Ethical Analysis of the Ed Fischer - Case Study Example

Ethical analysis of the "Ed Fischer Case" There are instances wherein one needs to make a decision between the responsibility and the morality. There are responsibilities in all the professions, in all the fields, whether the person is a scientist, a lawyer, a politician or a doctor. We always need to do the job in a responsible manner. All the jobs are service oriented wherein one benefits from the other in some way. For instance, a scientist discovers new things just out of curiosity, to understand the mechanism or to know the unknown. Those discoveries are used in a way to help the human kind. Thus, the responsibility of the scientist is to discover new things. In the same way a lawyer helps in the justice, it is lawyer's responsibility to make sure that a proper justice is done to his/her client, so on and so forth. However all professions are governed by something other than just mere responsibility and duty. Sometimes it is not enough to just do your job. There are times when one needs to decide between what can be done and what should be done and at times, there are more choices available. It is slightly more complicated than it sounds. This is because there are other factors that play a role in the decision-making. These other factors define ethics. Ethics is not just about right or wrong or true or false. It is not that simple to define either. Ethics is not governed by rules or laws. Neither is there any ethical book of conduct. Ethics is actually a philosophy that existed for a long time for the betterment of the mankind. So then, one may ask if ethics is not law, neither it's a rule then what is ethics And why should one even bother to think about it Well there are good reasons to do so. Ethics defines the right actions based on the moral conduct and behavior for a greater good of an individual or a society. i.e., following the ethical standards would lead to following the general beliefs of the society. However, having said this, one may ask if it is always good to follow the ethics. Well that is a difficult question to answer. There are occasions when one needs to make a decision on either to follow the ethics or not. This can be elaborated further with Ed Fisher's case. Ed is currently bed ridden and needs assistance for most of his activities. He can't move his arms, can hardly move, and is really week due to eating disorders. His wife has died and is has three adult children. He has lost his desire to live longer in spite of having the possibility. The question that one needs to ask now is should a person who is suffering with so many severe symptoms still be convinced to live. Nevertheless, before asking that question, we need to ask what should be the reason to live, alternatively, if there should be any reason at all. The reason that a person lives, is not simply because he or she can move around or has the ability to do difficult tasks, but it is due to the reason that he has a soul within him or her. Moreover, as long as the soul exists, every living form in this world has the right to live life to the fullest and as long as possible. Having said that, the next question that arises is, everyone has the right to live but does anyone has the right to end his life as per his wish no matter what the circumstances are. What shall one do when a person decides to not to extend the days in his life Shall that person be allowed to die or shall that person be treated to the maximum possible way in order to extend his days fully As discussed in the beginning of this essay, these are the questions of ethics. These questions are toughest to answer and a nightmare for medical professionals. In Ed Fisher's case, it is obvious that he will not live much longer without the feeding tube. Therefore, for Ed, the advantages and disadvantages of undergoing the surgery are as follows: Advantages: He can live longer Can see his children prosper in their careers and personal lives Can see his grandchildren May learn or experience something new because you never stop learning until you die His children can spend more time with him Disadvantages He may be the burden to his family He may suffer even more and maybe experience even worst days Could be a burden to the medical team This all will lead to him regretting that he is even born And if he doesn't undergo the surgery, the advantages become disadvantages. Ed's internist Dr Williams however has a very different set of options to think of before he can make his decision about the case. Mainly because being in the medical profession one always needs to weigh between whether to provide all possible help to make sure that the patient survives or to let the patient die. In order to for the doctor to decide, there are certain central values of American medicine that needs to be considered properly. And only after giving a thorough consideration to these central values can a doctor decide on the ethical aspects of the case. Here is the list of central values that can be used to evaluate the alternatives. 1. Extending Biological Life (by cure of a life-threatening condition or by life-extending therapy when treatment cannot end the life-threatening condition) Under this condition, the doctor can treat the patient in such a way that the disease or the disorder is prolonged as long as possible. 2. Patient autonomy in health care decision-making Under this condition, the doctor lets the patient decide what he likes and abides by the patient's decision 3. Elimination/limitation of pain (and other symptoms that interfere with functioning) If the patient is suffering with pain, then the doctor can cure the patient from pain 4. Restoration of normal physiological functioning (as determined by statistical/biochemical norms) The interior organs are treated to bring back the normal physiological functions of the patient 5. Preservation/maintenance of functions involved in Activities of Daily Living (ADLs ) -- and some special functions associated with typically chosen patterns of life. Common regular functions necessary for every day activities such as movement and senses are treated 6. Prevention, i.e. of future life-threatening or function-limiting processes; includes inoculations, etc., education for self-care, and medical and other regimens to limit the adverse impact of chronic incurable physiological conditions (e.g. diabetes, heart disease, etc.). Preventions and long-term medicines for commonly occurring diseases and disorders are treated under this point 7. Information and understanding, i.e. of the processes and causes of illness, for the sake of self-knowledge and to facilitate a person's have a coherent story about self to tell to self and/or others. Under this point, doctor needs to make the patient aware of the problems that the patient is going through and to explain him how it could affect his health. Having mentioned the central values, what should the doctor decide The patient Ed has already given his verdict that he would not like to undergo any surgery for the feeding tube. The patient doesn't want to prolong his days. On the other hand, Dr. Williams is well aware of the fact Ed is suffering multiple symptoms and that he will not live very long if the feeding loop is not provided to him. Considering the point seven of the central values, Dr. Williams has fulfilled that criteria very well. He has explained Ed that the symptoms he is suffering with and the danger he is in. Dr. William has also explained Ed that if he doesn't undergo the surgery then the food will pass in to his lungs and he will get another attack of pneumonia. Apart from this Dr. Williams explained Ed about how Ed will be able to see his grandchildren if