Define And Discuss The Difference In At Least 300 Words ✓ Solved

Define And Discuss In A Minimum Of 300 Words The Difference B

End-of-life healthcare delivery involves complex decisions that often distinguish between different levels of care provided to patients nearing the end of their lives. Two primary concepts in this context are ‘ordinary’ and ‘extraordinary’ care. Ordinary care refers to the essential, basic medical treatments necessary to sustain life, alleviate pain, and ensure comfort. These are typically routine interventions that align with the patient’s wishes and do not impose significant burdens or risks. Examples include administering medications for pain relief, hydration, and basic nutritional support. Such care is viewed as morally permissible and widely accepted as part of compassionate health management at the end of life.

In contrast, extraordinary care encompasses interventions that are invasive, risky, expensive, or prolong the dying process without providing meaningful benefit to the patient’s quality of life. These measures might include resuscitation efforts, ventilator support, invasive surgeries, or artificial nutrition and hydration when such interventions do not align with the patient’s desires or best interests. The distinction often hinges on the balance of burdens versus benefits, as well as ethical considerations regarding the patient’s autonomy and dignity. Healthcare providers and families must carefully evaluate whether certain treatments serve the patient’s values and goals, especially when the likelihood of recovery is minimal. The differentiation between ordinary and extraordinary care is critical in guiding ethically appropriate end-of-life decisions and respecting patients’ wishes.

What is meant by the DNR (Do Not Resuscitate) Order and when should it be implemented?

A Do Not Resuscitate (DNR) order is a legally binding directive that indicates a patient’s wish to forgo resuscitative efforts in the event of cardiac or respiratory arrest. It is typically made by the patient themselves when they are capable of informed decision-making or by their legally authorized healthcare proxy or family member if the patient is unable to communicate. The purpose of a DNR is to prevent invasive and potentially distressing procedures, such as chest compressions or intubation, that may not align with the patient’s goals of care, especially when the likelihood of meaningful recovery is slim. DNR orders are often part of broader advance care planning, reflecting individual values regarding quality of life and death.

Implementing a DNR should be considered under specific circumstances: when a patient has a terminal illness with a poor prognosis, when aggressive measures would only prolong suffering, or when the patient explicitly states a desire to avoid resuscitation. It is essential that the decision is made voluntarily and with thorough understanding of the implications. Ethical principles such as autonomy, beneficence, and non-maleficence underpin the use of DNR orders, ensuring that the patient's wishes are prioritized and unnecessary interventions are avoided.

What happens if Doctors want to impose a DNR but the family does not want it exercised?

When healthcare providers determine a DNR is medically appropriate based on the patient's condition and wishes, but the family opposes its implementation, ethical and legal tensions can arise. Generally, the healthcare team must respect the patient’s autonomous decisions if the patient has capacity, or adhere to legally authorized directives made by the patient or their designated surrogate. If the patient is unable to decide, the family’s wishes should be considered, but they do not have the ultimate authority unless they are acting as legally appointed representatives.

In cases of disagreement, healthcare providers are ethically obligated to facilitate communication and mediate between the family and the medical team, ensuring that the patient’s best interests and previously expressed wishes are prioritized. If conflicts persist, hospitals or care institutions may involve ethics committees to resolve the dispute. Legally, the emphasis is on honoring the patient’s autonomy; however, family members may sometimes seek court intervention if they believe the DNR contradicts the patient’s expressed values. Ultimately, the goal is to align end-of-life care with the patient’s preferences while respecting the family’s emotional and moral concerns.

References

• Braddock, C. H., et al. (1999). Informed decision making in outpatient care. Journal of the American Medical Association.
• American Medical Association. (2020). Code of Medical Ethics. Opinions on End-of-Life Care.
• Steinberg, A. M. (2015). End-of-Life Healthcare Decisions. Medical Ethics Journal.
• Muoy, D. (2012). The ethical considerations of DNR orders. Nursing Ethics, 19(4), 495-503.
• Turner, B., et al. (2017). Balancing care: Ordinary vs. extraordinary interventions. Healthcare Ethics Review, 28(2), 134-142.
• Kenny, A., et al. (2014). The role of family in end-of-life decisions. Journal of Palliative Care, 30(1), 19-24.
• Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics. Oxford University Press.
• American Nurses Association. (2018). Ethics and Patient Rights in End-of-Life Care.
• Nelson, J. E., et al. (2010). Shared decision-making in critical care. Critical Care Medicine, 38(3), 747-753.
• Hickman, S. E., et al. (2011). Preferences for end-of-life care: A national survey. Journal of the American Geriatrics Society, 59(7), 1191-1195.