HSA 4553-Legal and Ethical Ethical Dilemma I

Read the following ethical dilemma. You are the ethicist on an ethics committee and are asked to provide your ethical decision regarding this case. Utilize the four steps provided to you in the instructions to help you decide what the appropriate decision should be for this case. Follow the instructions as to the format required.

T. B. is a 91-year-old female found unresponsive at her assisted living facility. EMS is called and attempts are made to resuscitate her for 45 minutes before the patient regains a stable heart rhythm. Due to the lack of oxygen during this time period, the patient is now fully dependent on a ventilator and is unresponsive due to anoxic injury to her brain. The physicians have numerous meetings with the patient’s children and fully explain that the cardiac arrest has caused permanent damage leaving T. B. fully dependent on life support and with little to no quality of life. Taking into consideration her advanced age and now permanent disability, the physicians’ recommendations include instituting a Do Not Resuscitate (DNR) order and removal of all aggressive life sustaining measures in order to proceed with comfort measures and hospice.

There is significant disagreement among T. B.’s three adult children and no decisions are made regarding the patient’s DNR status and continuation of aggressive life-sustaining measures. Weeks pass by and the patient has begun to develop pressure ulcers from being bed-bound and pneumonia associated with long term use of the ventilator. Her neurological status remains unresponsive and her prognosis poor. The hospital’s ethics committee in consulted for assistance with the case.