PHI FPX 3200 assessment 5

Tonya’s Case: Ethical Considerations in End-of-Life Care Ethical Principles and Moral Theories 

Teenager Tonya Archer was hospitalized to have her ACL tear repaired, but she went into cardiac arrest during transfer and eventually died due to brain death via lack of blood supply. Although medical authorities advised removing Tonya from life support because the ongoing treatment was an exercise in futility, her parents continued therapy, appealing to the evidence of body warmth and a beating heart. This case raises ethical and moral concerns within the context of end-of-life care. Ethical principles of autonomy, beneficence, non-maleficence, and justice are at the center of Tonya’s case. Autonomy is the right of a patient to decide for herself regarding treatment, represented in this case by her parents. Parental autonomy does not preclude the obligation to refrain from futile or noxious therapy. Health care professionals must function in the best interest of the patient and act beneficently. Under the circumstance of Tonya’s irreversibility and keeping her agony alive with continuing treatment, medical professionals decided it is not her best interest to keep her receiving therapy. Being under no circumstance motivated by ill will, medical practitioners must abstain from making a further ill or injurious condition, i.e., from additional therapy. Justice mandates just decision-making that is unbiassed by socioeconomic status, where the medical staff makes a choice based solely on medical judgment (Nandifa et al., 2020). 

Moral Theory for the Case

Utilitarianism, one of the moral theories that ensures maximum overall pleasure and minimal pain, fits the case of Tonya.

For this approach, choices are deemed ethical when they bring the greatest joy or pleasure to the most people. Utilitarian application to Tonya’s situation is looking at the results of keeping her on life support or removing her from life support. As Tonya has been declared brain-dead and has no possibility of improving due to treatment, the medical opinion is to switch off life support (Marseille & Kahn, 2019). Utilitarian analysis involves a consideration of likely outcomes. Although removing life support from Tonya would surely cause pain to her family members, it would also remove her from further agony. Alternatively, prolonging life support would continue to inflict suffering on Tonya without the promise of improving her condition. Last, based on utilitarian arguments, removing life support will lead to more total happiness and less suffering at the expense of emotional impact (Vearrier & Henderson, 2021). 

 Application of Professional Code of Ethics

Professional codes of ethics guide healthcare practitioners in carrying out their duties towards patients.

The American Medical Association’s Code of Medical Ethics contains relevant principles in this case.

Non-maleficence prescribes not doing harm to patients, which substantiates the proposal to withdraw Tonya from life support to prevent prolonged suffering. Autonomy grants the patient the freedom to choose treatment, which in this case is exercised through Tonya’s parents’ surrogate decision-making, with whom they must act in her best interests. Beneficence demands that healthcare professionals act in the patient’s best interest based on the fact that further treatment will be of no avail to Tonya (Ebbs et al., 2020). Professional ethics that inform the medical team’s decision are centered on beneficence, autonomy, and non-maleficence. While Tonya’s parents still have a right to struggle for her, the medical team has an obligation to provide treatment as informed by rational medical reasoning and ethical standards.

Use of Organizational Documents 

Organizational documents like value and mission statements offer the basis for making decisions in healthcare organizations. The mission of the hospital is to prioritize quality care and patient well-being, validating the decision to withdraw Tonya’s life support to relieve her suffering. Integrity, respect, and compassion values reinforce the humane aspect of this choice based on Tonya’s incurable state (Minicuci et al., 2020).

Hospital protocols regarding end-of-life treatment most likely guided the choice, with reference to ethical committees and involvement of surrogate decision-makers.

Through adherence to organizational guidelines, the healthcare team is behaving in tandem with the hospital’s commitment to patient-centered practice and professional ethics (Luna-Meza et al., 2021).

Role of Accrediting Bodies

Accrediting organizations, such as The Joint Commission, have standards of care in health institutions. Adherence to these standards ensures the delivery of safe and quality care. The accreditation status of the hospital ensures the integrity of the decision to oversee Tonya’s treatment. The criteria for accreditation include policies on end-of-life care, ensuring that the medical staff decision to end life support was consistent with best industry practices (Gulati et al., 2021).

Compliance with the guidelines in place, even post-accreditation, is still topmost in making decisions, particularly end-of-life ones.

The medical team’s decision is ethical and aligned with patient care, ensuring the delivery of safe and compassionate care (Foglia et al., 2019).

Conclusion 

It is a thin line in striking a balance of ethical subtleties in end-of-life care between patient autonomy, beneficence, and professional integrity. Even with the challenging moral questions presented by Tonya’s case, ethical principles and professional standards guide healthcare workers and organizations in decision-making that best serves patients.