DNR or Do Not Resuscitate Essay Example

DNR or Do Not Resuscitate Essay Example DNR or Do Not Resuscitate Paper DNR or Do Not Resuscitate Paper DNR or do – not – resuscitate is a recommendation endorsed by a doctor in the patient’s medical record which indicates to the hospital staff that CPR or cardiopulmonary resuscitation should be stopped. The doctor’s order or recommendation is of great importance, while providing life enduring treatment to the patient. It prevents redundant and superfluous treatment to the patient who is dying (Do-Not-Resuscitate (DNR) Orders). Generally, doctors negotiate with patients with regard to possible cardiopulmonary arrest. They also discuss the procedures involved in the CPR and the patient is given a choice of treatment preferences. When a patient fails to take a decision or is incapable of taking decisions then a surrogate on behalf of the patient may take a decision with regard to the treatment preferences. It is the responsibility of the surrogate to take suitable decisions based on the previously expressed preferences of the patient. If the surrogate is ignorant about these preferences, it is essential to take decisions, which are in the best interests of the patient (Do-Not-Resuscitate (DNR) Orders). However, the DNR order of the doctor should not result in the cessation of the entire treatment; it should only effect an avoidance of the exercise of CPR. The customary treatment methods such as antibiotic administration, treatment for pains, dialysis and the use of ventilators can be continued if so warranted (Do-Not-Resuscitate (DNR) Orders). When CPR becomes futile and if the doctor decides that it is unnecessary then there is no need to provide this treatment to the patient. However, an opportunity is made available to the patient, his family members or any surrogate who acts on behalf of the patient to take a decision regarding the DNR order. The concerted involvement of family members arises due to the doctrine of respect for all people to play a role in decisions, which are very important to the life of the patients. It can also be termed as respect for the autonomy of the person (Do Not Resuscitate Orders). Euthanasia The word Euthanasia has its roots in the Greek word euthantos, which means easy death. It connotes an intentional act of either commission or omission, whose intent is to alleviate unbearable pain or suffering by bringing about the cessation of a person’s life. Most of the terminally ill patients prefer an easy death and such is the aim of soothing and hospital services. Nevertheless, these services would vehemently oppose any attempt to describe them as dispensers of euthanasia (Karen Chaloner, September 5, 2007). A major category of euthanasia is that of voluntary euthanasia, which denotes the use of euthanasia at the request of the terminally ill patient. It can also be defined as accelerating the dying process at the express request of the patient. Some of the moral principles that are alluded to in order to justify voluntary euthanasia are independence, rights and best interests. At present patients have the right to decide whether to accept or reject a course of treatment prescribed by the physician and many people are of the opinion that this principle should encompass the right to make an knowledgeable selection in respect of medically aided termination of life (Karen Chaloner, September 5, 2007). Furthermore, it is hypocritical to permit a passive withholding or withdrawal of treatment, whilst disallowing active measures to end life, because the end result is the death of the patient. In Airedale NHS Trust v.  Bland the House of Lords upheld the doctors’ decision to discontinue the treatment being accorded to Bland who had suffered irreversible brain damage, as a consequence of which he was incapable of feeling anything whatsoever (Airedale NHS Trust v. Bland , 1993). As per law, a doctor can effect euthanasia only by an act of omission. Living Wills The breathtaking advances made by medical technology have not only raised several moral questions, but they have also introduced a number of ethical dilemmas in the task of defining death legally (Frederick). An attempt has been underway to institute a person’s right to die, by the stratagem of living wills. An individual by means of a living will bestows upon either family members or legal figures the right to abandonment of treatment that is indispensable for supporting life. A number of States of the Union in the US have recognized the validity of such living wills, nevertheless there exist several unresolved issues in this regard (Frederick). Hospices Terminally ill patients are treated either at home, the hospitals or in hospices, which are institutions that care for the dying or the incurably ill. The medical professionals in such environments, like the physicians and the thanatologists, have to overcome their personal fear of death so that they can succor the hapless patients (Frederick). Despite the fact that physicians opine that patients should not be told about their imminent death, the general opinion being subscribed to by the public is that such disclosures have to be made to the patient. The fact is that most of the terminally ill patients are aware of the fact that their death is approaching very swiftly (Frederick). It is essential to inform patients about their approaching death, because this helps to do away with unwanted falsehoods and promotes the emergence of genuine thoughts. A terminally ill patient if provided with security and information about impending death will be enabled to meet death with equanimity and dignity. This process can be aided considerably by sympathetic physicians and men of the cloth (Frederick). Palliative care is provided with the objective of providing the patient with symptomatic relief and to improve the quality of life of the patient. Patients suffering from pain, fatigue and GI problems require palliative care. Some of the GI problems are nausea, vomiting, hiccups, cachexia, anorexia, constipation and dysphagia. These symptoms have to be treated carefully in order to ensure quality of life in the case of a dying patient. Patients who are suffering from advanced stages of cancer undergo unbearable pain. Relief and prevention of such pain would result in the improvement of their quality of life. Sometimes, such measures facilitate the person to survive and function normally (Charlton, 2/24/2006). Palliative care, being a medical approach, improves the patients’ quality of life. This approach prevents and alleviates the sufferings of patients with terminal illnesses and their families. Palliative care operates by detecting the disease in early stages, correct assessment and giving treatment to reduce the pain and other related problems whether physical, psychosocial or spiritual in nature (WHO Definition of Palliative Care). Palliative care as a distinguishing care, which is provided to a person suffering from incurable diseases, provides gentle comfort and life support to the patient as well as his family. However, palliative care neither prolongs the life of the patient nor hastens his death. It is mainly aimed to provide the patient with a reduction of pain and other corresponding problems such as depression, stomach upsets, etc. Another objective of palliative care is to help the patient and his family members with clear knowledge of the disease and tranquility of the mind (Information for the General Public). The act of making the patients’ health condition comprehensible to the patients and their family members would enable them to take a decision to either continue or discontinue the CPR treatment. In most cases, the patients and the family members will give their consent for a DNR order. In such cases, a DNR order can be issued by the doctor and it can be cosigned by the attending physician (Do Not Resuscitate Orders). Recommendations It is the right of every patient to obtain palliative sedation for pain, to be provided with sufficient pain and symptom management and to refuse treatment that sustains life. A living will helps to decide upon medical care to be adopted on becoming incapacitated and it also enables the patient to suggest a surrogate to take medical care decisions on his behalf. In respect of Euthanasia, the fact remains that people have the right to make crucial decisions regarding their life and how it should end. Therefore, if a person is terminally ill or incurably sick, he should be allowed to decide whether his life should continue or should be brought to a standstill. The provision of hospice facilities ensures that persons who are terminally ill obtain treatment that mitigates their suffering. Such treatment drastically reduces suffering in the last stages of existence of the terminally ill. The principal objective of all the above enumerated methods is to ensure that the terminally ill patients’ suffering is reduced drastically and that such persons are allowed to depart from this life in a manner that is dignified and to their liking. The major aim of these techniques is to provide the best available medical care for alleviating the suffering of those who are on the brink of death. The family members of these patients have to adopt procedures that are likely to prove most beneficial to the patients.