Discuss about the Not For Resuscitation Orders for Healthcare Industry.
It is important to have a proper understanding of Do Not Resuscitate (DNR) order legal and the ethical decision making for proper flow in the healthcare industry. DNR order is where the physician offers instructions to restrict resuscitative efforts when a patient stops breathing or when the heart stops beating. The DNR order is supposed to reduce the suffering of a patient by ensuring that there are limited machines used to facilitate breathing and heartbeat. According to BBC (2014) DNR order is passive euthanasia with the aim of reducing the negative effects of resuscitation such as broken ribs, fractures, and brain damage. The restarting of heart or breathing for terminally ill patients aims at increasing the days of the person. The DNR order is done by a physician with consultation with the next of kin of the patient. It is a process that requires the consent of other individuals of the family for proper execution of the order. According to Meikle (2011) the decision to do not resuscitate requires trust with the people involved in the wellbeing of the patient. Doctors analyse the condition of an individual in understanding whether resuscitate while suffering a cardiac arrest. Kevin, Brownyn and the nurse had a heated discussion over the not for resuscitating decision. Beauchamp and Childress four ethical principles are used in coming up with a sound decision on medical issues (Page, 2012). The essay argues the need for using respect for autonomy, beneficence, non-maleficence, and justice for medical ethics.
The DNR order aims at reducing the suffering of a patient by offering a merciful death or health without assistance from resuscitate machines. The primary reason for DNR order is an incurable or prolonged illness that is causing suffering to an individual. In coming up with the decision, the medics are required to evaluate the situation of the individual continuously. Terminally ill patients are provided with the option to reduce the suffering of due to the disease. The doctors are required to evaluate the situation of a patient in determining the proper decision to implement between continued treatment and DNR order (Rodriguez-Miranda et al. 2015). The suffering of an individual should be considered in developing a proper decision to implement for a person. Diseases conditions such as stroke can cause suffering to an individual for a long time requiring using a proper plan that will reduce the pain. According to Azad et al. (2014), the DNR order options are provided with the right to die for patients having severe or prolonged pains. The compassionate death of the terminally ill patients is performed after there is exhausting of all treatment methods for the individual (Aladangady et al. 2016). The doctors are required to provide the essential information to the patients with terminal illness to reduce unfair treatment. The treatment of terminal illness requires financial resources thus DNR order is used by individuals to reduce suffering and save money to the family.
Doctors and family accept DNR order due to a reduced ability to perform daily life activities making life hard (Robinson et al. 2017). The patients are required to stay in their beds leading to autonomy which reduces self-esteem and confidence which is a vital aspect of life. Terminal illness makes an individual lose dignity due to the increased dependence on other people to perform basic activities in life. Inadequate treatment of various diseases makes it hard for people to have a sustainable life which may lead to DNR order decision. It is crucial for the doctors to focus on the welfare of the family and community before implementing the DNR order decision as instructed by the patient. Evidence of extended suffering to an individual is used in accepting the decision to end life (Emanuel et al. 2016). Terminal illness by an individual makes one have a negative approach to life due to the uncertainties and fears in the life of dying. The patient or the medics may use DNR to reduce the cases of fears of the future of an individual due to the prolonged illness.
Respect for autonomy is where individuals have a decision to apply in advance to use DNR order in reducing pain (Galambos et al. 2016). Every person has a right to an existence where one can make a decision not to be resuscitated. Kevin, Bronwyn and the nurse are expected to decide as Dawn has a massive stroke making her unconscious. There are negative effects of resuscitating which requires an individual to consider death in case there are breathing and heart issue. Beauchamp and Childress state that it is important to respect the decision of an individual about the extreme measures taken when there is terminal illness (Gillon 2015). Paternalistic is done when a capable adult makes the decision to the children against the use resuscitate. The informed decision is aimed at ensuring that the patients intentionally understand the effects of DNR order. The respect for autonomy is done voluntary by an individual to deal with the issue of a condition that leads a person with breathing and heart beating problem. The informed consent ensures that there is a proper flow of operations in the health sector. According to Osborne (2016), there are over 200,000 patients issued with the DNR order without the consent of the patient or family who is against the rule of cardiopulmonary resuscitation.
