Research Paper on Medical Futility: An Ethical Dilemma Everyone Faces

Introduction

Medical futility is one of the many types of an ethical dilemma. The ethical dilemma involves a situation where an individual is expected to choose between two difficult choices. For example, issues to end life, to enclose a patient's information that was confidential and in some cases, issues to do with disease transmission.

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Anyone is prone to experiencing these ethical issues. For instance; an employee can face a hard time when she has an intimate issue with her boss, and at the same time, the person she is to report to is unethical. In this report, one of the ethical issues experienced in hospital, i.e., medical futility, its relevance to health professionals, various principles, laws, theories, and practice of standards will be our focus.

Medical futility is the provision of ineffective and unneeded care to a patient to result in a prolong suffering or reduce the quality of life or leads to death (Rostami & Jafari, 2016). It is often one of the sensitive issues addressed in healthcare. Also, a complicating topic because it requires decision-making and giving up life. For example, there is a case of a man lying on a bed in an Intensive Care Unit (ICU) and is said to be suffering from throat cancer.

The family members are advised by the doctor to take their patient home since there is less they can do to save his life. He is on his last phase of the disease, which is incurable. Due to the love they have for their brother, they refute the offer and request the physician in charge to do all he can to save their brother. The medical professional faces a difficult situation where he has to keep on administering drugs on their patient with the knowledge that nothing positive will come out of it.

Additionally, the physician is aware that when he performs the ineffective treatment to the patient, he might trigger pain, and the patient might experience discomfort. In such a case, a physician should uphold his professional standards and inform the family of the effects they are exposing their patients in.

The above case is an excellent example of pointless medical care that most physicians go through in their career life. Therefore, a futile treatment is one in which the goal of the patient is not met, 99% of the procedure is not sufficient, and it fails to comply with the standards set by the community.

According to the community, treatments that hold no value to the patient should not be performed. Qualitative and quantitative futilities are the two groups in which medical futility is grouped into. Quantitative is when the likelihood that a patient will benefit from a particular medical intervention is very minimal and qualitative focuses on the beneficial quality of that treatment to a patient.

As much as the role of nurses is to take care of the sick, advanced technology is too demanding that they have to concentrate on it more than on the patient. (Pishgooie et al., 2008) Every technology comes with various challenges that nurses should deal with. In some cases, they are forced to making wrong decisions due to the pressure they are getting from the family of the patient.

This technology has enabled the experts in the medical field to be able to extend the life of a patient even if the assurance for survival is zero. For instance, intensive care units have been one of the technologies in great demand. This demand has been even exceeding the facilities available in most healthcare's. Thus, creating a great problem to the medical experts whether to end some lives to create space for the incoming patients or not. (Pishgooie et al., 2008)

However, several people believe that futile treatments should not be made possible for patients. The process of identifying which treatments are futile and which are not has become a big challenge to both the medical professionals and the family members due to their varying perceptions. (Burkhardt & Nathaniel, 2013) These disagreements made it hard for medical professionals to come up with the right decision for the patient.

Besides, other cases like the one given earlier of a man in the ICU who has no hope of getting better even if medical treatment is delivered on him, but the members of the family insist the medical expert to continue giving him treatment is an ethical issue. In this case, the question of who determines the futility of treatment between the family and the healthcare expert becomes an issue. (Burkhardt & Nathaniel, 2013) By the above examples, we are made to rule out that medical futility as an ethical issue since it involves tough decision making.

The Relevance of Medical Futility to Health Professionals

Nurses must make this ethical decision to relieve the patient from experiencing more unnecessary pain and discomfort. By making this decision, nurses will also be preventing the family from unnecessary high medical bills. Nurses should, however, find a proper way of communicating the issue with the family members and not just showing them how pointless it is to continue treating their patient.

Additionally, nurses should make sure they have substantial evidence of why the medication is futile and consult first with the experts before relaying the information to the family members. The family might be having a wrong notion of the technology where they may be having hopes of the recovery of their patient once technology advances. However, the nurse must provide information regarding technology they are using and prove to the members that technology can do less to cure their patient.

The nurses should also educate the family on matters regarding the status of the patient regularly and try to convince them to consider withdrawal life option since it will do the patient better than harm. The nurse should keep on engaging the family for them to view the situation from her point of view. It is indeed not an easy task for the nurses since they have to change a person's belief and ethics.

