Terminal sedation, different from assisted suicide, is not dependent on the capacity of the patient to move his limbs or to swallow, and it is not dependent on the availability of appropriate substances or the assistance of others in providing them.
An ethical dilemma is a situation that often involves an apparent conflict between moral imperatives, in which to obey one would result in transgressing another Longman, What are the benefits of medically assisted nutrition and hydration? Any patient who is at increased risk for cardiopulmonary arrest should be given the opportunity to make a decision about CPR while he or she is still capable of making the decision.
However, a patient need not be terminally ill or imminently dying Termination of nutrition and hydration these discussions to be held. Religious Conflicts The Roman Catholic Church has exerted a tremendous influence over ethical decisions concerning withdrawing and withholding nutrition support.
Patients who generally should not be admitted to the intensive care unit include: Not only to become more Christian, but to become more truly human, society should protect the right to life through its laws and other policies.
Supplementary Material Click here to view. Ethical validity of palliative sedation therapy: Smith"Advocates for dehydrating the neurologically disabled assert that it is a painless end.
Human Dignity Introduction Over thousands of years Christians, and most physicians, have presumed that patients who are unable to feed themselves should receive assisted nutrition and hydration. However, there are psychological and sociological differences between withholding and withdrawing treatment.
An ethical dilemma is a situation that often involves an apparent conflict between moral imperatives, in which to obey one would result in transgressing another Longman, Freestanding hospice programs were more likely to deny admission based on these criteria than hospice programs that were part of a statewide or national chain.
The most important moral imperative for termination of treatment under terminal sedation is, however, that if the patient is competent and not sedated without his explicit consent.
Continue morphine infusion and titrate up until the patient is sedated and appears comfortable Start midazolam infusion and discontinue morphine because the patient will no longer need it Continue scheduled morphine at current dose and start midazolam infusion until the patient no longer appears agitated or distressed Refuse to use sedation because agitated delirium is not an ethically sound indication Ask for ethics consultation A year-old man with a history of ventricular dysrhythmia and an implanted cardioverter defibrillator ICD is admitted to the intensive care unit.
Cranford, "The Persistent Vegetative State: Finally, these moralists suggest that PVS is best seen as an extreme form of mental and physical disability—one whose causes, nature, and prognosis are as yet imperfectly understood—and not as a terminal illness or fatal pathology from which patients should generally be allowed to die.
A patient may wish to make known his or her general wishes about life support in advance; such expressions cannot have the weight of a fully informed decision made in the actual circumstances of an illness, but can help guide others in the event of a later state of incompetency.
Therefore, we believe people should make decisions in light of a simple and fundamental insight: In such cases, ways of alleviating such special burdens should be explored before concluding that they justify withholding all food and fluids needed to sustain life.
Autonomy, Obligation to Treat, and Medical Futility Patients have a right to control what happens to their bodies, so the decision about whether to forgo life-sustaining treatment should, in the final analysis, is theirs.
Direct killing of such a patient is as morally reprehensible as the direct killing of anyone else. Ten days later, he dies.
Ethical considerations at the end of life in the intensive care unit. First, particularly when a form of treatment "carries a risk or is burdensome" on other grounds, a critically ill person may have a legitimate and altruistic desire "not to impose excessive expense on the family or the community.
A means considered ordinary or proportionate for other patients should not be considered extraordinary or disproportionate for severely impaired patients solely because of a judgment that their lives are not worth living.
Cranford, "The Persistent Vegetative State: Fear of making patients uncomfortable due to thirst encourages clinicians and families to provide fluids to patients when oral intake is declining or artificial nutrition has been discontinued.Nutrition and Hydration: Moral and Pastoral Reflections A Statement of the NCCB Committee for Pro-Life Activities April Introduction.
Modern medical technology seems to confront us with many questions not faced even a decade ago. Combination of terminal sedation with withdrawing or withholding life-sustaining medical treatment; or.
Combination of terminal sedation with the termination of life-sustaining nutrition and hydration in addition to withdrawing or withholding life-sustaining medical treatment.
Both variants pose a number of questions, primarily conceptual ones. Termination of nutrition and hydration from patients that are in a persistent vegetative state is an example of an ethical dilemma, which will be discussed.
Ethical issue has raised questions regarding quality of life, appropriate use of resources, the wishes of the family, and professional responsibilities. WITHDRAWAL OF NUTRITION AND HYDRATION FROM INCOMPETENT PATIENTS IN MISSOURI Cruzan ex rel.
Cruzan v. Harmon1 I.
INTRODUCTION May a. A child in a vegetative state may present difficult decisions for physicians and families regarding the course of treatment.
We report a case of a child who entered a prolonged vegetative state following status epilepticus. The child's parents requested termination of artificial means of nutrition and hydration. Many ethical issues arise when treating individuals in the minimally conscious state.
In large part, this is attributable to the fact that these individuals have severe physical and cognitive impairment yet retain some degree of self- and environmental awareness. This article presents a point.Download