Question

Read the case and answer the below question. Note All the question are related to the case i cannot separate them

Mrs. Doe is a 33 year old paramedic who has discussed end-of-life 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 ½ 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?

I          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?

Answer 1

1. Ethics is the set of principles that guides us between right and wrong . In this case, Mrs .Doe is pregnant and she had pulmonary embolism and collapsed . She is brain dead but the baby is viable .Its not ethical if we do cesarean for completing her wish of do not resuscitate because it was cause death of the baby due to immature growth and development. We should not take the life of an individual to complete another persons wishes. Why the innocent baby has to pay for her mothers wishes . I accept the order of the state law about null a DNR order if a woman is pregnant because there is a legal duty to keep her alive while the fetus is viable.

2. Yes,I believe that i have a duty to care because we work on the basis of the ethical principles and we should consider it as a serious issue were it becomes difficult to decide whether to follow the advance directive or work ethically .No, we are not potentially breaching our duty . Yes there would have been potential injury to the baby if her wish of DNR was followed because it would have let to the death of the baby. No my actions would not be considered negligent because i am trying to save the life of both mother and baby .