Principles

There are various principles that nurses are required to hold when faced with an ethical situation during their career life. These principles include beneficence, accountability, justice, no maleficence, honesty, autonomy, and fidelity. Beneficence is when a nurse is required to perform things that matter to the patient like been kind to them. (Pishgooie et al., 2008) Accountability principle requires the nurse to be responsible for their deeds and to accept any outcome that may be brought about by their actions.

Justice, or in other words, fairness is essential in all healthcare providers. Every patient should be treated equally regardless of their ethnicity or financial status. No maleficence is yet another principle that requires nurses to adhere to. No nurse is allowed to do any harm to a patient even if it is not intentional. Thus they are to be extra keen when handling patients. (Pishgooie et al., 2008)

Principle of honesty requires nurses to be as open as possible to the patients and not to hold some information in avoidance of hurting their feelings. Autonomy is a principle that gives patients the right to share their beliefs, opinions, and give their views regarding their state. Nurses should avoid making decisions without consulting the patient or the family. Last but not least, there is a principle on fidelity. (Pishgooie et al., 2008) The nurse is expected to comply with various promises they make to the patients.

Theory in Medical Futility

Medical professionals suggest futile care theory to the family of the patient in a critical condition which they believe not even treatment can improve it. This theory is mostly misunderstood by most people where they end up refuting to it. However, futility is a well-thought judgment that prevents patients from undergoing unnecessary pain and unnecessary discomfort that is bound to bore no fruits at the end. (Pishgooie et al., 2008) This action is also beneficial to the family members since it prevents the medical bill from going too high.

Laws Concerning Medical Futility

In cases where the medical experts and the family members of the patient disagree in withdrawal options, they can decide to take that matter to court to resolve their disputes. The court, however, finds it difficult to resolve conflicts where life is involved but chooses to follow the ethics of healthcare providers to rule the case. The court, according to the Directive Act of Texas, permits the healthcare professionals to withdraw treatment for a patient who does show any improvement. (Truog, 2007)

The code of ethics of the America Medical Association also grant permission to the medical professionals to minimize treatment is it is futile. For example, when a patient is in the final phase of cancer, and there is no hope of that patient surviving even after performing all kind of treatment, the clinicians can explain the case to the family members and decide to render treatment as futile. (Truog, 2007)

Standards of Practice

There are various rules and roles found in the American Nurses Association that guide nurses in the course of their duty. They include dos and don'ts that all nurses are expected to adhere to. Firstly, all nurses are expected to perform an assessment for all patients and gather all comprehensive information. They should then analyze the data collected to be able to identify the right diagnosis for that patient. Identification of the diagnosis should then aid them to predict the outcomes. (Truog, 2007) With the expectation of the outcome, nurses can then plan on how they can intervene to meet the results.

There are various ways in which nurses can implement plans to meet the desired outcome. They include: teaching and promoting health, taking good care of the patients, consulting with the experts above them to ensure they offer the correct prescription to the patient and also ensure they provide proper treatment to the patient. (Truog, 2007) Another standard is that nurses are to perform an evaluation time to time to determine the progress of treatment.

Personal Professional Response

As a professional nurse, when an issue that demands withdrawal arises or when a patient request withdrawal of treatment due to his deteriorating body, decisions should not be made without consulting the medical expert. As a nurse, issues regarding end of life should be handled carefully, taking into account the beliefs and attitudes of the family involved. Trying to communicate with the family about the condition of the patient and their expected action is also viral. (Rostami & Jafari, 2016) However, this communication should be moderated to ensure they don't provoke the family.

The nurse should give a clear picture of the patient's situation and the effectiveness of continued medication to the family to help them come up with the decision which should be taken upon their patient. The nurse should also be very professional by avoiding their values, believes, and ethics control them in making the patient's decision. (Rostami & Jafari, 2016) As a nurse, showing compassion to the family is very important and therefore, the manner one conveys the report of their patient should be well moderated.

Conclusion

In conclusion, the above report demonstrates how medical futility falls under ethical dilemma due to the tough decision healthcare professional have to solve regarding a matter of life and death. Deciding whether treatment is futile or not is not an easy thing but requires a very sober mind.

Nurses are obliged to provide all information to the family member and communicate to them often. Nurses should comply with all principles, laws, and their standard of practice with no failure to ensure effectiveness in their line of duty. Family members of the patient should be consulted at all times before a judgment is made.