ETHICAL AND PROFESSIONAL VALUES

Ethical and Professional Values

Ethical and Professional Values

Introduction

Modern life has changed how we grieve as well as how we view death. Grief, a deeply private experience, has become public and superficial. With modern medicine, death is farther off than it once was and not seen as a natural and often welcome part of life. One should have the same sense of self-determination when dying as one expects when living. (Seedhouse, 2009)

Mrs. Jones is an 75 year-old woman with a fractured neck of femur, had a Do-Not-Resuscitate (DNR) order. This initiated an moral problem for the caring professionals regarding what must become of the Do-Not-Resuscitate order. They are confused if surgery should be performed or not. If surgery is performed then what has to become of the DNR order.

Discussion

The main issues in this case study concerns status of the DNR, Mrs. Jones's autonomy and beneficence. Some scholars suggested that health texts have some vagueness on the point of a Do-Not-Resuscitate (DNR) order and the resuscitative intrusions it stops in anesthesia and surgery. According to a circular sent by Department of Health in 2000 to all NHS trusts demanding that they must guarantee appropriate resuscitation strategy that value patients' rights, were in position. Resuscitation Council UK (2001) set out guidelines on when to initiate DNR order by giving consideration to the following prime issues:

the probability of effectively resuming the patient's breathing and heart and the Human Rights of patient

the patient's ascertainable or known wishes

Seedhouse (2009) stated that he right of patients to make personal end of life decision, which must be respected by health-care professionals, is both legal and professional requirements. For example, hospitals must have suitable resuscitation strategy, which respect patients' rights (DOH). Similarly, the doctor must respect the legal right of competent informed adults to refuse medical procedures using DNR order or any other form of advance directives. This means that Mrs. Jones may exercise her legal right to refuse treatment or resuscitative measures using DNR order. She could also exercise this right using Advance Directives. (Seedhouse, 2009)

The issue of Mrs. Jones's mental capacity is addressed in the Mental Capacity Act (2005), which established that nobody lacks capacity unless proven by a qualified clinician. On facts of the case study, the DNR order was signed by a member of Mrs. Jones's family, culminating in ethical dilemma for the health-care professionals caring for her. It is not clear what she would have preferred had she been able to speak for herself. It also raises the ethical question:

Whether DNR status must keep on being upheld in surgery? It is customary with health-care professionals to apply the guiding principles of ethics to aid their decision making when resuscitation status is being considered. As noted earlier, the guiding ethical principles are non-malficence, beneficence, and respect for autonomy and justice. Several ethical values direct the process of decision-making of the DNR. However, we shall discuss here only the most relevant principles to ...