Unlike most professions, healthcare often puts medical practitioners in very difficult moral dilemmas almost on a daily basis. While some dilemmas are of lesser magnitude i.e. giving over the counter “painkillers” others often define the moral fiber of individuals involved, a good example is the end of life care. In a case where physicians declare that a person will imminently die regardless of treatment diagnosed a lot of ethical issues and questions arise. The level of confidentiality that should be involved and/or when to terminate life is just but a few examples.
Tonya Archer is a fifteen-year-old who has officially been diagnosed brain dead. Doctors who were monitoring her determine that her condition is permanent and therefore advocate removing her from life support whereas her parents are adamant that whilst her heart continues beating she should remain on life support. Without even further explanation a variety of ethical issues are already present. For one, Conly articulates that health practitioners have a moral obligation to prolong life as much as they can as long as it does not endanger other patients’ lives (2014). In the short narrative, it comes out as if that the doctors want to stray from this obligation, which from my perspective is not right regardless of the reason.
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Moreover, another issue that often accompanies the end of life health care is autonomous decision making (Karnik & Kanekar, 2016). The patient in play should have full liberty to decide their fate. In this case, Tonya is brain dead thereby she cannot make a decision regarding her life hence the liberty falls on to her parents. As such it is safe to assume that no matter what the way forward to be taken Tonya’s parents should have the final say. With that being said it is prudent to delve into what the hospital and doctors alike should do.
The hospital, in my opinion, should confidentially and compassionately advise Tonya’s parents that removing her from life support is the best decision. This should be the first and only action that the hospital does. Whereas, they are free to air their opinions this should be done in the most patient and respectful way possible. In truth, Tonya’s parents will have to pull the plug someday one way or another. It is important that the hospital grants the parents and any other additional relatives the time and space to pay their last respects. In the case that the parents are defiant on ending life support it is imperative the hospital subtly hint that the cost would be unbearable at a future date (Karnik & Kanekar, 2016).
I base my perception on Kant’s categorical imperatives. Kantian ethics and consequently moral theory suggests that we as individuals should aim to live according to a universal maxim (Stern, 2015). In the case mentioned above, it is clear that the hospital is running impatient and if not they soon will be. Whereas, all “logical” thoughts point to ending life support a more humanitarian insight tells me that postponing such an action is the best way forward. This is because placing yourself in the parents’ shoes it can be quite tough to end the life of your daughter. Hence, I advocate an action that I believe is worthy of a universal maxim with regards to the end of life care.
Conclusively, end of life care has a lot of ethical issues. Whatever action a health practitioner takes, whether it is right or wrong, is a matter of perspective. This is due to the fact that humans are so morally different due to a plethora of reasons. It is in such scenarios that professional codes are very much imperative so as to make the most right decision if at all there is such a thing.
References
Conly, S. (2014). Against autonomy: justifying coercive paternalism. Journal of medical ethics , 40 (5), 349-349.
Karnik, S., & Kanekar, A. (2016). Ethical Issues Surrounding End-of-Life Care: A Narrative Review. Healthcare , 4 (2), 24. http://doi.org/10.3390/healthcare4020024
Stern, R. (2015). Kantian Ethics: Value, Agency, and Obligation . Oxford University Press, USA.