Beneficence is performed to ensure that there is no harm to other individuals involved in a particular operation (Pettersson, Hedstrom & Hoglund 2016). Especially in organ transplant, it is important to ensure that there is consideration of the interest of both parties. The nurse is expected to make an informed decision due to her knowledge of the illness. Kevin and Bronwyn should accept the decision of the nurse as she acts in the best interests of the patient. The health workers are expected to work towards the best interest of a patient for the achievement of the desired social production level. The DNR order is supposed to offer a positive step to an individual towards the accomplishment of the desired health condition. The cardiopulmonary resuscitation has harmful effects thus the medics are expected to evaluate the best decision to implement for a patient. In case of the DNR order, it is evident that the cardiopulmonary resuscitation has more harm to the patient than the benefits (Wang 2017). The operation in the best interest of a patient involves placing the patient protective environment or saving the life of the individual. The DNR order using the beneficence code of ethics requires the doctor to come up with the decision for the patient.
The non-maleficence ethic principle requires a doctor to focus on the performance that does not intentionally cause harm to the patient. The ability to deal with harm aims at reducing the negative effects that are evident due to a particular disease or condition. A physician is required to focus on ensuring that there are reduced errors of commission or omission in the service delivery (Malek, Rahman & Hasan 2018). The nurse is mandated to have the knowledge to deal with the massive stroke that Dawn has without causing harm to the patient. The activities performed at the hospitals are supposed to be safe to the individual health by reducing cases of injury. A doctor is required to follow the set Law and Medical Ethics for a proper flow of healthcare services. The risk of harm is evaluated by the physician with the aim of ensuring that the patient is protected from any harm.
Justice in the Beauchamp and Childress ethics aims at ensuring that there is fairness in various operations in the healthcare sector. In this case, the nurse is supposed to evaluate the views of Kevin and Bronwyn in making the suitable decision. The DNR order is a technique that is used by an individual to acquire a slow death due to the suffering. It is important to inform the patient and family members of the impacts of the DNR order (Putman et al. 2017). An individual can recover or die when there is the implementation of the DNR order. The social effects of the decision are considered to reduce cases of depression to the people who were a close friend of the patient. The distributive justice is considered before implementing the DNR order to determine whether the order is beneficial to the society (Zhang et al. 2018). It is important for an individual to focus on increasing the contribution to the society thus the DNR order is a bad influence on the community justice.
A nation is required to develop proper laws that will regulate DNR order for the community. In Australian government developed health laws that allowed patients to practice voluntary euthanasia in case of a prolonged illness. The Northern Territory passed the law on euthanasia on 25th May 1995 permitting the doctor to end the life of a terminally ill patient at patient’s request (Parliament of Australia, 2018). The active voluntary euthanasia was to be used in providing the individual with the needed assistance to die. It is important to offer an individual who is terminally ill a peaceful death through euthanasia. The Rights of Terminally Act 1995 provided an increased national and international debate with people supporting the law and other criticizing the law (Parliament of Australia, 2018). The euthanasia is practiced in the Northern Territory of Australia with the other parts of the nation being illegal to end a patient’s life even by request by the patient. The doctors in other parts of Australia are required to provide care to the patients until there is natural death to the individual (Willmott et al. 2016). The increased number of people willing to peacefully end their life due to pain led to the government developing the Rights of Terminally Act to allow DNR order.
In Australia, there are three sections that are used in coming up with DNR order decision by the physician. According to Parliament of Australia (2018), one is patient wants to die and requests the doctor to assists by offering a prescription or a mechanism to perform the act. Two is the excessive pain to an individual who requires a doctor to facilitate the patient’s death to relieve pain and suffering. According to Brodtmann (2017) a patient willing to die and request a doctor to offer a lethal injection that will lead to death. The intention of the doctor to relieve pain is supposed to be used in developing the appropriate plan to perform DNR order for an individual. In Australia, the government is focused on reducing pain to the terminally ill patient by offering them an option to end their lives using euthanasia or the DNR order. According to Quinlan (2016) drugs and mechanisms used are supposed to provide a peaceful death for an incurable disease. It is important to perform the DNR order with good faith where the medics continuously evaluate the condition of the patient by allowing the peaceful death. The DNR order applies to a patient suffering from pain with a problem of breathing and heart beating that is incurably leading to a reduced ability to live a comfortable life. The physical pain and emotional distress are evaluated by the doctor in determining the need for assisted suicide.
