A Comprehensive Report on Legal and Ethical Issues in Treatment

This report examines the legal and ethical complexities involved in withdrawing life-sustaining treatment, focusing on principles like autonomy, beneficence, non-maleficence, and justice. It discusses issues such as autonomous decision-making, the physician's role in providing information and respecting patient choices, advance directives, rationing of care, futile treatment, and the costs associated with end-of-life care. Ethical theories, including utilitarian ethics, deontological ethics, and virtue ethics, are considered in relation to end-of-life decisions. The synergy between law and ethics is emphasized, highlighting the importance of combining legal frameworks with ethical considerations to ensure patient-centered and legally sound healthcare decisions. The report concludes that a comprehensive understanding of these legal and ethical aspects is crucial for healthcare professionals in providing compassionate and ethically responsible end-of-life care. Desklib provides a platform for students to access similar solved assignments and study resources.

Legal and Ethical Issues

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Withdrawal of life sustaining treatment issue........................................................................4
Ethical theory relating with withdrawal of life sustain treatment issues................................5
Consider synergy between law and ethical theory.................................................................6
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
End of life care includes the physical, social, emotional and spiritual support which can be
effective for patient and their families. This is the one that are effective and lead to create high
impact on delivery of better and effective response toward individual health. In this, there are
various ethical concern which arises while deliver of end of life care. In this, report there is
selection of withdrawal of life sustaining treatment which can be ethical issues and is part of
discussion which include different ethical dilemma and are associates with different care. There
is also need to ensure about the identification of legal an d ethical issues, decision making
framework and policies along with communicating different complex ideas. There is also
discussion about the awareness of ethical code of conduct which can be effective and have high
impact on the delivery of better and effective care (Wheeler and et. al., 2018).
MAIN BODY
While delivering healthcare service there is need to provide better and effective healthcare
service which can be effective and can help to provide better healthcare support to improve
patient health. There is need to provide end of life care which should be taken in consideration
where it is essential to provide effective care that influence effective response toward patient
health improvement. There is need to take care of effective health where patient when not getting
health benefits from any medication or other health care service where they should need to
manage their health through getting different management and medication. There is a time when
individual is not able to get health benefits then there is need to ensure about taking care of
effective health through providing better compassion. Here, health care professional need to take
decision regarding patient health. This can include better and effective response towards proper
care service which are associated with improving patient health (Botti and et. al., 2019).
When any of medication or healthcare treatment are not working and are not able to provide
positive impact through it. In such situation, there is need to withdraw the life sustaining
treatment. Here, life sustaining treatment refers to treatment which service to prolong life
without create any impact or reversing any medical condition. This may include
cardiopulmonary resuscitation, haemodialysis, mechanical ventilation, antibiotics, left
ventricular assist device or artificial nutrition along with hydration. There are some of the
example of life sustaining treatment which includes renal dialysis, mechanical ventilation,

artificial nutrition, antibiotics, hydration and chemotherapy. When any patient is not getting any
positive impact on their health, then in such situation there can be removal or withdrawn of life
sustaining treatment. This is an ethical concern which can lead to create high negative health
impact on individual life.
Withdrawal of life sustaining treatment issue
There are 4 main ethical principles of end of life includes: autonomy, beneficence, non-
maleficence and justice.
Autonomous decision making: Patients have a right to take their decisions regarding end-
of- life treatment. The Federal Patient Self-Determination Act (PSDA) facilitated choice for the
patient to adopt the treatment for the end of life by using advance treatments. It is to be ethically
accepted to respect treatment choices of the patient while considering its limitations and perform
their duties in order to provide better services and benefits without doing any harm to the patient.
Physician's role and responsibilities to resolve the issue: It is responsibility of healthcare
professionals to provide complete information regarding the treatment to patients including
benefits, limitations as well as drawbacks (Vink and et. al., 2018). After knowing all the facts; its
patient's duty to think and analyse the worth of treatment and making a choice to go for it. If
according to physician's point of view the treatment is futile and has no sense, then he/she should
respectively explain the information facts regarding the medical treatment and explain all the
scenarios about withdrawal and carry on for the procedure. Physician also has a duty to prevent
unnecessary utilisation of medical resources for futile treatments and explain patient all the
demerits of expecting unrealistic results from ongoing treatment.
Advance directives: It enables patients to plan and design their preferences on end-of-life
treatment in advance. It allows competent individuals to make their own decisions on healthcare
choices and specify their wishes. But in case of an incapable individual; their families are
responsible for take decisions are known as proxies and primary care givers. On the virtue of
their relationship with the patient they may or may not be good enough in guessing the patient’s
preference for end-of-life treatment. Sometimes proxies may disadvantage the situation and may
take decision of their own benefit and interest irrespective of patient's choice (Bifarin and et. al.,
2021).
Rationing of Care and Futile treatment: Advancement in medicals treatments have
provided people with their choices of prolong their life. But people also should understand that

