Question one: Health care may have the main aim of saving life, but considerations have also to be done to the patients themselves. Competent patients have rights that they need to defend. They have a right to be free of pain and refuse medical treatment. A physician therefore is liable to refusal to any of these rights. A competent patient has the right to quality life, right to his values, aspirations and goals, and the right to a meaningful life to him. He/she therefore should make the decision on what is right for him and what he wants to do with his/her life.
They have health care values to be respected. Question two: DNR is a medical order given by a doctor to prevent any interventions on a patient under life saving treatments of cardiac arrest and respiratory arrest. A patient who does not want to undergo any lifesaving treatments and care is also allowed to get a DNR. DNR is issued when someone entitled to make decisions on the patients behalf does so, for example the physician who can decide on his own initiative if he/she finds out that the resuscitation would not help the current condition of the patient.
The family members to the patient can also decide to go for DNR. In most cases the life saving interventions has been done to the patients and it is the condition in which they are that make them decide on DNR. In some cases though, a patient may know of his/her conditions already, knowing very well that he/she will not have the kind of life he/she desired for and decides to have the DNR. DNR is always given on patients already on life saving interventions. Question three: CPR is a procedure meant to help patients in emergency situations of cardiac and respiratory arrest.
It is also used in life saving situations until the patient regains life or dies. This procedure maintains oxygen flow in the patient. In cases of short use of the procedure, the CPR cannot be said to be increasing health costs, but if it takes along time in patients with prolonged cardiac and respiratory arrest then it would be considered to be just like DNR is considered to increase cost. Question four: CPR if used in patients in a dying state cannot help much. It is only a procedure to oxygenate and prevent the brain from dying hence preventing other cells from dying too.
It is therefore meant to prolong life for the patient and does not at all improve the condition of a patient in a dying state. Question five: The code of medical ethics states that a competent patient can give an order of termination of treatment or removal of the life supporting systems when he is still competent so that when he/she is rendered incompetent, the DNR can be conducted. Most physicians are found not to obey this (Keyes 2007, p. 800). This is the reason why the doctors say that a patient is incompetent at the time of pain or when under confusion and would not follow the order.
The order is always given when a patient is competent so there is no reason why doctors should bring out another argument to cancel that, since the patient already knows his/her condition. This issue of doctors disobeying patients led to the American Medical Association offering competent patients quality services that discussed on matters of how they could be allowed death with dignity, which involved discussing with the patients how they should be taken care of in their ending life and how to manage pain and other problems.
It does not matter how complex the intervention is, be it dialysis or mechanical respiration, how simple the intervention is, be it antibiotic therapy or hydration, and it does not matter if the situation involves imminent or distant dying. The competent patient’s needs and preferences have to be followed with regard to withholding or withdrawing the intervention in accordance with the law and the established ethical rights.