An Ethics Committee, Application Essay Example

In every healthcare organization, an effective ethics committee must be in place to review the decisions and actions of workers. An ethics committee guides thoughts and actions that influence organization culture. In our society today, it is a given that patient s have the right to refuse medical treatment. However, there may be occasions when physicians refuse to administer treatment and this area within the field of medicine is still unclear as it touches on the individual’s professional integrity, the right of self-determination and the physician’s vow to do no harm (2). In the case of Catherine Gilgunn, the subject of futility arises and it is essential that the situation is examined based on facts and the perspectives of the people involved.

In this situation, Catherine is a 72 year old woman who had suffered a series of seizures leaving her comatose and dependent on a respiratory ventilator and a feeding tube. Doctors stated that the chance of a cognitive recovery is zero. Her daughter Joan was appointed by the family as her proxy. Catherine did not have a clear directive although her daughter Joan claims that her mother would want everything possible to save her life. However, the attending doctor still issued a DNR (Do not Resuscitate) order after consulting with the Ethics committee. Joan was weaned from the ventilator and suffered from cardiac arrest, from which she consequently died of.

In this situation, Catherine Gilgunn took a worse turn during hospitalization and her surrogate still demanded everything possible despite strong evidence that her mother is dying. Physicians are said to have two ethical principles to guide their practice: (1) to do no harm, and (2) to maximize health. In the case of a dying patient, it is a general principle that treatments that are ineffective and that have the capacity to inflict more suffering on the patient are usually contraindicated (13). CPR (Cardio-pulmonary resuscitation) is widely known and often offered to all patients except when it is expressly declined. However, CPR can be treated as any other medical procedure and risks and benefits should be weighed. Thus, after reviewing the patient’s records and discussion with the optimal care committee, the physician concluded that aggressive measures to prolong Catherine’s life are not in her best interests and he believed that these measures would instead prolong her suffering. This finding was in fact also supported by the court as they sided with Massachusetts General Hospital and its physicians.

Although the above analysis presents a strong argument clinically, it cannot be denied that there are still moral issues present. Although CPR is not a medically reasonable treatment for Catherine, it does not mean that it should be withheld. Similarly, the strong objections from Catherine’s family are also a big factor as they are subjected to additional stress and outrage along with dealing with grief over Catherine’s condition. Relationships with other members of the health care team can also be affected and strained at this time. In opposition to the clinical basis of refusing CPR, some ethicists state that some situations can justify CPR treatment despite the futility of the situation such as when it can be beneficial to the patient’s family who are assured that all measures are done for the patient. This case can certainly elicit contradicting views from different people. One good it has done, however, as positive steps are taken by Ethics committees around the nation by implementing a process that would attempt to resolve conflict between physicians and proxies.

References

Bishop, J.P et al. Reviving the conversation around CPR/DNR. 10(1):61-67. 2010

Truog, R.D. Is it always wrong to perform futile CPR? 362:477-479. 2010