they are mortals and it is not possible to carry on with these advanced treatments for a long
period of time. As these treatments are expensive and utilize medical resources; which should
not be wasted ethically on futile and pointless treatments. Considering the fact that these
advanced technologies provide no assurance for recovery of patient. They should adopt
acceptability and take a difficult decision for termination of treatment ethically without harming
themselves intentionally. For limiting the futile treatment, a term “rationing of care” has been
introduced. It is present in current healthcare system and establish decision regarding the
termination of treatment when needed and ethically correct.
Costs involved in end-of-life care: Advancement and innovations in healthcare are utilising
lots of money in providing extraordinary services to the people. By utilising such amount of
money it is compulsory to consider quality of life rather than focussing on length of life
(Hammami and et. al., 2019).
Ethical theory relating with withdrawal of life sustain treatment issues
There is need to provide better and effective healthcare service which can be effective and
help to deliver better care to individual regarding getting positive health. In this, there are large
number of elder people who are facing the ethical issues in getting healthcare serviced. Here, end
of life care can be effective and help to provide better improvement to quality of life which are
associated with improving patient health and enable them to cope with the illness, death, their
disability and honourable health process. This is an effective technique which can help patient to
live their remaining life effectively with coping with their health issues or illness through
managing it more effectively to reduce the impact at end of life (Boys and et. al., 2022).
Ethical theories refer to the attempts which can help to provide clear, unified account about
the ethical obligation. This can lead to create high impact on ethics which are effective and can
influence better and effective response towards end of life care. There are some of the ethical
theory which may include utilitarian ethics, deontological ethics and virtue ethics.
Utilitarian ethics includes the determining right from wrong through focusing on
outcomes. This is the form of consequentialism which can hold most ethical choices and are
produce greatest good for greatest number. This is the one in which theory have the focus to take
care of large number of people instead of less people. This can lead to create high positive
impact of the theory that can influence better and effective response towards better health. This
includes in making decision which can be effective and allow to implement within healthcare.

This can also influence individual which are associated with taking care of effective role that can
include direct impact on delivery of better and effective response towards care and provide better
response towards delivery of effective care during end of life (Frühwald, 2018).
Through using the utilitarian ethics which are effective and can ensure to include large
population which include better and effective response towards taking care of better and
effective response towards delivery of improving patient quality of life (Pieterse and et. al.,
2019). This theory includes many individual where it allows to take decision including taking
care of effective response which are associated with providing better understand and help to
influence large population about make decision. This can be effective and help healthcare
professional to provide better learning and help in associated with taking care of effective
response that can influence end of life care. Here, through using Utilitarian ethics which can
influence better understanding about the decision making where healthcare professional should
include better learning and help to influence healthcare professional to take decision which
should be in favour and benefit of patient health. Withdraw of life sustaining treatment can create
an ethical issue which create ethical concern regarding following of the Utilitarian ethics.
Consider synergy between law and ethical theory
Synergy refers to the concept of value and performance which includes different
combination which work combine and have more positive impact rather than working separately.
Low and ethics can work separately where ethics includes the core principle of autonomy,
beneficence, non-maleficence and justice within medical and healthcare decision. This can be
effective to deliver better care and support to patient through following the judgements and
decision which are based on values which includes law and govern them. Through including law
and ethics combine can allow healthcare professional to make decision accordingly where there
is ethical consideration that everyone should be provided better and effective healthcare services
where during end of life, it can lead to create high impact on delivery of better care support
which are associated with working synergy through applying law and ethical theories (Baek and
et. al., 2021).
While taking care of patient health, there is need to perform well and help in getting
better care in which it is essential to take care of response that can influence healthcare
professional to use these synergies that are associated with influencing better positive impact.
Withdrawal of life sustaining treatment can be effective and should crate ethical issue when

