions About Do-Not-Resuscitate Orders During Novel Coronavirus 2019 (COVID-19). JAMA , 323 (18), 1771–1772. https://doi.org/10.1001/jama.2020.4894

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

Do Not Resuscitate Week 10 Assignment

Related Documents