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Terminally ill patients would wish to enhance survival and prolong life. However, there are scenarios where pain causes too much suffering for patients. In this case, individuals may make decisions on their preferred end-of-life treatment. This paper discusses the moral aspects of withholding life support, ethical principles, and alternatives available when withholding life support.
The case study provides insights into Martinez’s situation and the decision to end life on his own terms. The patient has a chronic pulmonary disease. The hospital admitted the patient due to an upper respiratory infection. Martinez and the wife mutually agreed against a resuscitative process such as DNR if the symptoms worsen. The directive describes the patient’s preferred pathway in case they are unable to make informed decisions at an advanced stage of their illness.
Martinez’s long history of respiratory problem and consistent use of medications to assist with breathing reveals the seriousness of the condition. He is on oxygen, fluids and antibiotic treatments. While there are signs of improvement, the condition exposes Martinez to harm than gains, hence the need for the care team to respect the earlier directive. The family should acknowledge the directive and respect the patient’s wishes (Douplat et al., 2020). Acting in patients’ best interests means appreciating their wishes. The directives include those that could help alleviate persistent emotional, physical, and psychological harm. Equally, healthcare professionals should consider patients as individuals capable of understanding their complications and making informed conclusions about their preferred treatment.
According to Douplat et al. (2020), deaths precede decision to withhold or withdraw life-sustaining treatments for patients with chronic conditions and functional limitations. Healthcare professionals have an obligation to provide the best care based on the requirements on sanctity of life and dignified death. The care team could consider alternatives such as surgery, medications, and the use of experimental drugs to improve Martinez’s situation. On the other hand, proponents of directives support the need for healthcare professionals to avoid additional treatments if significant improvement is unachievable (Reignier et al., 2019).
Patients who cannot make critical treatment decisions may make earlier choices through a verbal order or a written consent. Individuals have the right to clarify their wishes, hence the need for the care team to acknowledge a patient’s preferences. In this case, physicians should consider a patient’s autonomy, which gives the patient the right to determine the preferred interventions involving their health (Reignier et al., 2019). The care team should consider protecting a patient from additional suffering after exhausting treatment options. Such patients may have challenges taking care of themselves and often put extra social and economic burden on family and friends. As such, the care team should offer moral support and compassion during end-of-life stages by withholding life support.
The autonomy principle allows patients to refuse additional interventions meant to enhance survival or prolong life. Such decisions may trigger conflict with the healthcare team, which is responsible for protecting life and supporting the sanctity of life. However, acknowledging a patient’s directives is part of the treatment initiatives that seek to honor and respect crucial decisions during end-of-life stages. Martinez clarified the decision to withhold life support if the symptoms deteriorated. Withholding the life support is a moral choice. Physicians should respect the decision in line with the autonomy principle.
Douplat, M., Fraticelli, L., Claustre, C., Peiretti, A., Serre, P., Bischoff, M., Jacquin, L., Freyssenge, J., Schott, A., Tazarourte, K., Frugier, S., Khoury, C. (2020). Management of decision of withholding and withdrawing life-sustaining treatments in French EDs. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 28(52), 1-9. https://sjtrem.biomedcentral.com/track/pdf/10.1186/s13049-020-00744-7.pdf
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