Dr. Malesker described situations where patients approaching end-of-life care cannot make decisions regarding their treatment. This is due to the cognitive dysfunction that these patients present with. This complicates the treatment because there is not a specific directive from the patient. They do not possess the autonomy to make their own decisions. The patients will have family members from all around the country and when they come to visit, they will have conflicting ideas about what the best treatment option for the dying patient is. Some family members could feel guilty because they did not spend enough time with the dying patient. Sometimes, the family will fight over what the best plan of action …show more content…
for the patient is. The many emotions involved in this case puts a lot of stress and pressure on the healthcare team about what the best course of action is.
The central issue in the case was the autonomy of the patient. The patient does not have the ability to make a decision about their treatment and this causes a conflict between family members. In addition, the healthcare team is unsure about what treatment to provide the dying patient. They cannot save the patient from death, but they do not want to extend healthcare dollars that is not necessary. The healthcare team wants to help the patient but extending care could just further put the patient in pain. With various cultural and religious differences, the situation is further complicated. It is difficult to assign who has the right to make decisions for the patient if they do not have the autonomy. The principles of beneficence and nonmaleficence are also important. The healthcare team is trying to provide the most good for the dying patient while avoiding more harm.
It is imperative that the healthcare team provide the patient with the most comfortable care possible.
This might include giving the patient pain medication in order to make them comfortable. Also, it is important to interact with the family and get them involved in the care of the patient. With any religious or cultural differences, the hospital has an ethics board that they can consult. It is also vital to have a private room where you can discuss the ethical issues with the patient’s family. Dr. Malesker explains how the whole situation can be rewarding if you are able to help the patient overcome their disease. However, it can be a challenge and frustrating trying to balance all of these
factors.