homework


Bioethics

1200words on the following topic

please please have self thinking 

and DON’T rehearse the case 

CASE: 

A Dispute Over Death: Mr. N, a 44-year-old man with a large extended family, is admitted to an ICU  with  raised  intracranial  pressure  from  an  untreatable  cerebral  malignancy  (a  brain  tumor).  Despite various measures, he has continued to decline and is now on a ventilator.  It is obvious to the  ICU  staff  that  the  patient’s  brain  is  too  compressed  to  respond  to  any  treatment.    On  no sedatives,  he  has  been  in  a  deep  coma  for  several  days,  completely  unresponsive  to  any  stimulation.  His score on the Glasgow Coma Scale (GSC), poor from the outset, has been declining for  several  days.    It  is  now  3—as  low  as  you  can  get—and  there  is  complete  absence  of  any  brainstem reflect activity on two assessments.  

Mr. N is in every neurological sense dead, “brain dead,” as that term is used.  As is usual practice, confirmatory  clinical  testing  by  way  of  an  apnea  test  is  arranged.    This  entails  temporarily   removing the patient’s attachment to the ventilator.  In response to raising carbon dioxide levels in the body, a brain-dead patient will fail to initiate respiration as would normally occur.  The lack of cortical responsiveness, the absence of brainstem reflexes, the lack of movements or breathing, a  flat  electroencephalogram,  are  all  consistent  with  death,  whatever  the  state  of  the  patient’s circulation might be.  

Mr. N’s loved ones strongly disagree with the diagnosis of death—they are a religious family and feel everything possible must be done to extend his life, arguing: “If God wanted him to die, He wouldn’t have allowed mankind to invent ventilators.  He’s not dead until his heart stops beating.”  

As the ICU resident and attending neurologist are about the perform the test on Mr. N, a family member exclaims, “Don’t touch him!  If you remove him from the breathing machine, we’ll sue you!”  According to the family’s (and the patient’s) religious, where there is a heartbeat, there is life,  and  one  may  not  disconnect  a  breathing  apparatus.  [This  case  is  taken  from  Hébert  and  Rosen, p. 333.]  

How should the doctors and hospital  handle this case?  Should they accommodate the family’s religious beliefs?  Should they insist that the test be performed, since it is important that hospital resources not be used on someone who is already dead?  Explain the considerations on both sides of the question and explain your own perspective.  In your discussion, draw substantially on the three following readings: 

1. https://link.springer.com/article/10.1007/s11673-015-9683-z

2 and 3 are in the pdf.

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