1 Determination of Death / Informed Consent 1. Uniform Determination of Death Act (UDDA): o
How this law was created – the UDDA was drafted by The President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and approved in 1981 by the American Medical Association (AMA), American Bar Association (ABA) and the National Conference of Commissioners on Uniform State Laws.
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Legal definition of death, describe The UDDA legally defines death based on two criteria. The irreversible cessation of circulatory and respiratory functions and the irreversible cessation of all functions of the entire brain and the brain stem. In both instances, death should be determined based on medical standards. The first definition of death is often followed by brain death whereas in the second definition, a person can be placed on life support and kept ‘alive’, even without any brain activity.
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2 Define dying within the context of faith, the basic principle about human life Beliefs on death and dying are approached differently based on one’s religion or faith. For most, dying can be defined as the transition to the spiritual realm. For example, Christians believe in life after death. Dying is seen as the transition whereby souls exit the physical body and goes either to heaven or hell depending on their deeds. 2. Bioethical Analysis of Pain Management - Pain Relief Adequate pain management is a patient right that should not be overlooked in care. Ethical decision-making regarding pain management is influenced by a lot of factors including its benefit to the patient, weighed against the risk of dependence or addiction. In all instances, patients have the right to be informed of the pain management strategies used and its effects. The ethical principle of autonomy gives patient the capacity to make decisions concerning their care, including the use or refusal of pain treatment. Care providers should strive to reduce harm caused and also to protect the vulnerable according to the principles of non-maleficence and justice (Carvalho, Martins Pereira, Jácomo, Magalhães, Araújo, Hernández-Marrero, Costa Gomes & Schatman, 2018). 3. What is the difference between pain and suffering? Explain Pain is a physical sensation that occurs as a result of our body's response to an injury, illness or tissue damage. The pain sensation can be described as emotional and unpleasant, often following nerve stimulation and requiring consciousness. On the other hand, suffering is a state of being in pain, distress or hardship. It is described as an experience rather than a sensation that occurs when one is in a bad or discomforting situation. 4. Diagnosis / Prognosis: define both.
3 Diagnosis is the identification of an illness/disease based on test findings and clinical examination. Prognosis is the prediction of disease outcomes with treatment and care, and how the condition will affect the patient. 5. Ordinary / Extraordinary means of life support. Explain the bioethical analysis. Ordinary means of life support offers hope of success and benefit to the patient, and is considered as a basic right to treatment. It is morally and ethically acceptable to provide ordinary treatment to support life. Extraordinary means has no reasonable hope of success or benefit to the patient. There is no obligation to providing extraordinary life support. Extraordinary life support raises several ethical dilemmas relating to end of life care, including the need to withhold treatment or not. 6. Killing or allowing to die? Define both and explain which one is ethically correct and why? Killing is the initiation of events that eventually leads to someone’s death. Allowing to die is letting someone die by not taking action against or intervening events that leads to death. None of the two are ethically correct as they both lead to someone’s death (Alanazi & Alanzi, 2015). 7. Catholic declaration on life and death; give a summary of this document: https://ecatholicsites.s3.amazonaws.com/17766/documents/2018/11/CDLD.pdf (Links to an external site.) 8. What is free and informed consent from the Catholic perspective? Free and informed consent in the catholic perspective refers to the process that a patient is educated on a procedure or intervention to be used in their care, providing details on the nature of the procedure, its risk and benefits and possible alternatives, then left to make a voluntary decision whether to undergo the procedure or the intervention based on their moral beliefs. The patient should be free to decide and decline if it does not align with their spiritual beliefs. 9. Define Proxi, Surrogate
4 Proxy or surrogate are advocates for incompetent patients in healthcare and are charged with the responsibility of making decisions on their behalf concerning their care and treatment options (Bute, Petronio & Torke, 2015). 10. Explain: o
Advance Directives – this is a legal document by a patient that provides details or directives on actions that should be taken concerning their health and treatment when they are not in a position to make decisions on their own.
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Living Will – This is an advanced directive that specifies a person's wish on their end of life care in situations that they cannot make the decision due to their illness.
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PoA / Durable PoA – This refers to an authorization that allows one to act on another’s behalf in different matters. In healthcare, it allows one to act as a decision maker, thus acting as a proxy surrogate (Bute, Petronio & Torke, 2015).
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DNR – this is a legal order provided by a patient instructing against cardiopulmonary resuscitations in case the patient stops breathing or the heart stops beating.
5 References Alanazi, M., & Alanzi, M. (2015). Is there a moral difference between killing and letting die in healthcare?. International Journal of Research in Medical Sciences, 3(1), 1-10. Bute, J. J., Petronio, S., & Torke, A. M. (2015). Surrogate decision makers and proxy ownership: challenges of privacy management in health care decision making. Health communication, 30(8), 799–809. https://doi.org/10.1080/10410236.2014.900528 Carvalho, A. S., Martins Pereira, S., Jácomo, A., Magalhães, S., Araújo, J., Hernández-Marrero, P., Costa Gomes, C., & Schatman, M. E. (2018). Ethical decision making in pain management: a conceptual framework. Journal of Pain Research, 11, 967–976. https://doi.org/10.2147/JPR.S162926 Nikas, N. T., Bordlee, D. C., & Moreira, M. (2016). Determination of Death and the Dead Donor Rule: A Survey of the Current Law on Brain Death. The Journal of medicine and philosophy, 41(3), 237–256. https://doi.org/10.1093/jmp/jhw002