Decision making module 6

The disease makes life quite difficult for the man as the disease makes him feel like ‘fighting for breath’. The disease is severely debilitating and over time, the man deteriorates. In such a condition, the best he could get was the best palliative care possible in a hospice, but that does not provide answers to some nagging questions. One of the most important questions has to do with ‘prolonging life or prolonging death.’ The importance of such a question comes to light when one realises that the patient under review here is suffering from a chronic respiratory illness which eventually took his life. However, as medical personnel and other care givers struggled to provide him with the best palliative care, his symptoms were also inadvertently prolonged. That creates a conflict of purpose in the mind of the physician: Am I prolonging life or death? The case also gives a good demonstration of the dilemma that families face when they are to cope with the painful choice of having to take care of a patient suffering from a terminal disease such as COPD, cancer and similar ones (Taylor, 2011). 2. Identify and discuss at least two legal considerations in the case While taking a look at this case, there are several legal issues that surfaced, and the most important or crucial ones are: -The question of ending life In countries such as New Zealand where euthanasia is expressly illegal, this is indeed a very tough issue. Therefore, the case of the patient approving or even thinking of euthanasia or any medically-assisted suicide does not come into the picture. End of life is a very crucial stage in our existence and when it is now burdened with a perennial disease such as COPD, as seen in this case, it all assumes even a more radical dimension, legal matters included. The status of illegality that has been conferred on euthanasia in New Zealand means that all the patients and the family have to rely on is the palliative care, which does not always give the best to the patients. This is a very important issue and has thrown up even more controversies, which have been settled with legislations in countries such as the Netherlands (Dowbiggin, 2007, p. 149). -Who determines the degree and extent of the advanced care plan/palliative care provided? Although the Advanced Care Plan (ACP) makes provision for the patient to choose those to make decisions on his or her behalf when incapacitated, this also has the possibility of raising some legal dust. This is particularly true of a case where the patient is either a homeless, stateless or even an immigrant person who does not have a next of kin who can be easily tracked or called to fill in the gap. This is not always an easy question to answer (Taylor, 2011). (Provide reference to legal documents, guidelines or other articles/texts that discuss legal issues in regards to end-of-life decisions). 3. Identify and discuss at least two ethical considerations in the case As hinted in the section above, there are legal and ethical issues that arise from the case of end-of-life patients. Those that have the highest significance in bioethics are: a) How proper is extending pain or postponing death? In this case, physicians narrated of how some patients with respiratory illnesses felt: the advanced