Question

Using the following information (below), explain how the ethical principle(s) associated with each section were either met or violated the Dax’s case.

MEDICAL INDICATIONS : The Principles of Beneficence and Nonmaleficence

- include clinical facts necessary to diagnose the extent and seriousness of burns, to make a prognosis for survival or restoration of function, and options for treatment

- after initial emergency treatment, his prognosis for survival was very low

- after six months of intensive care, his prognosis for survival improved greatly

- if his request to stop treatment during hospitalization had been respected, he would have almost certainly died

PATIENT PREFERENCES : The Principle of Respect for Autonomy

- initially, it was assumed that he lacked the capacity to make his own decisions

- doctors accepted the consent of his mother in favor of treatment over his refusal of care

- when hospitalized at the University of Texas Medical Branch in Galveston, psychiatric consultation was requested which affirmed his mental capacity to make decisions

- once his mental capacity was established, the ethical implications of his desire to refuse care became central

QUALITY OF LIFE : The Principles of Beneficence, Nonmaleficence, and Respect for Autonomy

- prior to the accident, he led a rather healthy, comfortable, and enjoyable lifestyle

- during the course of receiving medical treatment, he endured excruciating pain and profound depression

- even with the best of care, he was confronted with significant physical defects (i.g. notable disfigurement, blindness, and limitation of activity without being dependent of others)

- at some point, he had the capacity to determine what quality of life he wished for himself

- in the early weeks of his hospitalization, he was most likely mentally incapacitated at the time critical decisions had to be made

- as such, others would have had to make certain “quality of life” decisions on his behalf

CONTEXTUAL FEATURES : The Principles of Justice/Fairness

- his mother was opposed to terminating his medical care due to religious reasons

- at the time, the legal implications of honoring his demand to end his suffering were unclear

- the costs of intensive burn therapy he received aren’t insignificant, but it isn’t emphasized in this discussion

- distress caused to medical and nursing personnel by his refusal to cooperate with treatment might’ve influenced their attitudes toward him

Answer 1

Using the following information (below), explain how the ethical principle(s) associated with each section were either met or violated the Dax’s case.

Medical indications: The Principles of Beneficence and Nonmaleficence were met.Eventhough Dax wanted to die physicians always save patients from harm and do only good things to patients towards recovery and safety.

Patient preferences: The principle of autonomy has been violated but patients if given full freedom to practice their autonomy may lead to dangerous consequences. If Dax was granted his autonomy ,it would had been a great mistake because he is now happy .Dax's case provides us an opportunity to evaluate about what should have been done was right or what was done was right and what may be the outcomes of these measures.

Quality of life: Dax was in a life threatening situation ,even he was having mental capacity to take his own decisions on treatment because of excruciating pain and depression, he wanted to end his life.Every person has right to take their own decisions .Before he was healthy and happy individual but unfortunately an accident occurred which led to irreversible changes in him pushing him to take emotional decisions.So consent is taken from his mother to provide him with certain quality of life. Beneficence , nonmaleficence principles are followed. Autonomy is restricted for saving his life from the view of physicians .According to him it was horrible and he would have died for he was undergoing treatment for burns which brought untolerable immense pain for 10 long months.

Contextual features: The right to die is not accepted by regulations, laws, and stipulations.Religious factors influence clinical decisions.At the time he was receiving treatment ,any form of assisted suicide was non-existent.He was given forced treatment as he was not willing to live due to the pain , pain medications were not that much relieving for him making him arrogant and unco operative. The physicians wanted to save him because they practice beneficence but they were unfair to some extent for not considering his excruciating pain and for not giving adequate sedation .He is an human who needed empathy