The mercy-killing law in Victoria State allows the doctors to assist patients with severe pain and suffering in the region. The terminal illnesses require proper care to acquire the desired social and economic performance. The Victorian parliament allowed mercy-killing for the terminally ill patients from mid-2019 for the reduced suffering of the patients (McGuirk, 2017). An increase in cancer cases required the state to implement laws that allow euthanasia to the patients. Patients lose the need for life when there are extended suffering and pain caused by a disease or condition. In Victoria, Australia the medics will be allowed to use a lethal drug to practice the DNR order to the patients ten days after request (Baidawi, 2017). Doctors and patients are required to have an insight of the legal aspect in the state before executing the decision of the DNR order. According to Australian Human Rights Commission (2018) the Northern Territory, South Australia, Victoria, ACT, Western Australia and Queensland allow euthanasia while Tasmania and New South Wales are against euthanasia. The directives allow the doctors and patients to identify the state that allows the DNR order to avoid legal action by the government.
Conclusion
Beauchamp and Childress developed the four ethics that an individual is required to consider while implementing the DNR order. The ability of an individual to breath is enhanced by cardiopulmonary resuscitation. In case a patient, family member or doctor comes up with the DNR order it is an indication that the patient should not be assisted to breathe or for the heart to beat using the cardiopulmonary resuscitation. The technique is passive euthanasia due to the high possibility of an individual dying due to the DNR order. A physician is required to evaluate the ethical and legal aspect of the order towards a smooth flow of the society. The legal aspect in Australia considers the laws of euthanasia where DNR order should not be practiced in states which are against euthanasia. The ethical aspect should consider the respect for autonomy, beneficence, non-maleficence, and justice towards making a proper decision.
References
Aladangady, N., Shaw, C., Gallagher, K., Stokoe, E. and Marlow, N. (2016). Short-term outcome of treatment limitation discussions for newborn infants, a multicentre prospective observational cohort study. Archives of Disease in Childhood-Fetal and Neonatal Edition, pp.fetalneonatal-2016.
Azad, A.A., Siow, S.F., Tafreshi, A., Moran, J. and Franco, M. (2014). Discharge patterns, survival outcomes, and changes in clinical management of hospitalized adult patients with cancer with a do-not-resuscitate order. Journal of palliative medicine, 17(7), pp.776-781.
Baidawi, A. (2017). Euthanasia Law Passes in Australia for First Time. Nytimes.com. Retrieved from https://www.nytimes.com/2017/11/29/world/australia/australia-euthanasia-victoria-assisted-dying.html
BBC. (2014). BBC – Ethics – Euthanasia: DNR – Do Not Resuscitate. Retrieved from https://www.bbc.co.uk/ethics/euthanasia/overview/dnr.shtml
Brodtmann, A. (2017). Comment: Does patient sex affect decision-making after hemorrhagic stroke?. Neurology, 89(4), pp.353-353.
Emanuel, E.J., Onwuteaka-Philipsen, B.D., Urwin, J.W. and Cohen, J. (2016). Attitudes and practices of euthanasia and physician-assisted suicide in the United States, Canada, and Europe. Jama, 316(1), pp.79-90.
Galambos, C., Starr, J., Rantz, M.J. and Petroski, G.F. (2016). Analysis of advance directive documentation to support palliative care activities in nursing homes. Health & social work, 41(4), pp.228-234.
Gillon, R. (2015). Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics. Journal of medical ethics, 41(1), pp.111-116.
Malek, M.M., Rahman, N.N.A. and Hasan, M.S. (2018). Do Not Resuscitate (DNR) Order: Islamic Views. Al-Qanatir: International Journal of Islamic Studies, 9(1), pp.35-43.
