[Solved] Halting Treatment on a 41-year-old woman Case Study Cancer Patient Ethical Dilemma

Halting Treatment on a Cancer Patient Ethical Dilemma

In solving ethical dilemmas, the reasoning behind the framework consists of deductive reasoning aimed at achieving an amicable solution that is “least evil” in every situation. In this case study, the evaluation process will occur, and a framework will be established; additionally, the different ramifications for all stakeholders involved will be examined, and the premises gained throughout my arguments will be used to defend a position.

Ethical Dilemma Framework for the case study

The dilemma pertains to a terminally ill 41-year-old woman with breast cancer and developmental issues from birth. The patient needs the medical administrator to stop her cancer treatment. In the medical field, such action qualifies as categorized as passive Euthanasia. As Hope & Dunn (2018) observes in their scholarly work Medical Ethics, “Euthanasia is one form of what is generally termed assisted dying. Other forms include assisted suicide and also withholding or withdrawing of life medical treatment.” In the journal by James Racheal, Active and Passive Euthanasia, she sums up the argument on withholding life-sustaining drugs as having no moral distinction between letting die and killing (Ebrahimi, 2012). The goal of cancer drugs, especially in terminally ill patients, is to prolong their life (Mastromarino, 2012). Therefore, withholding Cancer drugs and treatment on a terminally ill person qualifies as passive Euthanasia, and the ethical dilemma affiliated with the situation will be considered in this study. An exploration into the ethics of such a decision in this case study will use normative ethics and, more specifically, Negative Consequentialism, which focuses on minimizing unpleasant consequences rather than promoting functional values.

Personal and Ethical Values Affiliated with the Dilemma

Empathetically-Induced Personal Values

Empathy refers to the ability to understand, be sensitive, and share the feelings of others. It enables an individual to put themselves in another person’s position and view their thoughts and feelings from their perspective. In interacting and caring for the sick, there is a need for empathy as an ethical value to the medical team (Jonasson, Liss, Westerlind, & Berterö, 2010). From the patient’s perspective, the development delay at birth has led to incapacitation that may result in them developing emotional stress. Additionally, caregiver stress is associated with the care of such disorders, incredibly subjective internalized, subjective externalized, and objective strain (Kirby, White, & Baranek, 2015). Therefore, the patient’s stress, coupled with the emotional pressure that her family is currently experiencing due to her impending death, contributes to the decision she proposes to the medical administrator to withdraw from life medical treatment.

Secondly, the financial strain incurred by cancer’s maintenance medications and the costs associated with caring for a developmental patient may make one feel obligated to refuse treatment. Considering the low impact in earnings that she has had on the family may prompt the patient to consider rejecting the maintenance drugs to save the family from more financial ruin. The financial burden attributed to cancer drugs ranges from $10,000 to about $35,000, with one out of ten patients spending more than $18,000 in medical care per month (Bach, Saltz & Wittes, 2012). Therefore, her decision to ask the doctor to halt the medication, especially since she is terminally ill and the chance of her recovery is slim, is not only subjective but also strongly objective from her standpoint.

Adherence to Laws and Regulations

The first objection to her request lies in the legal field; in the US states, only 5 have legalized the practice of physician-assisted suicide; they include Vermont, Washington, California, Montana, and Oregon (Emanuel et al., 2016). The laws and regulations guiding the possibility of granting her request by any professional medical practitioner will depend on whether the institution is situated in one of the five States. For the five states that have already allowed a medical practitioner to withhold life-sustenance drugs at the customer’s request, the ethical framework used in this study would advocate agreeing to the request to avoid legal repercussions.

Societal and Professional Ethical Guidelines

There is strong support for withholding or withdrawing life-supporting medical treatments in the medical community, with the advocates of this practice acknowledging that it is ethical in some situations. Proponents of these arguments argue that letting a patient die by withholding treatment from a terminally ill person allows the illness to be the primary cause of death while escaping the tremendous financial and resource burden associated with it (Kerridge, Lowe, & Stewart, 2013). Additionally, they argue that its ethics lies in fundamental moral and societal values, empathy, mercy, and compassion by rejecting unnecessary and unbearable suffering on the part of the patient (Ebrahimi, 2012). Therefore, a case in medical ethics can be made on why such an offer by the patient can be morally and ethically justified, with minimal adverse consequences for the medical practitioner performing the act, the institution, and the medical community at large.

