Do Not Resuscitate Case Study

Memorandum
To: Professor Bizzell
From: Candace Jones
Date: September 17, 2017
Subject: Do-Not-Resuscitate Order
Purpose
This case is pertaining to Ms. Smith, an 85-year-old female suffering with right lower lobe pneumonia and dehydration, a current patient of Memorial Hospital. Ms. Smith is in and out of consciousness and has an unclear prognosis; however, physicians admit she may possibly recover. Ms. Smith’s attending physician would like to order a Do Not Resuscitate (DNR) order due to her age and fragile health condition; however, Ms. Smith’s daughter, who has legal authority to make health decisions on Ms. Smith’s behalf, opposes due to their religious beliefs. The purpose of this memorandum is to give recommendations to the case
The essential principles of medical ethics are autonomy, non-maleficence, beneficence, and justice. Autonomy supports informed consent of the patient to act voluntarily and with an understanding of the consequences of his or her actions. Every patient has autonomy; therefore, a patient may choose end-of-life decisions that others may think to be incorrect. Although, it is every patient’s choice to make those decisions for themselves. It is the duty of the healthcare providers to respect and honor those decisions. Non-maleficence associates the ethical principle of “above all do no harm”, meaning to avoid any act that may have negative consequences. In the matter of resuscitation, the patient is in danger of dying and any attempt of resuscitation aims to deter death or maleficence. Additionally, beneficence means care given to patients should be beneficial to the patient. Resuscitation can be beneficial to the patient due to being an attempt to save the patient’s life. Lastly, justice ensures some standard of equal distribution of medical resources to everyone. Therefore, everyone has the right to receive resuscitation
Smith and her daughter’s wishes by performing resuscitation and any life-saving interventions. Furthermore, the ethical principle beneficence contributes to my recommendation due to Mrs. Smith’s physicians admitting there is a possibility for recovery. A DNR order may cause maleficence in this case; however, resuscitation may be beneficial due to the possibility of recovery. It will also serve Mrs. Smith ethical justice to provide available life-saving care. Additionally, I would advise against a DNR order due to the legal requirements of Texas Senate Bill 11. Mrs. Smith’s daughter has the right to make health decisions on her mother’s behalf by law and the daughter refuses a DNR order due to their religious beliefs. The attending physician can’t legally enforce the DNR order due to not having the daughter’s permission. Additionally, the physician does not qualify for the exception to Texas Senate Bill 11 due to the uncertainty of Mrs. Smith’s recovery. Based on ethical principles and state law, I advise against the DNR order to protect the patient’s rights and positive outcomes of the organization as well as prevent the organization from any legal