After Studying The Course Materials Located On Module 498601

After Studying The Course Materials Located Onmodule 7 Lecture Materi

After studying the course materials located on Module 7: Lecture Materials & Resources. Cure / care: compare and contrast. Basic care: Nutrition, hydration, shelter, human interaction. Are we morally obliged to this? Why? Example Swallow test, describe; when is it indicated? When is medically assisted N/H indicated? Briefly describe Enteral Nutrition (EN), including: NJ tube NG tube PEG. Briefly describe Parenteral Nutrition (PN), including: a. Total parenteral nutrition b. Partial parenteral nutrition. Bioethical analysis of N/H; state the basic principle and briefly describe the two exceptions. Case Study: Terry Schiavo (EXCEL FILE on Module 7: Lecture Materials & Resources). Read and summarize ERD paragraphs #: 32, 33, 34, 56, 57, 58.

Paper For Above instruction

Medicinal ethics and clinical care principles form the cornerstone of healthcare delivery, especially when managing nutrition and hydration (N/H) in patients with complex needs. The juxtaposition of cure and care underscores a moral and professional obligation to uphold the dignity, comfort, and well-being of patients. In this examination, we explore the ethical distinctions and similarities between cure and care, elaborate on basic and medically assisted forms of nutrition and hydration, and analyze the bioethical principles that underpin decision-making in this context, illustrated through the case of Terri Schiavo.

Comparison Between Cure and Care

Cure and care serve as two fundamental aspects of medical practice. Cure typically aims to eradicate disease or restore health through interventions like medication, surgery, or therapy. It is predominantly disease-centered, focusing on pathophysiological processes. For example, administering antibiotics for infections embodies cure, targeting the root cause to restore physiological normalcy. Conversely, care emphasizes providing comfort, dignity, and support to patients, especially when cure is unfeasible. It encompasses emotional support, symptom management, and ensuring quality of life. For instance, palliative care for terminal illnesses prioritizes comfort over curative measures.

While cure may involve invasive or aggressive interventions, care tends to be less invasive and more holistic. Nevertheless, both are morally intertwined; clinicians have an obligation not only to strive for cure but also to render compassionate care, respecting patient autonomy and dignity. The moral obligation to provide basic care—nutrition, hydration, shelter, and human interaction—stems from principles of beneficence and respect for persons. These basic needs are fundamental rights, and neglecting them can amount to ethical violations.

The Morality of Providing Basic Care

Healthcare professionals are morally obliged to provide basic care because it aligns with the principles of beneficence and non-maleficence—doing good and avoiding harm. Nutrition and hydration are essential physiological needs; neglecting them can cause suffering or death. For example, the swallow test is a diagnostic procedure used to assess swallowing ability and prevent aspiration pneumonia, a common complication in patients with dysphagia. It is indicated when a patient is suspected of having swallowing difficulties, particularly after stroke or neuromuscular disorders. The test involves giving small amounts of food or liquid and observing the patient for signs of aspiration.

Medically assisted nutrition and hydration (N/H), such as enteral or parenteral nutrition, become indicated when patients cannot meet their nutritional needs orally. Enteral nutrition (EN) involves delivering nutrients directly into the gastrointestinal tract via tubes: the nasojejunal (NJ) tube, nasogastric (NG) tube, or percutaneous endoscopic gastrostomy (PEG). EN preserves gastrointestinal function and is generally preferred for its safety profile and physiological benefits. Parenteral nutrition (PN), on the other hand, involves delivering nutrients intravenously, bypassing the gastrointestinal tract. Total parenteral nutrition (TPN) provides complete nutrition intravenously, suitable for patients with non-functioning GI tracts. Partial parenteral nutrition supplies supplementary calories and nutrients.

Bioethical Principles in N/H Decisions

The bioethical analysis of N/H hinges on core principles: autonomy, beneficence, non-maleficence, and justice. Respecting patient autonomy requires honoring their wishes regarding N/H, which may involve advance directives. Beneficence and non-maleficence entail providing appropriate nutrition while avoiding undue harm, such as infections or pain. Justice involves fair allocation of resources.

Two notable exceptions challenge the obligation to provide N/H. The first is when N/H prolongs suffering or is deemed medically futile, aligning with the principle of proportionality. The second involves cases where patients expressly refuse N/H, invoking the right to refuse treatment based on autonomy and personal values.

Case Study: Terri Schiavo

The Terri Schiavo case encapsulates the complex ethical tensions surrounding N/H withdrawal. Schiavo suffered a persistent vegetative state, and her husband's and parents' conflicting wishes over continuing artificial nutrition ignited a national debate. The ethical dilemma centered on whether prolonging life under such circumstances respects the patient's dignity or constitutes unnecessary suffering. Courts ultimately allowed the removal of N/H, emphasizing respect for autonomy and the patient's presumed wishes, though her actual preferences were unknown. This case highlights the importance of advance directives and the ethical necessity of balancing beneficence, non-maleficence, and autonomy.

Conclusion

Providing appropriate nutrition and hydration in healthcare involves navigating complex ethical considerations. Distinguishing between cure and care clarifies the moral obligations clinicians have toward patients, emphasizing the importance of respecting dignity, autonomy, and basic needs. The case of Terri Schiavo illustrates how bioethical principles guide difficult decisions, emphasizing the role of advance directives and the importance of honoring patient wishes to ensure ethically sound care.

References

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  • Johnson, D. L. (2009). Ethics of end-of-life decisions: Foundations and dilemmas. Journal of Clinical Ethics, 20(3), 227-230.
  • Magiligan, E. (2011). Ethical issues surrounding artificial nutrition and hydration. Nursing Ethics, 18(5), 655-664.
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  • Tanaka, H., & Kizawa, Y. (2012). Ethics of artificial nutrition and hydration: A review. Bioethics, 26(2), 91-99.
  • Vespa, J. C., & Holland, C. (2012). Ethical considerations in nutrition at the end of life. Dimensions of Critical Care Nursing, 31(2), 68-75.
  • Wright, D. (2020). Advance directives and ethical decision-making in healthcare. Journal of Palliative Care & Medicine, 10(3), 1-7.

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