Bio-Ethics Case Study: Ethical Considerations in Euthanasia Scenario

This case study examines the ethical dilemma surrounding a 79-year-old woman, T.G., facing multiple health complications, including a recent stroke and kidney failure requiring dialysis. After undergoing two dialysis sessions, T.G. refuses further treatment and expresses her desire to die, prompting an analysis of bio-ethical principles. The study explores the application of the four bio-ethics: beneficence, non-maleficence, autonomy, and justice, emphasizing T.G.'s right to self-determination (autonomy) and the principle of non-maleficence, which argues against imposing unnecessary pain and suffering. Considering T.G.'s age, health conditions, and the pain associated with dialysis, the study supports her decision based on the ethics of autonomy and non-maleficence, aligning with the concept of informed consent. The analysis also references the legal context of euthanasia, suggesting that T.G.'s wish to discontinue life-saving treatment is justifiable within the framework of end-of-life care. The conclusion emphasizes the importance of respecting patient autonomy and minimizing suffering in medical decision-making, referencing relevant guidelines and literature.

BIO-ETHICS IN RELATION TO CASE STUDY
Presented by:

Introduction of the Case Study
• The following presentation is based on the case study of a 79 year women named
T.G
• She has numerous health complications
• She lives with her husband assistance care living
• At present she is finding it difficult to conduct the daily living activities though she
loves to be independent
• She has recently encountered stroke that has hampered her physiological
equilibrium
• Doctor has recommended a dialysis of kidneys for three times a week in order to
ascertain the condition of the kidneys
• After second dialysis, T.G refused to conduct the treatment any further and opted
to die (euthanasia).

Points to be Covered
•The four common bio-ethics in health and
social care service
•The ethics that goes in favor of the patient in
the case study
•The rule of euthanasia in USA and how it
supports this case

Four Bio-Ethics
• According to the American Academy of Physicians' Assistance (AAPA) (2013), the
four bio-ethics that is applicable in medical science include:
• Beneficence
• Non-maleficence
• Autonomy
• Justice

Ethics in Favor of Patient
• Autonomy means self-choices. Thus going by self choice of T.G, she must be
allowed to discontinue the treatment
• This again coincides with the medical principle of informed consent that preach
that consent must be taken from the patient before initiation of the treatment
• Under her full sense, T.G have refused to undertaken the treatment further after
having 2 consecutive dialysis and thus her decision must be given respect
(Wardrope, 2014)

Pain and Withstanding the Therapy
• Non-maleficence states that not to impose unnecessary burden on the patient
(Schröder-Bäck et al. 2014)
• The dialysis of the kidney is imposing pain to T.G with large needles inserted into the
large arteries and veins
• However, in spite of the giving this life saving treatments, it is not clear that whether
the dialysis will help to recover T.G
• World Health Organization. (2014) states that main rule of palliative care or geriatric care is
to reduce the severity or sufferings from pain but dialysis is further imposing pain to
T.G
• She was also suffering from depression and increased level of pain from dialysis,
frequent visit to hospital for dialysis is imposing a negative state of mind to T.G and
further increasing depression

The Age of the Patient
• The age of T.G is 79 years
• She is having numerous physiological health complications like diabetes, heart
disease and kidney problems.
• She is also suffering from depression
• The socio-economic status of T.G is not clearly state in the case study but she used
to live in assisted living with her husband
• Taking her age into consideration, discontinuation of the therapy (dialysis) is
justified or goes in favor of her

Euthanasia in Relation to the Case Study
• Under the law of euthanasia it can be stated that T.G must be allowed to
discontinue the treatment.
• The law specify assisting the patient with the process of death in order to end the
sufferings
• T.G was suffering from severe pain and mental health complications
• She was also suffering from other associated physiological complications that is
increasing the pain and sufferings further
• Thus the wish of discontinuation of the life-saving renal dialysis and vouching for
death is justified under the rule of euthanasia (Keown, 2018)

Conclusion
• Thus from the above discussion, it can be concluded that:
• The bio-ethics that goes in favor of the case study of T.G is the ethics of non-
malefience and autonomy
• The ethics of autonomy again coincides with the medical professionals code of
conduct of informed consent
• Under this two ground of bio-ethics and informed consent of decision taken by T.G
is justified

References
• American Academy of Physicians' Assistance (AAPA) (2013). Guidelines for Ethical Conduct
for the PA Profession. Access date: 1st July. 2019. Retrieved from:
https://www.aapa.org/wp-content/uploads/2017/02/16-EthicalConduct.pdf
• García-Llana, H., Remor, E., del Peso, G., & Selgas, R. (2014). The role of depression,
anxiety, stress and adherence to treatment in dialysis patients' health-related quality of
life: a systematic review of the literature. Nefrología (English Edition), 34(5), 637-657.
• Keown, J. (2018). Euthanasia, ethics and public policy: an argument against legalisation.
Cambridge University Press.
• Schröder-Bäck, P., Duncan, P., Sherlaw, W., Brall, C., & Czabanowska, K. (2014). Teaching
seven principles for public health ethics: towards a curriculum for a short course on ethics
in public health programmes. BMC Medical Ethics, 15(1), 73.
• Wardrope, A. (2014). Relational autonomy and the ethics of health promotion. Public
Health Ethics, 8(1), 50-62.
• World Health Organization. (2014). Strengthening of palliative care as a component of
integrated treatment throughout the life course. Journal of Pain & Palliative Care
Pharmacotherapy, 28(2), 130-134.