Tag Archives: Autonomy

Family Dilemmas in End of Life Care – Withdrawal of Artificial Nutrition and Hydration Withdrawal/Withholding of Care

The patient, Larry M, is a man in his 40s with a wife and three children at his bedside. He is in end stage liver cancer. He has been receiving total parenteral nutrition and IV fluids and has now decided to have his feeding tube and IV fluids withdrawn and to then return home with his wife and children, and with the assistance of hospice, die as comfortably as possible. The patient feels that this is be best for him and helpful to his wife and children to go through this process with him. His physicians fully support this decision….

Genetic Bastards: The Moral Status and Human Worth of Persons Born By In-Vitro Fertilization Reproductive Technololoy

The Vatican and the 2004 President’s Council On Bioethics establishes a second class group of persons who they deem less worthy of dignity and respect. On September 8, 2008, the Vatican issued a new statement on bioethics entitled “Dignitas Personae on certain bioethical questions.”  The Vatican’s paper updates church doctrine regarding the ethics and morality of individuals and the duties and authority of physicians in using in-vitro fertilization (IVF).  The Vatican has always demanded absolute and unconditional recognition of the respect and dignity owed to all persons from the time of conception.  This does not apply to persons conceived by…

Hospital Ethics Committee Failure Autonomy

Being right does not make a decision morally correct. The patient, a 98 year old man was suffering from a dissecting aortic aneurysm of 7.5 cm. He was unresponsive and near death. He previously, and with unquestioned capacity, executed an advance health directive indicating that he refused surgery. He also had previously told his physician that he would rather die than to face the probable mental and physical damage and quality of life deterioration that would accompany such damage.  Without question, principles of clinical bioethics would demand respect for the patient’s wishes and directives. In this instance, the patient’s spouse…

Autonomy: The Patient is the Patient – the family isn’t Autonomy

    Many patients facing illness or disease that places their lives at risk do not generally ask why their life is at an end. Instead they often ask, “Why did I live at all?”  “What difference did my life make? It is remarkable how disempowered one feels when seriously ill. Dr Paulina Taboada, describes it:      “Indeed, perhaps the most devastating aspect of despair is the inability to find meaning.”      When we become weak, confused and exhausted we often enter into a void where our thoughts and decisions are distanced from us. As football coach Vince Lombardi said,…