Ethical Issues: Withholding Life Sustaining Treatments During End of Life Care - Essay Example

Clinicians’ essential role in planning and implementing of medical interventions, providing continuity of care and make changes in the regimen of treatment over time during the care are known and established. They are also responsible for ensuring that the patient's wishes and consents. When a cure is absolutely impossible certain life sustaining medical treatments such as cardiopulmonary resuscitation, ventilation, nutrition and hydration, dialysis, transfusions, and antibiotics may have to be withdrawn or withheld.

In this essay the impact of withholding and withdrawal of treatment from a nursing perspective is discussed with the ethical issues involved. Beginning with the Karen Ann Quinlan case (1975), followed by, the Nancy Beth Cruzan case of 1990, the federal Patient Self-Determination Act (1983), the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT, 1995), court rulings and statutes have created a widely accepted framework for decision making forgoing life-sustaining treatment in situations where they were either medically futile, unwanted by patients and families, or both.

Establishing this framework is one of the great accomplishments in bioethics. Decision making and implementing decisions about life-sustaining treatments are essential skills for clinicians. Bottlenecks to good care include misconceptions about legal and ethical issues, as well as unfamiliarity with the practical aspects of implementation. In withholding treatment, care providers typically withhold information about interventions, as they are deemed purposeless to be told to patients or proxies, in turn, doctors retain greater decision?

making prerogative and don’t feel obliged to get consent from patients or proxies. Clinicians’ essential role in planning and implementing of medical interventions, providing continuity of care and make changes in the regimen of treatment over time during the care are known and established. They are also responsible for ensuring that the patient's wishes and consents are documented and supported by the appropriate medical orders. There is a wide range of life-sustaining treatments that may be considered for an individual patient.

These include cardiopulmonary resuscitation, elective intubation and mechanical ventilation, surgery, dialysis, blood transfusions or administration of blood products, artificial nutrition and hydration, diagnostic tests, antibiotics, other medications and treatments. After determining the general goals of care, the clinician discusses specific treatments with his/her patients and families and whether those treatments will possibly help achieve the patient's overall goal. Asking a patient's preference for a specific invasive intervention and an alternative noninvasive intervention may help the clinician to get a general idea of a patient's priorities for making treatment decisions.

Different cultures and religions may have varying views of the role of suffering and the perspective of withholding and withdrawing the life support is diametrically opposed. Although many healthcare providers may support withholding life support at the end of life as a compassionate act that prevents unnecessary suffering, not all patients share this value. The believe that only God knows when it is time to die may also impact patients view in the use of life-sustaini