Default Options Advance Directives Influence
Question:
Discuss About The Default Options Advance Directives Influence.
Answer:
Introduction:
Euthanasia is undoubtedly a significant conflict in the health care scenario, the debate between direct or indirect death has been going on for past few years in the health care industry (Halpern et al., 2013). It is the topic of our debate as well. My fellow speakers for the affirmative team have discussed the outcome consideration and the connection with patient autonomy and dignity. However, in my set, I will try to reaffirm my team line with focusing on the advanced care perspective. I would like to discuss in my time that when advanced care is considered in the context of care planning and delivery, the concept of euthanasia and withdrawing medical treatment are mire similar than different.
Supporting evidences:
Advanced care directive can be considered a key innovative element of the health acre industry which taken the concept of autonomy a few notches higher in the idea of patient centered care. As mentioned by Lyon et al. (2014), advanced care directive can be defined as the living will of patient; this is a legal document that allows a critically ill individual to specify the course of actions to be taken for their health in case they are no longer capable of decision making due to the severity of illness. Considering the Australian demographics, the popular format for advanced care directives in here is the power of attorney. Two particular legislative acts define and guide the use of advanced care directives in Australia, Powers of attorney act of 1988 and Guardianship and administration act of 2000 (White et al., 2014). Elaborating more, a patient can consciously make the doctor or any other health care professional or any family member the future decision maker in case the patient is critically ill and is not able to take the decision for themselves. Hence, according to the advanced care directives, a physician, when given the responsibility by a conscious patient can engage in physician assisted suicide or euthanasia. On a more elaborative note, the physicians can opt for lethal means for direct or assisted suicide if the patient provides conscious consent to the process or expresses direct wishes for the same. Hence, under this directive, as the condition of the patient worsens, with the advanced care directive giving the doctor the opportunity to decide as per the wishes of the patient, can decide to opt for direct physician assisted suicide or euthanasia.
Rebuttal:
As mentioned by the opposing team member before, if a doctor came in and turned off the ventilator it is considered an act of killing. However, I would like to point out a few overlapping errors in this argument. First and foremost, I would like to state, withdrawal of medical treatment is only considered ethical because the patient gives consent to the process to rightfully refuse life sustaining medication in order to receive a peaceful and dignified death. Under the advanced care directives, if the patient provides the physician with the liberty to make decisions for the patient for direct death, it is no different than the patient’s own consent to death (Menzel & Steinbock, 2013). Hence, I would like to emphasize that it is not the physician’s intent to kill if the patient has given directions to follow through with euthanasia in a state where the medical treatment has no hopes of defying inevitable death.
Critical thinking and reaffirming the team line:
Hence, it can be stated that that under advanced care directives a patient can choose euthanasia and provide the liberty to the physician with the liberty to choose this alternative when there is no other hope left for the patient (Kouwenhoven et al., 2013). Hence, when the physician is only respecting the dignified choice of the patient, it is no different from withdrawal of medical treatment. The opposing team may counter on the pain felt by the patient in euthanasia might be the basis if the ethical difference among both of the phenomenon. However, as my team has already mentioned before, the outcome of the euthanasia and withdrawal of the medical treatment is similar and as there is no sensation of pain felt by a critically ill patient in life support or ventilator, the moral grounds of painful death does not apply to the scientific reasoning and logic of the scenario (Gastmans, 2013). Hence, I would like to reiterate that there is no fundamental difference between the euthanasia and withdrawal of medical treatment when advanced care directives are considered.
References:
Gastmans, C. (2013). Dignity-enhancing care for persons with dementia and its application to advance euthanasia directives. In Justice, Luck & Responsibility in Health Care (pp. 145-165). Springer, Dordrecht.
Halpern, S. D., Loewenstein, G., Volpp, K. G., Cooney, E., Vranas, K., Quill, C. M., … & Arnold, R. (2013). Default options in advance directives influence how patients set goals for end-of-life care. Health Affairs, 32(2), 408-417.
Kouwenhoven, P. S., Raijmakers, N. J., van Delden, J. J., Rietjens, J. A., Schermer, M. H., van Thiel, G. J., … & Weyers, H. (2013). Opinions of health care professionals and the public after eight years of euthanasia legislation in the Netherlands: a mixed methods approach. Palliative medicine, 27(3), 273-280.
Lyon, M. E., Jacobs, S., Briggs, L., Cheng, Y. I., & Wang, J. (2014). A longitudinal, randomized, controlled trial of advance care planning for teens with cancer: anxiety, depression, quality of life, advance directives, spirituality. Journal of adolescent health, 54(6), 710-717.
Menzel, P. T., & Steinbock, B. (2013). Advance Directives, Dementia, and Physician?Assisted Death. The Journal of Law, Medicine & Ethics, 41(2), 484-500.
White, B., Tilse, C., Wilson, J., Rosenman, L., Strub, T., Feeney, R., & Silvester, W. (2014). Prevalence and predictors of advance directives in Australia. Internal medicine journal, 44(10), 975-980.
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