those life sustaining treatment are not providing positive impact. In this, there is need to ensure
about taking care of effective response which are associated with improving patient health.
Withdrawal of life sustaining treatment can be ethical concern and healthcare professional
should make effective decision through using the evidence based decision where it should be
confirmed that life sustaining treatment is not effective and providing positive impact that can
associates with improving patient health. There is need to provide better and effective learning
where law and ethical theories. Through taking care of law and ethical theory, healthcare
professional should use those combine to make effective decision which can be in favour of
patient and should not allow to include any negative heath impact (Hernández-Marrero and et.
al., 2019).
CONCLUSION
From the above discussion, it can be concluded that there are large number of older age
people who need end of life care to improve and cope with their illness. There are many cases in
which people who are getting life supporting treatment are not enough to improve patient health.
In such situation providing life supporting treatment can be worthless where removing or
withdrawal of life supporting treatment can not have any negative health impact. This can be
point of ethical concern and ethical issues which should take in consideration about its
importance. There is also discussion about the ethical theories related with this issues. This also
includes the synergy between law along with ethical theories.

REFERENCES
Books and Journals
Baek, S.K., Kim, H.J., Kwon, J.H., Lee, H.Y., Won, Y.W., Kim, Y.J., Baik, S. and Ryu, H.,
2021. Preparation and practice of the necessary documents in hospital for the “Act on
Decision of Life-Sustaining Treatment for Patients at the End-of-Life”. Cancer Research
and Treatment: Official Journal of Korean Cancer Association, 53(4), p.926.
Bifarin, O. and Stonehouse, D., 2021. Autonomy and capacity: the ethical and legal
considerations. British Journal of Healthcare Assistants, 15(11), pp.545-549.
Botti, C. and Vaccari, A., 2019. End‐of‐life decision‐making and advance care directives in Italy.
A report and moral appraisal of recent legal provisions. Bioethics, 33(7), pp.842-848.
Boys, R.M., Beausoleil, N.J., Betty, E.L. and Stockin, K.A., 2022. When and how to say
goodbye: An analysis of Standard Operating Procedures that guide end-of-life decision-
making for stranded cetaceans in Australasia. Marine Policy, 138, p.104949.
Frühwald, T., 2018. Ethics and Legal Issues in the Care of Older Persons. In Learning Geriatric
Medicine (pp. 347-358). Springer, Cham.
Hammami, M.M., Abuhdeeb, K., Hammami, M.B., De Padua, S.J. and Al-Balkhi, A., 2019.
Prediction of life-story narrative for end-of-life surrogate’s decision-making is inadequate:
a Q-methodology study. BMC medical ethics, 20(1), pp.1-17.
Hernández-Marrero, P., Fradique, E. and Pereira, S.M., 2019. Palliative care nursing
involvement in end-of-life decision-making: Qualitative secondary analysis. Nursing
ethics, 26(6), pp.1680-1695.
Pieterse, A.H., Stiggelbout, A.M. and Montori, V.M., 2019. Shared decision making and the
importance of time. Jama, 322(1), pp.25-26.
Vink, E.E., Azoulay, E., Caplan, A., Kompanje, E.J. and Bakker, J., 2018. Time-limited trial of
intensive care treatment: an overview of current literature. Intensive care medicine, 44(9),
pp.1369-1377.
Wheeler, N.C., Murali, S. and Sattin, J.A., 2018, October. Ethical issues in vascular neurology.
In Seminars in Neurology (Vol. 38, No. 05, pp. 515-521). Thieme Medical Publishers.