- Briefly summarize the key features of the case.
A Good Death delves deep into the condition of a certain individual by the name of Martin Cavanagh who suffered from COPD and was being treated at the Dunedin Hospital in New Zealand.
The documentation of the ailment and the assorted conditions which shrouded the life of this person channelizes the thought of the audience toward the associated trauma and impediments which affect the hapless patient in such cases where the contemporary health care system is not equipped enough to provide respite from the prolonged ailment. The video describes how the health deteriorates over time with no hope of cure. The doctors discuss the issue of life and death and their interrelation. It is as if by saving the person suffering so much from COPD or any other chronic incurable disease, the death is being prolonged instead of prolonging the life of that person. The suffering which these patients go through is incomparable and needs to be addressed from a different perspective of humanity. The video ignites debate on the end of life care and draws comparisons between the hospital and the hospice in regard to their difference in approach to the ailment. Advance Care Planning is being developed to serve the patients who wait for the inevitable and can never be cured fully.
- Identify and discuss at least two legal considerations in the case.
When the question of end-of-life care comes into reckoning, the legal issues need to be kept in mind. As in this case, the consent of the patient, Martin Cavanagh, suffering from COPD attains omnipotence. It is though giving or refusing consent the patient can opt to accept or refuse the medical treatments which will only suffice in minimizing his sufferings. As such, what is very important is the understanding of the proper information about the decision which needs to be taken by the patient. (Rosenberg, Lamba, Mishra 2013) The role of the clinical staff needs to be considered as they must act promptly to aid the decision making procedure of the ailing person. The staff should provide information with optimum simplicity so that the patient may comprehend the situation. The clinical staff described how coma minimizes the sufferings of a patient as he cannot feel anything in that state. The staff discussed about the possible deterioration of his health and the impending consequences. The hospice too urged the patient to mull over what he wanted them to do for him. Surrogacy is another important legal aspect which entitles a relative of the patient to make the decision when the ailing person is not in a state to make his own decisions regarding the end of life treatment. In the time of absence of any decision regarding the goal of treatment, the surrogate in association with the medical team can determine a plan of care or end of life care. (Smith, Fisher, Schonberg, Pallin, Block, Forrow, Philips, McCarthy 2009) The primary concern in such cases is ending or pacifying the sufferings of the patient who can never be cured. The person is approaching death slowly only to suffer even more. Whatever be the philosophy of life, the person should be attributed with a peaceful and less painful path to reach the inevitable end.
- Identify and discuss at least two ethical considerations in this case.
The actions of the medical team in supervision have to be in the best interest of the patient. The doctors and the staff need to scrutinize and comprehend the impending condition of the patient and if there is any chance of betterment or cure. (Twycross 1995) In the case of COPD, the patient could have not been cured. The only respite could have been in the form of pacifying the suffering to a certain degree. In the last months of life, he was given morphine which is known to aid the physical condition in such cases of COPD.
Self-determinism of the patient is extremely important in such cases. It needs to be understood that the patient has the paramount right to make the decisions regarding the treatment procedure based on his beliefs, values and life plans. The gradual approach toward death with suffering would bring upon the patient severe suffering.
However, the end-of-life care would also require the consideration of the effect of the occurrence on the patient’s relatives and loved ones. It needs to be remembered that death would bring a metamorphosis in the lives of the people closest to the ailing individual. The sufferings may actually be extended by providing the temporary treatment as the problem will recur very soon with similar symptoms.
Fair allocation of resources is another very important aspect of ethics in relation to this case. The medical team supervising the patient needs to be equipped and the communication among them needs to be flawless so that the best possible respite can be provided to the man in trouble. (Lord, O’Connor, Yates 2012) Moreover, the hospital takes inspiration from the amicable ambiance of the hospice which places the patient on a pedestal of respect and honor. The system of treating in the hospital in such cases where end of life cares are associated needs to be transformed to comply with the parameters which determine the proper care for the ailing person.
In the context of this case, the patient opined that he felt better at the hospice in comparison to his stays at the hospital. The person is standing at the verge of demise and every possible measure needs to be taken to make things easy for him. Martin Cavanagh too opined at the hospice that he would like to face the inevitable with as less suffering as possible. Thus, the ethical issues need to be kept in mind while dealing with such cases which require optimum care and consideration.
- Reflect on the case and how it was managed.
The case was that of a person whose condition had deteriorated in the past year by leaps and bounds. The person could not even move his head or eat without running out of breath. This only testifies his severe problems in living life in the shackles of the sufferings of the disease. The heart-wrenching story leaves tears in the eyes of anyone who sees this video. One can only envisage the immense problems which the patient would have faced for such a prolonged time with no hope of being cured. His situation was nothing but of helplessness and the medical team could provide him with the necessary treatments which would lessen the sufferings. At the hospital, the team was instrumental in providing him with the care. However, it was at the ambiance of the hospice where he found the solace to his soul. Regular discussions and support from the staff was of immense aid to the patient. He deserved to get a peaceful and painless death after all that he had gone through due to COPD. The hospital did its best to nurture him, although there could have been a better approach to aid the patient. The ambiance at the hospital required to be more amiable and sensitive to his problems as was the environment at the hospice. (Twycross 1995) While at a hospice the patient is treated with personal care and support, in the hospital it becomes instrumental and hence it is not too comfortable for greatly ill persons like Martin. If I were to manage the case, the paramount aim would have been to arrange for a very comfortable situation for the patient. (Mitchell 2008) The endeavor would have been in providing him with optimum mental support through discussions and counseling. The patient would have been provided with a clinical staff to take care of all his needs to make things easier. More that medicines, they needed the sensitivity and assurance of the health care staff to be able to face the impending inevitability for Martin Cavanagh.
References
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Twycross, Robert 1995, Introducing Palliative Care, Radcliffe Publishing Ltd., Oxon.
