Respond to each post at least 100 words

Respond to each post at least 100 words.

You play we play responses student 1 -kasey

1. I don’t think that the lifestyle choices should change the health benefits because someone who smokes could live an illness free life and a healthy nonsmoker could develop lung disease. This is true for all illnesses. People who live a sedentary lifestyle have more of a risk for illness and disease, yes but that doesn’t mean they will become sick. Also, this would go against the ethical principle, justice. Justice refers to fair treatment in matters related to physical and psychosocial care and use of resources (Holman et al., 2019).

2. Prohibitions that could be in place are increasing prices of those items. Another could be increase cost of medical bills if related to these items.

3. Some incentives to promote healthy living could be money back or carry over to the next year, decreased cost on health care visits or money off medications or equipment.

Student 2 -brooke

If David were born next week, instead of 1971, I would not recommend that he should begin the bubble process. The first, most prominent argument, is an infant cannot make their own medical decisions on whether that would be the life that they choose. People were not meant to live in plastic chambers, having little to no contact with the outside world. Yes, David did have teachers, friends, and experiences (Immune Deficiency Foundation, n.d.), but all limited while living through a protective barrier. On another note, is it in a person’s best interest to live everyday so close to the edge of death? One bad encounter and an entire life could be compromised. In my personal opinion, David’s life could closely be considered a series of trial and error. David had no choice but to be in the bubble, because even if one day he decided he did not want to be enclosed anymore, he would be choosing death. The bottom line, his legal right to choose care was taken away. Everything in David’s life was experimental, even the bone marrow transfusion that ultimately acted against him and took his life (Immune Deficiency Foundation, n.d.). If we were to continue this in a week from now, it would bring to question the concepts of justice, beneficence, nonmaleficence, accountability, and autonomy (Ethical Practice, 2021). David had only known the life he knew, but think about this situation if it were happening to you. Would any human, walking the earth today, be happy to be locked in a bubble for the rest of time? Would that be the life they wish for themselves, having known what it is like to be free? The answer itself should be argument enough.

Module 11 -megan

Student 1

Nancy Cruzan was a 25-year-old woman who got into a car accident on January 11, 1983. When found, she had no vital signs, but paramedics were able to restore her heart rate and breathing and was in a coma. A few weeks later, she woke up but was diagnosed as in a persistent vegetative state, and a feeding tube was inserted to keep her alive. After 4 years passed, Nancy’s parents requested to remove the feeding tube, but the hospital refused to do so without a court order. This sparked the ethical dilemma of withholding/withdrawing life support vs. maintaining life support.

Step 2 of the framework for ethical decision making consists of gathering the facts, asking the following questions:

What are the facts and circumstances?

The facts and circumstances include that Nancy was diagnosed in a persistent vegetative state and the feeding tube was what was keeping her alive. She was exhibiting no signs of awareness of her surroundings and was not in a state capable of making her own medical decisions but had no advanced directive on file.

Are there any formal or informal opinions in the media or elsewhere? What are the legal ramifications?

The opinions of Nancy’s family were that she would not want to live like this, but the court declared that the feeding tube was “not heroically invasive,” a “painful invasion,” and not “oppressively burdensome” (McCormick, 1989). The court’s opinion declared that the ruling was in the preservation of life. The legal ramifications of this case resulted in the first “right to die” case and corresponding laws, but as far as Nancy, she was to remain with the feeding tube since there was a lack of clear and convincing evidence of her wishes.

Has this issue been decided by the courts before or did it result in new legal direction/new laws?

Because the hospital refused to remove the feeding tube without a court order, Nancy’s case was taken to the Missouri Supreme Court. The Supreme Court declared that it could not be removed without clear and concise documentation of her wishes and the case was appealed to the United States Supreme Court. It was then declared for the first time that “any competent person has a constitutional right to refuse medical treatment and that artificial nutrition should be considered the same as any other medical treatment” (Young, 2013). The U.S. Supreme Court upheld the ruling, but Nancy’s parents were later able to prove that this is not what Nancy would have wanted and were able to remove the feeding tube allowing her to pass away 8 years after the initial accident.

Student 2- Ali

After watching the story of Nancy Cruzan, one will realize how decisions in life are a game-changer. Meaning every choice will have an impact and the impact can be beneficial or none beneficial. The story of Nancy Cruzan is about how a person was trapped in a state between both life and death. Nancy got into a bad car wreck and lost oxygen to her brain which lead to other complications for a period of 12-14 minutes. After being taken to the hospital and placed into care. She soon was in a coma but lead to her awakening. In this awakening, she wasn’t able to function normally, was on a feeding tube, and couldn’t even do much. This Is pretty much considered a vegetative state. Now it came down to the family and state arguing on what to do with her. Many other states would let a patient in this condition die but the courts here want to preserve life.

