Ethical Issue Presentation in the Elderly Do Not Resuscitate/Do Not Intubate Essay

The persistent use of the DNR/DNI order proves to be very perplexing to health care staffs. Even though ethics committees could help in explanation, and the use of developed orders could further identify the patients’ wishes, patient as well as family education is still crucial to determine what the patient actually desires. As technology progresses, nurses would carry on to be showered with ethical concerns regarding the DNR/DNI orders. This paper aims to tackle how nurses could be practical in getting answers to the difficult question and find out how to deal with the issues concerning the DNR/DNI orders (Belcastro). What exactly is DNR/DNI? Nurses often get a chance to face such an order. To begin the paper a detailed explanation of what DNR/DNI is needed. Do Not Resuscitate/Do Not Intubate is a written order which came from a doctor. Do Not Resuscitate orders entail that if a patient experiences a cardiac arrest, he should not be given a CPR or electric shock treatment. Do Not Intubate on the other hand is an order which states that no breathing tube should be placed on the patient when he experiences a breathing difficulty or respiratory seizure. Although DNR and DNI orders often go hand in hand, the presence of one does not necessarily entail the presence of the other, meaning to say that they could be given separately (a doctor could give DNR order and not give DNI order in the process). The presence of DNR/DNI order does not necessitate that the hospital staff would stop all treatments for the patient. Medical as well as nursing care would still be given up to the point when the patient experiences a cardiac or respiratory seizure (Belcastro). The nurses and the doctors always discuss the possibility of ordering a DNR or DNI to the patient’s relatives. Although it is hard to accept, one should try to get used to the idea or at least be open to the possibility that your loved one is in a situation which could not be reverse and that to continue the patient’s treatment would only produce further discomfort for the patient which would only delay the dying process. It is understandable that people shrink from the possibility of death however, whether humans want it or not, death is the ultimate conclusion of every human life. Prior to the discussion of the DNR/DNI order the patient’s relatives ought to cautiously consider everything the physician and the nurses would tell you. The ultimate decision to issue a DNR/DNI order would be decided by the patient’s relatives. The decision regarding the issuance of DNR/DNI order is reversible depending to what necessity requires. Before deciding whether the DNR/DNI order would be issue, the patient’s relatives usually ask nurses if there is a possible chance the patient would recover. Nurses, having faced the situation a number of times would be liable to give you honest opinion. In deciding DNR/DNI the quality of life over the quantity of it should be considered. One should take into consideration the pleasantness available for the patient should he chance a survival. Would his survival be solely dependent on the machine sticking on every part of his body, would he be forever mentally incapacitated? These are only some of the questions a relative should take into consideration especially since the abovementioned scenario is liable to produce only pain and discomfort for patient and relative alike. One should weigh if living would really be best for the patient or if dying a quiet and painless death is much preferable. Financial burden should also be taken into consideration. One should analyze if the patient would really be happy for the financial burden forced upon his family when the overall result of the treatment is not really good (Eckberg). One should also accept the fact that unless one has a power of attorney, the patient is still the one to choose if he would like to have a DNR/DNI order (unless of course if problem such as the patient being mentally incapacitated arises). Numerous standards direct the decision-making process of the DNR/DNI orders. Beneficence and autonomy often comes into consideration. Beneficence is the tenet that orders one to do right to other people and stop from doing harm. Autonomy, on the other hand could supersede beneficence when a choice is needed to supply or remove life support. Under situations in which it could be rationalized to try CPR on the patient under cardiac or respiratory arrest, and the patient made a choice concerning life-sustaining procedures, autonomy must reign. The basic notion of futility is also categorized as the directing belief behind the DNR/DNI order. A treatment could be categorized as futile if it could not benefit the patient or if it could not end a reliance on intensive medical care. If the physician make use of the principle of futility to decide if a DNR/DNI order is to be retained, the physician should ascertain that he have thoroughly consulted the patient or the patient’s relatives. (Belcastro; Eckberg) Freedom on the other hand includes the belief of human life and dignity, and in a way it also takes into consideration the principle of autonomy. Freedom gives consent to the patient to make his own decision based on his personal beliefs. This freedom ought to be given to the adept patient and his decision must be upheld even if it is contrary to the wishes of his relatives. Ethic committees also play a role in DNR/DNI orders. Ethic committees are available for discussion about life support necessities. They deal with discussion and education, advanced procedures and principles. Through these committees, concerns taking place in the society are brought about for debate. Case studies are made accessible to determine whether a certain state of affairs was managed in the most efficient way. If a problem arises the said committee is ready to make rational and well-supported plans which avoid the existence of rushed decision (Eckberg). To conclude, DNR/DNI orders does not necessarily entail that one would allow murder of the patient. Rather, considerations which are mostly centered on the patient’s welfare were taken into account before issuing such an order. In cases of difficulty the ethical committees could help in solving the problem. Factors such as beneficence, autonomy, futility, and freedom must be taken into consideration before issuing the DNR/DNI order.