McGuirk, R. (2017). Australian state legalises voluntary euthanasia. The Independent. Retrieved from: https://www.independent.co.uk/news/world/australasia/australia-euthanasia-law-victoria-parliament-assisted-suicide-dying-terminal-illness-a8081601.html
Meikle, J. (2011). NHS hospitals warned over ‘do not resuscitate’ orders. Retrieved from https://www.theguardian.com/society/2011/dec/05/nhs-hospitals-warned-resuscitate-orders
Osborne, S. (2016). Do not resuscitate orders imposed on thousands of patients without families’ consent. Retrieved from https://www.independent.co.uk/life-style/health-and-families/health-news/do-not-resuscitate-orders-imposed-on-thousands-of-patients-without-families-consent-a7009621.html
Page, K. (2012). The four principles: Can they be measured and do they predict ethical decision making?. BMC Medical Ethics, 13(1).
Parliament of Australia (2018). Euthanasia – the Australian Law in an International Context. Aph.gov.au. Retrieved fromhttps://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/RP9697/97rp4
Pettersson, M., Hedstrom, M. and Hoglund, A.T. (2016). Physicians’ Experiences of Do-Not-Resuscitate (DNR) Orders in Hematology and Oncology Care–A Qualitative Study. J Palliat Care Med, 6(275), p.2.
Putman, M.S., D’alessandro, A., Curlin, F.A. and Yoon, J.D. (2017). Unilateral do not resuscitate orders: physician attitudes and practices. Chest, 152(1), pp.224-225.
Zhang, W., Liao, J., Liu, Z., Weng, R., Ye, X., Zhang, Y., Xu, J., Wei, H., Xiong, Y. and Idris, A., 2018. Out-of-hospital cardiac arrest with Do-Not-Resuscitate orders signed in hospital: Who are the survivors?. Resuscitation, 127, pp.68-72.
Quinlan, M. (2016). “Such is Life”: Euthanasia and capital punishment in Australia: consistency or contradiction? Solidarity: the Journal of Catholic Social Thought and Secular Ethics, 6(1), p.1-22.
Robinson, E.M., Cadge, W., Zollfrank, A.A., Cremens, M.C. and Courtwright, A.M. (2017). After the DNR: surrogates who persist in requesting cardiopulmonary resuscitation. Hastings Center Report, 47(1), pp.10-19.
Rodriguez-Miranda, R., Swetz, K.M., Hernández-Ortiz, A., Strand, J.J., Lara-Solares, A., Hernández-Martinez, E.E., Tamayo-Valenzuela, A. and De la Fuente, J.R. (2015). Palliative sedation: Clinical practice challenges in Mexico and development of a national protocol for Mexico. Progress in Palliative Care, 23(5), pp.274-280.
Wang, Y. (2017). A Chinese perspective on the concept of common morality by Beauchamp and Childress. Eubios Journal of Asian and International Bioethics, p.132-141.
Willmott, L., White, B., Stackpoole, C., Purser, K. and McGee, A. (2016). Failed Voluntary Euthanasia Law Reform in Australia: Two Decades of Trends, Models and Politics. UNSW Law Journal, 39, p.1-36.
Essay Writing Service Features
Our Experience
No matter how complex your assignment is, we can find the right professional for your specific task. Contact Essay is an essay writing company that hires only the smartest minds to help you with your projects. Our expertise allows us to provide students with high-quality academic writing, editing & proofreading services.
Free Features
Free revision policy
$10Free bibliography & reference
$8Free title page
$8Free formatting
$8How Our Essay Writing Service Works
First, you will need to complete an order form. It's not difficult but, in case there is anything you find not to be clear, you may always call us so that we can guide you through it. On the order form, you will need to include some basic information concerning your order: subject, topic, number of pages, etc. We also encourage our clients to upload any relevant information or sources that will help.
Complete the order form
Once we have all the information and instructions that we need, we select the most suitable writer for your assignment. While everything seems to be clear, the writer, who has complete knowledge of the subject, may need clarification from you. It is at that point that you would receive a call or email from us.
Writer’s assignment
As soon as the writer has finished, it will be delivered both to the website and to your email address so that you will not miss it. If your deadline is close at hand, we will place a call to you to make sure that you receive the paper on time.
Completing the order and download