This all comes down to ethical decision-making. Now when in a situation like this not many would know what to do, some will want to preserve the life while others would just want to avoid the suffering. When looking at the facts and the ethical decisions, the court stated that they favor life and wanted to continue her life due to “living laws”. It was pretty much an argument between parties on how to handle the case. It was known as the right to die. This case was the beginning in making choices. Soon the court decided that they will remove her feeding tube to soon let her die. This was done due to the family’s evidence presented and was considered clear and convincing. In a case like this, there is no option to coming back from a vegetative state. Now allowing one to live should’ve been anyone’s choice but the family and patient if they have an advance directive. This is because there could be cultural choices and or reasoning behind their decisions to withhold or maintain life support.

Discussion 5- Victoria

This was such an insightful article and I’m glad it was assigned to us. I’ve spent a fair amount of time in the ICU settings. It is an unwavering feeling to understand a human being’s function is dependant on a ventilator, echo machine, dialysis, temperature regulation, and 10-15 drips of medication. These individuals are so sedated they cant even see those around them. I still do like to believe they can hear us though. It personally makes me feel better about caring for an individual like this when I keep the idea that what I’m saying to them is providing comfort in what must be a terrifying time. It absolutely amazes me, the advances in medicine that have occurred. However, when is enough, enough? This was the concept that was discussed in Elizabeth Reis’s article. Elizabeth understood her father did not want to live a life hooked up to machines. But when her dad was taken to the hospital, the goal was to save his life. This resulted in five days of machine used to do so. The author explains how the conversation regarding her father’s prognosis happened too late. She states she wishes her family would have had a conversation with the providers about her father’s prognosis before the treatment had started. Because in that case, her family would not have gone through with the extraordinary measures. If her father’s advanced directive was filled out he probably would have been a DNR and been pronounced dead on the scene. I know that may sound harsh but we have to respect the wishes of the client. The client would have died naturally and because it was his time to go. For the family, it may have been an easier concept to grasp. This family is now traumatized because they had to make the decision of when to stop the treatment. Furthermore, it almost sounds as if the family has guilt for allowing their dad to go through with all these excessive treatments. An advanced directive is a specific form that states how one would like medical decisions made if they cannot make them, themselves. Therefore the daughter or wife may have immediately stopped treatment instead of the doctor deciding to provide treatment. If you haven’t had these conversations with your families already, I would advise doing so. Furthermore, I would advise everyone to fill out an advanced directive. Life is short and it’s important we spend our time how we want to.

Student 2- meghan

After reading the article, “When Doctors and Daughters Disagree: Twenty-Two Days and Two Blinks of an Eye” I was very frustrated with the entire situation. It was very plain and simple that Mrs. GF had already made the decision not to take any life prolonging measures should she need them. She had filled out the correct paperwork and it was clearly filed with the emergency department. I think the daughters came in at a very stressful time and were reacting with emotion and not with logic. I believe the biggest issue here was that Mrs. GF did not verbally communicate with her daughters prior to putting them in such a position. Mrs. GF had said to her PCP, “I don’t want extended medical treatment or a breathing machine. My sister was on the machine. I don’t want any of that… I do not want you to tell me daughter because they would not understand” (Abadir, Finucane & McNabney, 2011). It is understandable that Mrs. GF would want to protect her daughters from the painful conversation of death, however, by not hearing the words from her mouth, they were torn between whether or not their mother was of sound mind when she signed the DNR/DNI forms. While she was in the hospital, she had exhibited body actions rejecting the tube. “Overhearing a daughter and the ED physician planning for intubation, the patient appeared to understand the situation clearly; she became agitated, moving her index finger back and forth to signal “no” and making sounds like “nuh-nuh.” Despite this, she was intubated and admitted to the intensive care unit” (Abadir, Finucane & McNabney, 2011). This was one of the things that I found to be incredibly disrespectful and unethical on the physician’s part. Already knowing that the paperwork had been signed, and now seeing the patient physically attempt to refuse intubation, the correct measures to take should have been exceptionally clear. I believe the best thing that could have been done to avoid the entire situation is that Mrs. GF should have sat down with her two daughters and told them her wishes as well as present them with the signed DNR/DNI paperwork. Daughter P reacted when she was blindly presented with her mothers wishes by stating, “They’re telling me ‘She wanted to be on DNR/DNI, this is what your mom wanted; this is what your mom would have wanted.’ I don’t want to hear that. They don’t know my mom like I know my mom” (Abadir, Finucane & McNabney, 2011). While her response was more than natural, it most certainly could have been handled much differently. I believe that encouraging the patient to share their wishes with their families, particularly someone who will be left to execute them is key to achieving a respectful death of a patient. By sitting down and talking to the patient and their family together, the physician is able to answer any questions and provide some comfort for everyone. In this case, the physician acted on emotion and not on ethics which was ultimately wrong. This whole situation was approached the wrong way entirely.

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