Ethical decisions are a trade-off between rights, justice, and utility. Ethics is not only concerned with how individuals behave towards others but also delves into the duties we owe society by seeking their approval (Lewis, n.d.). Therefore, any act performed by an individual is not morally exclusive, and the community should be treated as an end in itself (Lewis, n.d.). This is why societal expectations on the issue should also be considered. According to the selected framework, the path with the little negative consequences should be used. Therefore, resulting in the avoidance of a backlash from the public due to bad publicity aimed at the institution and medical practices. According to a survey by Emanuel et al. (2016), there is an increasing trend toward acceptance of physician-assisted suicide in Western Europe, while there is a decline in support in Central and Eastern Europe. Closer home, the public support trend in the five US states that legalized Euthanasia has plateaued since the early ’90s. However, the public is likely to favor Euthanasia if the patient’s dilemma gets explained to them; arguably, the sociopolitical values and personal morality upheld by most Americans towards the issue are just superficial and impervious to external moral structures (Trahan, 2017). Therefore, an ethics-driven society will likely lean towards allowing the withdrawal of life medical treatment, mainly when the situation leading to this event receives positive coverage once it is exposed. When ethical guidelines and consequences are considered, there is little chance of backlash if the physician adheres to the patient’s request and withdraws the cancer treatment medications.

Using the Negative Consequentialism Framework in Resolving the Ethical Dilemma

Having outlined the effects from both sides and looked at the various scenarios that are bound to occur in this particular ethical dilemma, I would withhold the treatment of the patient on the condition that the state in that I am operating allows passive physician-assisted death and the patient signs the necessary documents that will ensure the legality of the act. My decision has arisen through eliminating risks and finding the best way to minimize adverse consequences from such action.

The significant stakeholders that need protection from adverse consequences in this scenario are me as the individual, the institution I am working for, and the medical field as a whole. The institution follows the medical ethics conduct and state laws, if my institution lies within the five states, then it is secure from prosecution, and I, too, will be safe from the legal standpoint. The public reaction towards the act will be divided at first, according to the study by (Emanuel et al., 2016), and with the institution’s public office releasing the ethical dilemma leading to passive physician-assisted death, the public is likely to support it, according to Trahan’s study (2017). In regards to the patient and her family, the decision will help in reducing the emotional and financial burden affiliated with caring for a terminally ill patient; additionally, the knowledge that they adhered to her wishes rather than the medical practitioner’s judgment will yield positive sentiment as they come to terms with her decision. The alternative would be legal actions for not adhering to a patient’s constitutional rights according to the state laws and for a continued emotional and financial burden to her family. Therefore, it is more probable that the negative consequences of the scenario are lessened in agreeing to her request than in disagreeing with it.

Conclusion

There is no one right way of carrying out a philosophical problem, and because an ethical dilemma is one of them, the reasoning behind my judgment may be found by some to be flawed. However, when carried out in an ethical dilemma framework, these decisions aid in efficient, consistent, and usable decision-making for future precedence. Through the advanced premises, it is clear that Negative Consequentialism dramatically reduces the risk involved for all stakeholders in such a sensitive scenario. Therefore, it is an excellent ethical framework to apply. From the premises that stem from my outlook on the ramifications of opposing decisions, I believe that the course of action I recommended is the best in this case study.

References

Bach, P. B., Saltz, L. B., & Wittes, R. E. (2012, Oct. 14). In cancer care, cost matters. New York Times. Retrieved from https://www.nytimes.com/2012/10/15/opinion/a-hospital-says-no-to-an-11000-a-month-cancer-drug.html

Ebrahimi, N. (2012, May 24). The ethics of Euthanasia. Retrieved from http://www.amsj.org/archives/2066.

Emanuel, E. J., Onwuteaka-Philipsen, B. D., Urwin, J. W., & Cohen, J. (2016). Attitudes and practices of Euthanasia and physician-assisted suicide in the United States, Canada, and Europe. Jama, 316(1), 79-90.

Hope, T & Dunn, M. (2018). Medical ethics. New York, NY: Oxford University Press.

Kirby, A. V., White, T. J., & Baranek, G. T. (2015). Merino, S., Aruanno, M. E., Gelpi, R. J., & Rancich, A. M. (2017). “The prohibition of euthanasia” and medical oaths of Hippocratic Stemma. Acta Bioethics, 23(1).

Kerridge, I., Lowe, M., & Stewart, C. (2013). Ethics and law for the health professions. New South Wales: Federation Press.

Jonasson, L. L., Liss, P. E., Westerlind, B., & Berterö, C. (2010). From the next of kin’s perspective, ethical values in caring encounters on a geriatric ward: An interview study. International Journal of Nursing Practice, 16(1), 20-26.

Lewis, R. (n.d.). Ethics in Society. Retrieved from https://philosophynow.org/issues/102/Ethics_in_Society

Mastromarino, A. J. (2012). Biology and Treatment of Colorectal Cancer Metastasis: Proceedings of the National Large Bowel Cancer Project 1984 Conference on Biology and Treatment of Colorectal Cancer Metastasis Houston. Boston, MA: Springer Science & Business Media.

Trahan, A. (2017). Public attitudes toward legal abortion, Euthanasia, suicide, and capital punishment: partial evidence of a consistent life ethic. Criminal Justice Review, 42(1), 26–41.