All too often people in the medical field find themselves dealing with the medical dilemma of the Full Code versus Do Not Resuscitate order. One article in particular that I came across details a nurses personal struggle when placed in that situation.
She had been taking care of an 80 year old man with bone cancer. He had gone into surgery to have his leg amputated, but during surgery he stopped breathing. The medical team was able to resuscitate him, but he had been without oxygen for too long and suffered anoxic brain damage. This left him confused and with limited mobility. (which is often the case when a patient is left without oxygen for a period of time) The patient, a once active man, was aware of his confusion and had become depressed. He often would state that he'd rather just die. His family thought the confusion was temporary and that he'd recover and be sent home. (again common in these situations) Unfortunately the patient declined and began to develop Cheyne-Stokes respirations. (often called the "death rattle" it's a common breathing pattern occurs when a patient is very close to dying) The nurse was in a tough situation because the doctors wanted the man to be resuscitated if he were to arrest to deter a law suit, but she felt it cruel to resuscitate a person in this condition.
The article goes on to explain that the main issue this nurse was faced with was whether or not to hold her obligation to the doctors or to the patient. In nursing school you are taught that you are there for your patients and that you must do whatever is in the patients best interest. Unfortunately the law keeps nurses from doing this at all times. The article continues to debate the sanctity-of-life principle (which states that all life is sacred and that to let life end is unethical) versus the quality-of-life principle (which focuses on quality of the patients life).
The article concludes that in order to make a decision that best benefits the patient, the medical team must consult the family and discuss what they believe the patient would want. Whether he would agree with the sanctity of life or quality of life and what he may feel is normative of a quality life.
Reference
Davis, Anne J. "To Make Live or Let Die." American Journal of Nursing. 1981. p 582. JSTOR. 13 February 2007.
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2 comments:
That is such a hard decision for a single person to make...especially when a patient is in that bad of a condition. I kind of wish you would have went more in detail on the two principle's stated at the end; sanctity-of-life and quality-of-life. I think that would be an interesting next blog to see...lol have the two battle it out. Which is used most commonly?
I feel sorry for that old man. I think the nurse made the right decision. Whether or not its against the law, I think I'd do the right think just so I'd be able to live with myself.
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