Ethical Principles in Health Care

Introduction

When faced with an ethical dilemma, one often has to make an unpleasant choice. This paper explores the “end of life” dilemma involved in the Woods v. Commonwealth (1999-SSC-0773) case. In the case, the dilemma revolves around the removal of Woods from a life support given that he has right to life and dignity.

Ethical principles

Nurses in end-of life care face ethical dilemmas for patients in life support machines as it is in the case of the Woods v. Commonwealth (1999-SSC-0773) (Pozgar, 2013). The major ethical concern in the case revolves around end-of life care on whether to discontinue or continue life support (Judith et al., 2011). Since nurses are the prime caregivers to patients especially those under end-of life care, termination or continuation of life support is a major ethical dilemma. Therefore, as nurse making end of life decision could be challenging. Moreover, the American Nurses Association’s Code of Ethics requires the protection of the safety, health, and the rights of the patient (American Nurses Association, 2010). As such, when a patient under life support is removed from the support machine, a nurse has a key role in assisting the patient to die in comfort and with dignity. This has been supported and discussed by American Nurses Association’s Code of Ethics (American Nurses Association, 2010). Moreover, under end-of life care, nurses are required to respect the dignity as well as worth of all people (American Nurses Association, 2001). For example, provided that Woods could not make end of life decision, a nurse has legal and ethical obligation to the request for end-of life care.

Pros and cons of an ethics committee serving as a patient’s guardian

One of the benefits of an ethics committee serving as a patient’s guardian is that there is a higher chance that the set codes of ethics and standards shall be followed. The committee is able to agree on whether the patient is incapacitated or in a vegetative state and could never recover. The ethics committee “provides assistance in clarifying situations that are ethical, legal, or religious in nature that extend beyond the scope of daily practice” (Pozgar, 2013, p. 143). This means that the ethics committee provides substituted judgment based on major ethical principles (American Nurses Association, 2010). This means that since an ethics committee upholds high ethical standards, it is more likely to make a decision that Woods would have made if he was competent enough. According to Pozgar (2013), an ethics committee is not always a good decision maker because in most cases, a unanimous opinion is not always achieved. For example, in the case under review, a disagreement between members of the committee leads to the ethical dilemma.

The ethics committee in the case served as the legal guardian in Woods’s life support removal. Moreover the ethics committee is mostly chosen when the patient does not have an immediate guardian or when a patient is not in a position to make a decision (Pozgar, 2013). In such a case, the ethics committee acts as the surrogate in the decision making process since the patient lacks the capacity to give consent voluntarily.

Recommendations

As a member of the ethics committee I would have recommended the removal of Mr. Woods from the life support machine because “It was generally agreed that he would never regain consciousness and would die in 2 to 10 years” (Pozgar, 2013, p. 168). Moreover, there was clear evidence that Mr. Woods would eventually die even though he was on a life support machine. The patient was also fully unconscious and the withdrawal would be in his best interests. I normally draw from my ethical lens when faced with ethical issues. For example, since I value autonomy and equality, I always endeavor to protect the rights of patients, respect the dignity and worth my patients. For this reason, I am required to respect the dignity as well as worth of Woods and the appointed guardian wishes as required (American Nurses Association, 2010).

When faced with end-of life care ethical dilemma like in the case study, it is my obligation to ensure the protection of the safety, health, and the rights of the patient as advocated for under the American Nurses Association’s Code of Ethics (American Nurses Association, 2010). It is also my moral duty to ensure that Mr. Woods does not suffer in pain, and as it is my role to assist the patient to die in comfort and with dignity. I uphold justice as a classical value and for this reason, I act on others fairly. Lastly, besides behaving ethically, “I make ethical choices for myself and others.” This means that the decision to terminate would be ethical, just, and fair as it reflects my ethical lens attributes.

In the Woods v. Commonwealth (1999-SSC-0773) case, the major ethical dilemma revolves around end-of life care. In conclusion, ethics committee could be chosen as a guardian when “end of life” dilemma is involved. This is because they provide legal, ethical, and substituted judgment in situations when ethical principles are compromised. As a nurse, I could have recommended the removal of Woods’s life support was legal, ethical, and moral. From personal my previous knowledge and personal and professional experiences, I have learned that when faced with an ethical dilemma, one often has to make an unpleasant choice.

Reference List

American Nurses Association. (2010). Code of ethics for nurses with interpretive statements. Washington, DC: Author. [ISBN: 978-1-5581-0176-0].

Judith A. A., Baile, D.E., Anderson, R. A., & Docherty, S. L. (2011). Nursing roles and strategies in end-of-life decision making in acute care: A systematic review of the literature. Nursing Research and Practice, vol. 2011, Web.

Pozgar, G.D. (2013). Legal and ethical issues for health professionals (3rd ed.). Sudbury, MA: Jones and Bartlett.

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