Question

please read the case in the top part and answer the question below

Mrs. Doe is a 33 year old paramedic who has discussed end-of-lite decisions including the importance of Do Not Resuscitate orders with her husband. Mrs. Doe (having lost her brother years earlier) expressed to her husband that she never wanted to be kept alive by machines. She also expressed a desire to sign a DNR order but had not done so yet. Eighteen weeks (4 % months) into her second pregnancy, Mrs. Doe collapsed on the living room floor. Mr. Doe performed CPR and called 911. She was put on life support after suffering a suspected pulmonary embolism but never regained consciousness and was considered brain dead. Knowing his wife's wishes, Mr. Doe makes the decision that she would NOT want to be kept alive since her quality of life would never be what it was and wants her removed from life support and be allowed to die with dignity However, the fetus is still viable with a normal heart beat. If delivered now, the fetus would not be viable, however, if the mother was kept "alive" and the fetus had time to develop to 24-28 weeks; the fetus could survive and be delivered by cesarean. To complicate matters, Mrs. Doe lives in Texas where state law nulls a DNR order if a woman is pregnant because there is a legal duty to keep her alive while the fetus is viable. Do you as the attending physician honor the patient's wishes and remove life support knowing that the patient AND the unborn child will die or do you follow state law and keep the mother on life support for the sake of the developing fetus? Assignment: WOULD WOULD NOT remove the patient from life support. Circle one) Please consider and write a response to the ethical and legal considerations of the case. You do not need to necessarily answer each question individually. They are there to guide your response. 1) Ethical considerations: What morals and values are you basing your decision on? What is the effect of this action? Will it set precedence for others? Where is the ethical line drawn when it relates to a medical issue in letting a family member make a decision in such a short time period and under dire circumstances? Should a sense of right or wrong outweigh the rights of a person to determine her own medical care; even if that means consequences for an unborn child? 2) Legal Considerations: Please answer the questions based on your decision 1. Do you believe you have a duty to care? What do you believe is a reasonable standard of care? 2. Are you potentially breaching your duty? 3. Was there potential injuries? 4. Is there a direct cause to your actions and could you foresee that happening? 5. Can your actions be considered negligent? Write your response beginning on the second page

Answer 1

As an attending physician, we have to respect and honor the patient wishes, then also we have to save the life of human beings. Here the patient does not wish for DNR, then also she is 4.5 months pregnant and she has undergone the brain death then also her fetus is still alive in her abdomen with the normal heartbeat but is not at the period viable outside the womb if undergone cesarean section. As state law and humanity we have to follow the state law and keep the mother on life support for maintaining the viability of the developing fetus.

1) Ethical considerations:

As an attending physician, we have to respect the patient wishes. But here if we are following the wishes and giving the respect and dignity of the patient we can't safeguard the baby in the uterus If does not resuscitate, result in the death of the patient as well as the baby in the uterus. Here before taking the decision, we have to confirm the decision with her husband also and as well as we have to confirm with the gynecologist that if we going with life support of the patient with the medical equipment and the continuing the pregnancy with life what are ahead complications to the baby and what are the consequences of an unborn child. If the benefits outweigh the risk we can continue the pregnancy until 28 weeks of gestation if her husband wishes.

2) Legal considerations:

1. As our duty is to give standard care to the maximum level to improve the quality. If we maintaining the standard thus can deliver high-quality care.

2) If we are continuing the pregnancy of the women with life-saving support with the husband permission we are not at all breaching our duty according to the state law.

3) Surely this may some times results in injury to the women may or may not according to the following standard care given.

4) If the gynecologist confirmed she can continue her pregnancy until 28 weeks without any complications to the baby with life-saving support to the mother we can continue our care.

5) If state law supports the action could not be considered negligent.