In accordance with the religious beliefs and the demand of the patient’s family, as a member of the healthcare ethics committee, I have advised transferring patient to an inpatient hospice (Rainsford, Rosenberg & Bullen, 2014). As commented by Leo et al., (2014), inpatient hospice is a designed to provide short-term relief with medications for the patients. The treatment demanded by the patient’s family is unethical and against the policies of the healthcare organisation. In the case of the patient, inpatient hospice care will ensure a peaceful and less painful death for the patient. The patient will be provided with medicines that will keep him alive that is better compared to leaving the patient completely unattended due to the religious perspectives. According to Amano et al., (2015), the inpatient hospice setting provides a homely environment for the patient thereby, providing a peaceful environment. Therefore, transferring the patient to an inpatient hospice will be beneficial for the health of the patient thereby, avoiding non-compliance with the healthcare policies.
2.According to the present medical condition of the 80-year-old patient, there is no sign of further improvement. Therefore, as there is no scope of recovering from the coma, the patient needs to be fed nutrition and hydration artificially by insertion of the tube. However, the religious belief of the patient and the family restricts the healthcare organisation in doing so and allow the patient to die naturally. Such a situation is unethical on the part of the healthcare organisation and the physician treating the patient. As commented by Brinkman-Stoppelenburg, Rietjens & Van Der Heide (2014), it is the principle and fundamental duty and responsibility of the physician and healthcare organisations to provide care to the patients regardless of any anything. It is the sole duty of the healthcare organisations and physicians to suggest treatment for the patient aiming for health improvement. In the case of the patient, the religious belief of the patient’s family is causing hindrances in providing suitable treatment for the patient. Abiding by the religious belief of the patient’s family is unethical and against the fundamental duty of the physician. According to Levine & Wolf (2012), the principle duty of the physician is to provide care to the patients for health improvement. In the case of the patient, the duty of the physician is compromised in order to fulfil the wish of the patient on the religious ground.
According to the national healthcare legislations, the healthcare organisations need to provide care facilities in accordance with the requirement of the health conditions of the patients (Husso et al., 2012). In this case, the medical condition of the patient requires artificial nutrition and hydration by insertion of the tube. However, the religious beliefs and perspectives of the patient’s family are causing hindrances by stopping the health care to provide the required facility. The wish of the family to let the patient die naturally is unethical and the policy of the hospital is violated. The hospital, in this case, is failing to provide necessary care to the patient thereby, resulting in slow, painful and uncomfortable death.
3.According to the American Code of Medical Ethics (AMA), the healthcare organisation and physicians are meant to respect and abide by the wish of the patient in terms of the medical treatment the individual wants to receive ("AMA CODE OF MEDICAL ETHICS", 2017). Therefore, the healthcare organisations and the physicians are bound to abide by the wish of the patient if stated in a healthcare proxy or living will. In this case, if the 80-year-old patient had a healthcare proxy or living will mentioning that he does not want a feeding tube and wishes peaceful death, the healthcare organisation and the physicians were bound to abide by his wish (Wiener et al., 2012). In this case, the present medical condition of the patient would not have mattered as he has already stated his wish. Apart from this, if the healthcare proxy stated that the patient wished to use medication to keep him comfortable at the expense of shortening his life, the healthcare organisation and the physicians were supposed to follow and implement the mentioned treatment procedure regardless of the patient’s health conditions.
Under such circumstances, the healthcare organisation and the physician are supposed to describe the present medical condition of the 80-year-man and the treatment procedure selected by him in the healthcare proxy. Consultation with family members before treating the patient is necessary, as he was in the coma and unable to take decision for him. Therefore, if the family, too, agrees with the wish of the patient, then the healthcare organisation needs to follow the treatment procedure stated by the 80-year-man. However, against the organisational policy of the health care and the working principle of the physician, the healthcare organisation and the physician cannot impose the treatment procedure on the patient. Therefore, if the 80-year-old man had a living will or health care proxy, the healthcare organisation and the physician would not have encountered the ethical dilemma and conducted the treatment mentioned by the patient.
AMA CODE OF MEDICAL ETHICS. (2017). AMA PRINCIPLES OF MEDICAL ETHICS. Retrieved 29 June 2017, from https://www.ama-assn.org/sites/default/files/media-browser/principles-of-medical-ethics.pdf
Amano, K., Morita, T., Tatara, R., Katayama, H., Uno, T., & Takagi, I. (2015). Association between early palliative care referrals, inpatient hospice utilization, and aggressiveness of care at the end of life. Journal of palliative medicine, 18(3), 270-273.
Brinkman-Stoppelenburg, A., Rietjens, J. A., & van der Heide, A. (2014). The effects of advance care planning on end-of-life care: a systematic review. Palliative medicine, 28(8), 1000-1025.
Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes. Oxford university press.
Leo, S. D., Bono, L., Romoli, V., West, E., Ambrosio, R., Gallucci, M., ... & Valenti, D. (2014). Implementation of the Liverpool Care Pathway (LCP) for the dying patient in the inpatient hospice setting: development and preliminary assessment of the Italian LCP Program. American Journal of Hospice and Palliative Medicine®, 31(1), 61-68.
Levine, A. D., & Wolf, L. E. (2012). The roles and responsibilities of physicians in patients' decisions about unproven stem cell therapies. The Journal of Law, Medicine & Ethics, 40(1), 122-134.
Rainsford, S., Rosenberg, J. P., & Bullen, T. (2014). Delirium in advanced cancer: screening for the incidence on admission to an inpatient hospice unit. Journal of palliative medicine, 17(9), 1045-1048.
Wiener, L., Zadeh, S., Battles, H., Baird, K., Ballard, E., & Osherow, J. (2012). Allowing adolescents and young adults to plan their end-of-life care. Pediatrics, peds-2012.
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