he accepts the surgery. Thus, point seven has been properly fulfilled. Ed is suffering ALS and TIA, both non-curable and life long symptoms. Under point six, Dr. Williams has done his job and treated Ed for several years for these symptoms. He also made Ed aware of these symptoms. Points three thru five don't matter here so much mainly because Ed is currently on the death bed and thus he as other severe health complications to deal with. Thus there are two most important points that are remaining. Point two where in the patient gets full freedom to for his future. In this case if the patient chooses to not to undergo any further treatment then that might lead to end of his life sooner than later. If the patient chooses to undergo the surgical procedure then it makes thing a lot easier. Under point one, if the doctor thinks that the life of the patient can be extended longer by a certain treatment then he can do so provided the patient agrees. These two points are the most decisive and the important points in this case. These two points can save Ed's life if dealt with properly. However, they also raise certain ethical issues as discussed earlier. In this case, Ed doesn't agree with point one i.e., he doesn't want to undergo the surgery. That means Dr. Williams is not allowed to do his job and to fulfill his responsibility. Though he knows that it is important that Ed undergoes the surgery, he can't proceed until Ed agrees upon it. What shall he do What is ethically and morally correct The question that was raised in this essay earlier was that every person has the right to live, but does he have the right to stop living as per his wish The answer to this question according to ethics and according to the central values is no because that is called as a suicide. Thus, it is important that Ed undergoes the surgery. He cannot have the option of not going through it. As mentioned earlier, ethics defines the right actions based on the moral conduct and behavior for a greater good of an individual or a society. i.e., following the ethical standards would lead to following the general beliefs of the society. That means when it comes to the ethical decision of the case, it is pretty much clear that the surgery must be done, because the very definition of the ethics says taking an action based on the moral values for the betterment of an individual. Thus the question, what ought Dr. Williams do in this case Is answered. Dr. Williams need to treat Ed Fisher by introducing the G tube and to help him live longer. This is both ethically and professionally right. The question that now needs to be answered is how would that happen. How would Dr. Williams convince Ed Dr. Williams has several alternatives here to convince Ed. Some of these alternatives are listed below: As discussed earlier, as per the point two in the central value system, Dr. Williams can respect Ed's autonomy and let him decide what he really wants. If Ed wants to have the surgery then he can go ahead with it or else he can stay without it. If he likes, he may also seek counseling from another specialist. In that case, the doctor will loose his right of speech and will have to abide by whatever the patient decides. In that way the doctor is leaving everything on patient. Though the doctor fulfills point two in central values, he misses on all the other points. Another alternative that is possible is that the doctor can force the patient to have the procedure done. Well this alternative can always work. If the doctor insists enough then the patient might change his mind and decide to undergo the surgery. That is using point seven of the central values to force to patient to follow the other points of the system. Depending upon the urgency of the case, the doctor can give Ed sometime and ask him to think about it. Again this point goes with the point seven of the central value system. The doctor himself can think about an alternative procedure for the problem. So instead of putting the feeding tube in, he can think of an internal surgery that can repair the gag reflex. This option can be followed based upon point three thru six of the value system. Though it may be difficult to find an alternative procedure that is effective enough, it may well worth it as it may anyways help the patient. The following points are based upon the point seven of the central value system. Doctor can also counsel the family and try to convince the children to be more insistent in convincing Ed to go for the surgery. This could produce positive results and it is likely that the patient might listen to his family members. The doctor may explain the patient in more detail about the success rate of the surgery and the benefits the patients will have from the surgery. The doctor may involve other patients who have had the similar surgery and ask them to talk and convince Ed for undergoing it. The doctor may also ask the patient to meet other experts in the field and get their opinion on his case. In case the patient is religious, it might also be effective to take the patient to the religious place and ask the religious head to convince the patient that it is in the religion to not to end his life this way and to undergo the surgery. The doctor can also take Ed to the school and kindergarten to give him a felling about how it is to be with the kids again. That way he may want to live longer to see his grandchildren. Doctor can take Ed to meet the patients suffering with acute illness such as cancer or HIV. That way Ed will realize how much those patients really want to live but can't due to their illness. That will make him realize how precious life is. If nothing really works, the doctor can file a court case against Ed. The reasoning behind this is, if Ed doesn't go for the feeding tube would mean that he is forcing himself to die. Though it is not suicide, but it is very similar to it. Thus the doctor can file a lawsuit against Ed on charges of doing a suicide. Being a doctor, it is Dr. Williams's moral and professional responsibility to treat Ed to the maximal extent. Not treating a patient while knowing that it might result in the death of the patient is similar to mercy killing. Thus the doctor should take all the possible legal help to treat Ed. The legal actions though could be effective should be avoided as much as possible due to the personal risks involved. Though the patient will undergo the surgery due to the law, he would be forced to do so and thus may not totally believe in it. Apart from this, there is a risk of revealing his medical complications in public. It is difficult to say exactly where in the central values system the above two points fit in. Most likely in point seven. But these are options as well that may be worth following if nothing else works because the aim here is to cure Ed by any procedure possible and to convince Ed by any means possible. All is fair as long as it helps with successful completion of the surgery. From the possible alternative listed here, most of the alternatives actually fit in to the point seven of the central values. This means that when there is a difference of opinion between the doctor and the patient, point seven of the central values hold an important rank. As only information and understanding can help to proceed further with the case. A right mix of physiological understanding, medical suggestions and personal relationship can make a difference between a successful case and a failed one. As we saw from the different alternatives, following the central values definitely help. This case shows that, sometimes, ethical beliefs show us the right path in solving the problem in a way that benefits an individual, a family and a society. Read More