NURSING ETHICS: Ethical Issues in Limiting Life Support Decisions

This essay delves into the ethical considerations surrounding the limitation of life support in nursing, emphasizing the critical role of ethical principles in healthcare decision-making. It examines a case study where a patient with a DNR order experiences respiratory failure, prompting a discussion on patient autonomy, beneficence, non-maleficence, and justice. The essay highlights the importance of adhering to patient wishes, ensuring quality of life, and navigating the complexities of withdrawing or withholding life-sustaining treatments. It underscores the legal and ethical obligations of healthcare providers to provide optimal care while respecting patient autonomy and the ethical implications of decisions regarding end-of-life care. The essay references several scholarly articles to support its arguments, providing a comprehensive analysis of the ethical dilemmas faced by nurses in end-of-life situations.

Running head: NURSING ETHICS 1
NURSING ETHICS
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Decision-making is a vital process in healthcare. In the course of undertaking
professional responsibilities, Healthcare providers continuously encounter situations where they
must decide on the best course of treatment for their patients. On the other hand, professional
ethical guide their practice and inform what is morally right and what id not. This paper explores
the ethical issues in limiting life support.
Clinicians have a responsibility to provide the most optimal care for their patients. It is
legally and ethically allowed to give patients end of life support if doing so has the possibility of
improving the condition of a patient. On the other hand, they have a responsibility to adhere to
the wishes of a patient or family members when making decisions regarding end of life care.
Additionally, clinicians have a duty of educating their patients together with their families on the
importance and consequences of various interventions available for patients requiring end of life
support.
In this scenario, the patient, together with his wife has directed that no CPR should be
performed if a need arises. Because their decision regarding end of life support options is
synonymous, it could be argued that the decision was arrived at after consultations. In this
regard, patient autonomy is a critical requirement in healthcare. Healthcare providers are obliged
to allow patients to make decisions on the type of interventions they wish to or not to receive
(Sedig, 2016).For this reason, therefore, the directive by the patient needs to be adhered to.
The patient’s quality of life is an essential consideration in healthcare. Based on the
medical intervention adopted by healthcare providers, the quality of life may significantly be
improved or hampered. Improvising the quality of life entails assisting a patient in leading a
better life in their present medical condition. Based on the information in the case study the
quality of life for the patient would have been improved with the adoption of CPR because an

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improvement in his condition had already been observed. This is true also because the resulting
respiratory failure was caused by an accidental turning up of his oxygen (Zhang, Nilsson &
Prigerson, 2012).The fact that the patient already has a DNR order makes alleviates the
possibility of any CPR for the patient (Manalo,2013).
The decision to withhold or withdraw life sustain treatments tend to be quite challenging.
Depending on the current condition of a patient, the decision to withdraw or withhold may be
termed as ethical or unethical. For example, withdrawing life-sustaining treatment for a patient
whose death was imminent would be considered ethical because the impact of such interventions
would be insignificant. However, for a patient such as Mr Martinez whose condition would have
improved may be regarded as unethical (Welie & Ten Have, 2014).
Healthcare providers also have to adhere to ethical principles guiding their professional
practice. Based on the case study the most important ethical principles are autonomy,
beneficence, non-maleficence, and justice. According to the autonomy principle, they have to
comply with the wish of the patient. Beneficence and non-maleficence principles require them to
strive to benefit the patient and do no harm in all decisions. Finally, the justice principle roots for
fairness in all decisions (Levitt, 2014).
In dealing with the patient’s condition, therefore several issues need to be considered. To
start with the failure to adhere the wishes of the patient might lead to legal ramifications.
Secondly, failure to offer the most appropriate care benefiting, and improving the quality of life
might again be considered as a breach of ethical obligations (Levitt,2014).

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References
Levitt, D. (2014). Ethical decision-making in a caring environment: The four principles and
LEADS. In Healthcare Management Forum (Vol. 2, No. 27, pp. 105-107).Manalo, M. F.
C. (2013). End-of-life decisions about withholding or withdrawing therapy: medical,
ethical, and religio-cultural considerations. Palliative Care: Research and Treatment, 7,
PCRT-S10796.
Sedig, L. (2016). What’s the role of autonomy in patient-and family-centered care when patients
and family members Don’t agree?. AMA journal of ethics, 18(1), 12-17.
Welie, J. V., & Ten Have, H. A. (2014). The ethics of forgoing life-sustaining treatment:
theoretical considerations and clinical decision making. Multidisciplinary respiratory
medicine, 9(1), 14.
Zhang, B., Nilsson, M. E., & Prigerson, H. G. (2012). Factors important to patients' quality of
life at the end of life. Archives of internal medicine, 172(15), 1133-1142.