Physician Disagreement Regarding a Patient’s Wishes Case Study

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Introduction

The case involves biomedical ethics where the doctors involved had to decide on whether to violate the original request by patient, John R, that he should not be resuscitated in case he was taken to cardiac arrest center.

The patient was diagnosed with cancer, and his situation was deteriorating. He asked his physician, Dr. W, to stop further treatment; and the oncologist, Dr R, agreed. Later, the patient’s condition worsened, and he started experiencing internal bleeding which forced him to change his original request.

The two doctors differed on whether to resuscitate and resume treatment. They disagreed regarding the issue with Dr. W insisting on the earlier request while Dr. R suggested doing something (DeGrazia, Mappes, & Brand-Ballard, 2011).

This paper analyzes the case and uses Kant’s approach on ethical decision to support Dr. R’s stance on doing soothing.

Analysis of the Case

The represents a conflict between Dr W and Dr R who have to agree on a common ground to deal with the situation at hand. Apparently, each doctor supports his opinion on the matter but since only one option has to be selected, the conflict must to be settled.

It is clear that the patient originally stated his will of not being resuscitated incase he suffers cardiac arrest. He also requested termination of further treatment.

Therefore, the two doctors were obligated to follow the instructions of the patient. However, the patient could not imagine at that moment that the situation would worsen to the extent of experiencing internal bleeding.

The decision by his physician was ethically correct since he upheld the patient’s decision made when John R had been conscious. On the other hand, the stance by Dr. R seems to be rational since doing soothing could save the life or simply stop the severe pain of the patient.

This presents a dilemma on whether to maintain the original or the second request from the patient. The main task in analyzing the case is to decide on whether to stand on the previous or the current request.

Kant’s approach on ethics can be applied to analyze this case. The approach is based on the categorical imperative principle which insists that the consequence of any ethical act is relevant but what matters most is the principle behind the action (Ess, n.d).

As such, evaluation of an act is based on the principle of intention or the will. For instance, two individuals can do a similar act which may lead to the same consequence, but their basic intention may determine whether the act was ethical or not (Haslanger, 2001).

With relation to Dr. R’s, who insisted on doing something, he realized that if no treatment was given, the patient would suffer severely and finally die.

In other words, the doctor intended to stop the bleeding or save the life of John R; thus deviating from the original request. He was conscious that failing to take any action would terminate the life of the patient.

In the case, the best decision is to do something as requested by the patient.

This implies that Dr W should change his stance and follow the opinion of Dr R. As per medical ethics, it may not be rational to insist on the original request the patient made while sober just for a mere reason that the second appeal is influenced by pain caused by internal bleeding (Fremgen, 2010).

The intentions of the patient’s physician do not appear rational, and he should have thought of changing his stance. Opting to do nothing puts the patient’s life at risk as he was experiencing lethal internal bleeding.

Furthermore, the apparent condition of the patient compels the two doctors to do something in order to save his life. Therefore, the two doctors should agree on what to do to save the patient’s life. Currently, saving the life of John R should be the priority.

Conclusion

The dilemma of the case is whether to maintain the patient’s original request or do something to save his life. Adopting Kant’s approach on the ethics suggests that doing soothing would be necessary to save John’s life.

The paper, therefore, supports Dr. R’s decision on following the second wish of the patient to do something and resume treatment.

References

DeGrazia, D., Mappes, T., & Brand-Ballard, J. (2011). Biomedical Ethics (7th ed.). New York: McGraw-hill.

Ess, D. (n.d). Three Approaches to Kant:Values Analysis. Web.

Fremgen, B. F. (2010). Medical Law and Ethics. London: Pearson.

Haslanger, S. (2001, December 2). Kantian Ethics (and more on famine). Web.

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IvyPanda. 2019. "Physician Disagreement Regarding a Patient's Wishes." April 8, 2019. https://ivypanda.com/essays/physician-disagreement-regarding-a-patients-wishes/.

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