Legal and Ethics: Analysis of Not for Resuscitation Order in a Case Study

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LEGAL AND ETHICS 1
Analysis of legal and ethical issues relating to Not for Resuscitation by
evaluating a case study
Medical professionals take an oath that they did not harm any people or breach the sanctity of human
life by purposely killing a person. They are expected to do whether in their power to ensure they save
the life of a patient. The ethical codes of medical field deal with common elements which include
honesty, respect for patient autonomy, respect for the law, non-maleficence, confidentiality,
beneficence and distributive justice (Percival, 2014). Ethical dilemmas in medical field arise when
there is a conflict between two ethical principles. Euthanasia is referred to the killing of a patient in
order to relieve him from the pain which he/she is suffering from an injury or disease which cannot be
treated by medical professionals. This concept has caused many controversies in the medical field
because there are a number of ethical and legal issues relating to the same. The concept contravenes
the principle of resuscitation which is referred to a process of reviving a person’s life especially from
apparent death or from unconsciousness. The advancement in the medical field has increased
recoverability from untreatable conditions, for example, cardiopulmonary resuscitation (CPR). Not for
resuscitation (NFR) or do not resuscitation (DNR) is referred to an order which prohibits a medical
professional from performing CPR on an individual (Mentzelopoulos, Haywood, Cariou, Mantzanas
& Bossaert, 2016). The thesis contributes to debates regarding ‘Not for Resuscitation’ order by
evaluating different legal and ethical issues with the same and understanding its importance to save a
person from suffering. This essay will provide different arguments regarding the legal and ethical
issues relating to NFR and critically analyse its principles to provide advice in the given case study.
This essay will evaluate the four ethical principles of Beauchamp and Childress to provide advice to
the family of Dawn.
Based on the principle of autonomy, an order for NFR should be valid because its motive is to stop
the suffering of a person. But, a medical professional takes an oath to protect the lives of others and
not to cause any harm to another individual. However, as per the American College of Emergency
Physicians (ACEP), the medical professionals are not obligated to provide treatment to a person who
will not have any realistic medical benefit by the treatment (Marco, 2005). It means that if the medical
professional is certain that the treatment will not assist in improving the health of a person than he/she
did not have to provide such treatment. In particular, while deciding on euthanasia, the party has to
consider the legal and ethical issues. The principle of autonomy provides that a patient has the
independence to determine the direction which he/she decides to take as long as he/she has his legal
rights. Ethically, a patient should be treated autonomous, and he had the right to voluntarily select the
treatment and procedures which include life support and euthanasia, but it is important that the person
must make his/her wish known even if the family members oppose it (Albtoosh & Mrayyan, 2014). In

LEGAL AND ETHICS 2
this case, Bronwyn told that Dawn mentioned her that she did not want to live like a vegetable for the
rest of his life and she would rather die in comfort than living in suffering for a long time. As per the
ethical principle of autonomy, an order for NFR can be issued in this case because Dawn make her
wish known and the opposition of her family does not matter. Thus, an order for NFR is an ethical
decision for the medical professionals in this case.
In case the medical professionals believe that there is not proper palliative care available which is able
to cure the patient than they can consider euthanasia in order to ensure that the patient is not suffering
from pain. The concept of euthanasia has become popular based on the concept that people have the
right to decide whether or not they should live or not. It has been argued that euthanasia is not
necessary in case appropriate palliative care is available for a patient and he/she can relive his/her
pain by taking medicine (Coombs & Grech, 2016). However, if the disease or injury is untreatable,
then an order for euthanasia is ethical especially if the patient is suffering from pain. The ethical or
moral theory obligates a medical professional to know what is best for the welfare of others which
include eliminating harm to another party by taking the decision which is in the best interest of the
patient. The principle of beneficence applies in the case when a person in permanent vegetative state
and the life support is not long for the best benefit for the patient. By keeping the patient’s best
interest in mind, the doctor decided to end the suffering of the patient through euthanasia because it is
the right or moral thing to do at such moment (Cameron-Taylor, 2014). Preventing or reducing the
suffering of a person is considered as an act of mercy and beneficence. In the case of Dawn, her
doctor has clearly mentioned that she is in a permanent vegetable state and she is suffering from a lot
of pain as well. The nurse mentioned to the family that the hospital will ask advice from an
independent medical expert or the family can appoint a doctor themselves to get a second opinion on
the situation of Dawn. Based on such opinion, the family should take the right decision which is in the
best interest of Dawn. Therefore, it can be concluded that according to the doctor, removing the life
support of Dawn will be more beneficial for her and it will be an act of mercy and beneficence.
It is argued that the actions of a medical professional must be non-maleficence and euthanasia could
be considered as maleficence but if its purpose to prevent the pain of an individual, then it is
considered as non-maleficence. The oath which is taken by medical professionals is considered as
Hippocratic Oath because it provides that a physician should treat a person to the best of one’s ability
and preserves a person’s privacy and above all, do not harm (Levinson, Ho, Mills, Kelly, Gellie &
Rouse, 2017). However, an ethical dilemma arises when a patient is suffering from an untreatable
disease or injury, and the medical professional knows that the life support system is no longer useful
and the patient will be in a vegetable stage for his whole life. The theory of non-maleficence forbids a
medical professional from inflicting any evil or harm on another person, and it is his/her obligation to
protect people from harm. Based on this theory, the doctor should do whatever in his power to treat