An understanding of the principles that underlie biomedical ethics is important in addressing the issues that confront health care practitioners and their patients at the end of life. The ethical principles include autonomy (the patient’s right to self-determination), beneficence (acting in the patient’s best interest), non maleficence (do no harm), justice (determine what is fair and just), and fidelity (truthfulness and faithfulness).
Discussion Questions
1. Assume you are an emergency medical technician (EMT) responding to a 911 call at a grocery store. An elderly shopper has collapsed, and she is unconscious on the floor when you arrive. Her vital signs are weak. The woman is placed in the ambulance, where she arrests. You notice that the woman is wearing a bracelet that says “DNR,” and a quick check of her purse reveals a signed and witnessed DNR order. What do you do?
2. An 80-year-old woman has suffered a massive heart attack and is on a ventilator in the hospital’s ICU. She apparently has no advance directive. Her three daughters arrive from different areas of the United States and express their opinions about their mother’s medical care. One daughter says her mother would “not want to be kept alive” in her present state, while a second, more aggressive daughter demands that “everything” be done to keep her mother alive. The third daughter expresses no opinion. In your opinion, what should be done?