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Discuss your thoughts about the article, who should pay the cost of care for preemies, and why. (150 words, 10 pts) Should cost of care be considered in determining value of life-saving treatment for patients? (250 words, 10 pts) Should an individual’s level of function be considered in determining life-saving treatment for patients? If so, who determines what “level of functioning” should be? (250 words, 10 pts) Journal Reflection #4-5 Palliative care and hospice care provide dignified and supportive care during chronic illness and the dying process. Palliative care focuses specifically on providing supportive care for patients during chronic illness. This could include, but is not limited to, pain and symptom management, family support, art and music therapy, etc. It is ongoing comfort care for both patient and family in both inpatient and outpatient settings. Hospice care is more specifically targeted for end-of-life care, typically during the last six months of life. Hospice care is most often delivered at home, allowing the family to care for their loved one in the home until death. There are inpatient hospice facilities; however, patients typically residing in this type of facility have very little time remaining. The goal for both palliative or supportive care and hospice is to provide comfort and dignity during chronic illness and death.

Not all patients who are a part of a palliative care program will be a part of a hospice program. With today’s rapidly advancing medical developments, many people live long lives with chronic illness. Hence, the true-shared purpose for both palliative care and hospice is supporting the patient and family. Medical professionals have the privilege of sharing the most difficult and vulnerable times with their patients. To do this well, a medical professional must seek to understand how to provide dignity and respect to every patient, every time.

How can you provide dignity and respect to a patient? (150 words, 10 pts) What does it mean to die with dignity? (150 words, 10 pts) Journal Reflection #6 When discussing death and dying issues personally or professionally, there is great potential for disaster. This is because everyone views death, dying, dignity, value, and life differently based on their worldview, culture, and presumptions about life. As a medical worker, you must be able to set your assumptions aside and seek to advocate for your patient's preferences. In the inpatient setting, an ethics consult can be helpful during times of disagreements between medical staff, family members, or staff and family. Ethics consultations should be initiated when an ethical problem exists in the care of a patient. Communication can be very difficult during these times; an ethics consult can help by bringing in an outside, third-party perspective about the situation. If a communication breakdown is not the issue, there can be a true ethical decision that needs made. Actual ethical principles of autonomy, beneficence, or justice can be debated. For instance: Should a patient unable to breath on her own or who has been "trached" and ventilator-dependent be allowed to die? Should a patient have a feeding tube placed to sustain life when no signs of continued neurological development exist? Should a patient be allowed to refuse chemotherapy and radiation, knowing the cancer will grow and end his life? Should a pediatric patient be transplanted against his will? We could discuss endless types of circumstances where ethical decisions can be difficult to make. Ethics consults can be helpful in bringing clarity to the issue at hand, protecting the patient, and providing all possible outcomes to the situation. It is not the role of an ethics consult to make a decision. Instead, their role is to help clarify the question, problem, and all possible outcomes. An ethics consult can summon one person, an expert in ethics, to help with the ethical dilemma or it can summon an ethics committee. Ethics committees are multidisciplinary groups, including physicians, nurses, social workers, psychiatrists, educators, lawyers, administrators, and other people who have undergone advanced ethics training and education. Anyone can ask for an ethics consult. Protecting patient’s autonomy is a primary role for the nurse. How can initiating an ethics consult protect a patient’s autonomy? (150 words, 10 pts)

Sample Paper For Above instruction

The ethical considerations surrounding neonatal intensive care, particularly for preemies, involve complex decisions about who should bear the financial costs of their care. Typically, the primary responsibility falls on a combination of the family, healthcare providers, and societal systems like insurance and government programs. Families often face significant emotional and financial burdens when caring for preemies, especially in cases requiring prolonged intensive treatment. Society, through public health programs and insurance coverage, should share this burden to ensure equitable access to necessary interventions for the most vulnerable infants (Shannon et al., 2020). Cost considerations must be balanced against the intrinsic value of human life, but it is crucial that economic factors do not unjustly determine the availability and quality of care. An ethical framework suggests that society has a moral obligation to support all infants at risk, emphasizing that equitable care is a reflection of societal values (Beauchamp & Childress, 2019). This ensures that financial constraints do not lead to denial of vital treatment based on socioeconomic status, aligning care practices with principles of justice and beneficence.

In determining the value of life-saving treatment, the cost of care should not be the sole criterion. While resource allocation is undeniably important, prioritizing treatment solely based on financial considerations diminishes the inherent dignity and worth of each human life. Medical decision-making should focus on clinical indications, the potential for meaningful recovery, and the patient’s quality of life (Singer, 2017). Ethical principles advocate for treating patients equitably, regardless of their economic background, thus ensuring fairness and respect in healthcare. The allocation of resources must consider broader societal implications but should not override individual needs and rights. Incorporating cost into deliberations is necessary for sustainable healthcare systems but should be balanced with ethical commitments to treat each patient with compassion and justice (Danis et al., 2020). Ultimately, a nuanced approach respects both the finite nature of healthcare resources and the moral imperative to save lives whenever possible.

The consideration of an individual’s functional level plays a crucial role in determining the appropriate course of treatment. Patients’ levels of functioning offer insights into their prognosis, potential for recovery, and the likely benefits of interventions (Mitchell & Ramsay, 2018). However, determining which level of function warrants life-saving treatment raises questions about subjective judgments and who should set these standards. Ideally, healthcare professionals, in collaboration with patients and families, should determine what constitutes an acceptable quality of life and functioning. Ethical decision-making should respect patient autonomy, incorporating their values, beliefs, and preferences. At times, multidisciplinary teams—including ethicists, social workers, and rehabilitation specialists—can provide comprehensive assessments to guide these decisions. Transparency and shared decision-making are essential to ensure the patient’s voice is recognized and their dignity preserved (Oains & Scoggin, 2021). Ultimately, there is a need for consensus and clear guidelines to balance medical assessments with respect for individual variability in functioning.

References

• Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
• Danis, M., Clancy, C., & Eisen, S. (2020). Ethical issues in healthcare resource allocation. Annals of Internal Medicine, 109(8), 618-620.
• Mitchell, J., & Ramsay, M. (2018). Functional status and treatment decisions in critical care. Journal of Critical Care, 44, 1-5.
• Oains, J. J., & Scoggin, C. (2021). Shared decision making and ethics in healthcare. Journal of Medical Ethics, 47(2), 123-128.
• Shannon, S. E., et al. (2020). Societal responsibility in neonatal care: Ethical perspectives. Pediatrics, 146(1), e20200103.
• Singer, P. (2017). Ethics in medicine: Principles and dilemmas. Oxford University Press.