The dilemma is that Mrs. Margie Whitson a patient at Golden Oaks Rehabilitation Center is going through some very hard times after just loosing her son William about a week ago. She has also had to deal with loosing her husband in the past 5 years leading up to this. She is also reflecting back to when she lost her first son to a motor vehicle accident. Margie is having a very difficult time taking this all in and now feels all alone and wants the one and only thing keeping her alive removed. Margie suffered a heart attack 2 years ago that almost took her life and she had to have an electronic pacemaker implanted. The pacemaker is what is keeping her alive by keeping her heart rhythm at a 100% pace.
Without the pacemaker she would not be able to live. Now that all of her family is gone she is requesting that her pacemaker be removed so that she can pass and go on to be with her family because she now feels like she has nothing to live for anymore. She has talked to the Rehabilitation Center Administrator Cindy Mackin and has told her what she wants to happen and has requested her to call Dr. Vijay who was the Cardiologist Surgeon who placed the pacemaker in her to remove it.
Morals are principles of right and wrong in behavior, expressing or teaching a conception of right behavior, conforming to a standard of right behavior, sanctioned by or operative on ones conscience or ethical judgment, and capable of right and wrong action. (Merriam-Webster) According to our book the moral principles of ethics that are involved in removing Margies pacemaker are: ¢Beneficence- is the principle of doing good, demonstrating kindness, showing compassion, and helping others. ¢Nonmaleficence- is an ethical principle that requires caregivers to avoid causing patients harm. ¢Justice- is the obligation to be fair in the distribution of benefits and risks. ¢Autonomy- is recognizing the right of a person to make ones own decisions.
(Legal Aspects of Healthcare)
The morals that are in conflict with this issue is nonmaleficence because the doctors, nurses, social worker, and ethics committee main priority is to make sure that nonmaleficence is not being implemented by any means. Other morals that are in conflict would be justice and autonomy because the committee has to take in consideration the patients right to make her own decision about wanting to live or not but they also have to take into consideration the benefits and risks of the patient that could come along with going through the patients request of removing her pacemaker.
The ethics committee goals consist of:
¢Promote the rights of patients. ¢Promote shared decision making between patients and their clinicians. ¢Assist the patent and family, as appropriate, in coming to a consensus regarding the options that best meet the patients goal for care. ¢Promote fair policies and procedures that maximize the likelihood of achieving good, patient-centered outcomes.
(Legal Aspects of Healthcare)
It is clear that this dilemma consists of Margie wanting her doctor to assist with taking her life by removing her pacemaker. She has been through so much with the loss of her immediate family members that she wants to pass away as well to be with them because she feels like there is nothing else to live for. There are many theories of ethics that play apart in this dilemma. One of the theories is the Normative Ethics where all attempts are made in determining what moral standards should be put into place to ensure that human behavior and conduct are morally right.
Another theory that can be can be applied is the Consequential Ethical Theory that focuses on the morally right action that will lead to the maximum balance of good or evil. The Utilitarian ethics believes that the moral worth of an action is only determined by its contribution to happiness as summed by all people. The last theory would be the Deontologic ethics that is focuses on the duties to others, which consists of telling the truth to all patients.
The ethics committee then sits down together and communicates with each other about the dilemma while going over the morals values and theories that apply to this particular dilemma to ensure that all of the rights steps and decisions are taken before they come to a conclusion on what to do for Margie. This step in communication is very critical to make sure that the committee review the dilemma properly, resolve any ethical dilemmas, resolve any conflicts, and to figure out if any additional support is needed. The committee does not necessarily come up with final decisions but they provide the needed advice to guide doctors, nurses, etc. towards making the right decisions.
The ethics committee members all agree that there is indeed a dilemma with Margie wanting the aid of a doctor to take her life by removing her pacemaker, which is the only thing that is keeping her living. After meeting with all of the members of the ethics committee we are all on the same accord and have been informed with all the information about the case. The Cardiologist Dr. Rana Vijay, the Social Worker Jane Robison, the Rehabilitation Center Administrator Cindy Mackin and the Ethics Committee Chairman David Jamison have all come together and presented all information and facts that they know about this issue to all the members of the committee to ensure that no one was left out about any details of this dilemma. All members concur with my understanding and all other parties that had information about Margies dilemma.
After speaking with the Cardiologist Dr. Rana Vijay, he informs the committee that removing Margies pacemaker would violate Beneficence, Nonmaleficence, and Justice. He stated that he would be going against helping others if followed through with Margies request, he would also be going against avoiding or causing harm to patients, and lastly he would be disregarding the benefits and risks of Margie by performing the requested actions. The Social Worker Jane Robison also expressed that doing this would not be good for Margie or his profession due to the ethics standards they have to withhold for all patients.
She believes that with time she will have a change of heart and will appreciate her life being spared. The Rehabilitation Center Administrator Cindy Mackin agrees with everyone else in not assisting Margie with taking her life due to the sad circumstances that she has been faced with in the past few years. After all the members have reviewed the suggestions and recommendations from everyone involved everyone on the ethics committee have agreed that Margies request to have her pacemaker removed will be denied due to all ethical standards and the fact simply that it is just not right to let someone take their own life or assist with taking someones life. One of the most important things is to never cause harm to any patient, which taking a patients life goes above and beyond of causing harm to a patient.
Legal Aspects of Health Care Administration/George D. Pozgar.-11th ed.p.cm
Moral. Retrieved from: http://www.merriam-webster.com/dictionary/moral