Table of Contents
- Issue Recognition
- Information Engagement
- Option Consideration
- Action Explanation
- Outcomes Evaluation
In everyday life, most do not think of the ethical choices they make. Those who have taken this class will undoubtedly be more mindful of their ethical choices because of all we have read and learned. We repeatedly answered ethical dilemmas to refine our ethical thought process. After looking at the scenarios, I have chosen to write about story four. This scenario is about Mrs. Bennett, who is battling her last stages of colon cancer. She is in horrible pain and asks for more pain medication. Her doctor has given her the highest safe dose he can and a higher dose could hasten her death. In a clear and rational state of mind, Mrs. Bennett states that she understands but she wants to end her pain and suffering, even if it means ending her life. Should her doctor give her an increase dosage, even if it this dosage could shorten her life? Mrs. Bennett’s doctor has multiple options they could discuss with their patient. Even if she does not listen, at least her physician tried to guide her with the best of their knowledge.
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Mrs. Bennett’s doctor does want to help her feel more comfortable during her time of treatments. The doctor knows that she is in horrible pain, but she is on the maximum safe dose and an increased dosage could shorten her time left. So, does the doctor give Mrs. Bennett the increased dosage of pain medication and run the risk of it killing her faster or do they not give her anything and let her be in excruciating pain? It all depends on the doctor’s ethics and his moral code. Mrs. Bennett is practically asking her doctor to help quicken her death, which has a “formal” name called “physician-assisted suicide”. There is a huge debate going on all over the world over physicians giving medication to help kill or even hasten a patient’s death. Some say it’s incompatible with the physician’s role as a healer (Association, n.d.). Almost all religions are opposed to physician-assisted suicide, saying that life is a gift from God and should be treasured. Two churches seem to support the right to choose to die, the United Church of Christ and the Unitarian Universalist Association (Center, 2013). I happen to share the same views as those two churches. If a patient is terminally ill and wants to make the decision to die or hasten their death, they should have the right to. This is what Mrs. Bennett is trying to accomplish.
Physician-assisted suicide is legal in nine states and the District of Columbia and it is an option given to those in California and Montana (Library, 2019). In Oregon, physician-assisted suicide accounts for around 1 in every 1000 deaths each year, all the patients have met the criteria and more than 85% were enrolled in hospice programs (Quill, 2007). We are not given what state Mrs. Bennett lives in, but with the hesitance of her doctor we can assume that she lives in a state where physician-assisted death is not legal. If her health permits it and she is determined to end her pain, is there anything stopping her from going to a state where it is legal? There are multiple stakeholders in this scenario. Mrs. Bennett, her family, and her insurance company are one side of the stakeholder. The other stakeholders are Mrs. Bennett’s doctor, the colleagues he works with, the hospital they work at, and the insurance company that covers the hospital employees. Another stakeholder could be the pharmaceutical company if Mrs. Bennett does get the choice to end her life with physicians-assisted death.
One option that the physician has is to increase her pain medication. This option has risk because the increased dosage could kill Mrs. Bennett faster, this could lead to the doctor being sued. If someone or Mrs. Bennett’s family sees that her medicine dosage has increased and they look for the safe range, they could see that the dosage is over. They could sue both the doctor and the hospital. Another option is to not give Mrs. Bennett the increased pain medication. This option would cause the patient to be in pain and discomfort. That is not something a doctor would want a patient to go through, especially if they are going through their last stages of cancer. There is an alternative to this option, the physician could find a different way for Mrs. Bennett to lessen the pain. Maybe a heating or a cooling pad could help. Maybe a massage could help relax her muscles. There are multiple different alternative ways to relieve the horrible pain Mrs. Bennett is going through. Another option is if Mrs. Bennett really wants to end her suffering, she could go to a state where physician-assisted death is legal. This option is if she is really tired of the suffering she is going through. She even stated in the scenario in a clear and coherent mind, that she wants to end her suffering even if she has to end her life.
I believe that the best option is for Mrs. Bennett’s doctor to find an alternative way to help relieve her pain. With this option, everyone wins if the alternative method works. As a healthcare provider you want to do what it best for you patient. If finding a different way to treat the patient is what is best for the patient, then it should be what the healthcare provider does. Maybe a different pain medication will work better. There could be a medication out there that has a better pain response with a higher safe maximum dosage. There could be an alternative medicine that could work. Acupuncture, massage, and herbal medicine (among others) could possible work to help Mrs. Bennett’s pain. Exploring all options to try and relieve her suffering should be a priority for this doctor.
If an alternative medicine works, this could benefit everyone involved. Mrs. Bennett is suffering less and able to enjoy her life as much as she can with final stages of colon cancer. Her family can enjoy having her around longer and make her as comfortable as possible. The doctor could possibly get new patients because of how hard they worked to do what they could to help their patient. On the other hand, there are people who do not believe that the alternative medicine works and that could possibly turn patients away. Who knows what the future could hold for Mrs. Bennett? She could live for many more years to come. It is also possible that she dies the very next day. Cancer can be an unpredictable disease and the outcomes vary from patient to patient.
This scenario can either have a happy or sad conclusion. It all depends on what Mrs. Bennett wants to choose to do with her health and how much more pain she can go through. It also depends on the doctor’s ethics. Does he believe that increasing the pain medication is worth the risk of shortening Mrs. Bennett’s life, or does he think that alternative medicine can help the suffering she is going through enough to help her want to possibly live longer. There is always a chance that Mrs. Bennett’s cancer will become more and more aggressive, causing her to be in more pain. There is also a chance that her cancer reacts to whatever treatment she is going through. We do not know the future, but we can help ensure that Mrs. Bennett and her doctor make the most ethical and correct choice for her health.