Life-sustaining treatment may include, but is not limited to,
mechanical ventilation, renal dialysis, chemotherapy, antibiotics, and
artificial nutrition and hydration (AMA 2020). There are different
ways in which life support can be viewed. Patients on a form of life
support are given more time to live and recover, and in some cases
these patients pull through and make a full recovery. On the other
hand, life support can be looked at as prolonging the dying process,
especially for patients with low or no chances of recovery. While
people who are in support of life support say that it is morally wrong
to let someone die, those against it argue that it is morally wrong to
keep someone alive without their consent, possibly prolonging their
suffering (ACLS 2020).
There are many other factors to consider, which can add
complication to the situation. One complication: if the patient is
incompetent to make the decision, they should have an advanced
directive that states what they want their wishes to be and a decision
maker who is designated as a proxy, many patients do not have this,
therefore family is left to make the decision on what to do. Many
families do not want this type of responsibility, or do not know what
to do; some family members can have opposing views, which causes
a dispute; and some family may not have the best interest of the
patient in mind, especially if they know money is involved.
To complicate things more, sometimes the patient does not have any
family or close friends to make these decisions for them, which is
something I have seen first-hand at our hospital. This makes things
very difficult for not only the physicians and nursing staff, but also on
the patient who is unable to make any decisions. In the instance
there is a proxy, family, or close friend to make this difficult decision,
they have to think about many different factors such as the patient’s
values about life and the way it should be lived; and the patient’s
attitudes towards sickness, suffering, medical procedures, and death.
If the patient has no one at all to make decisions of their best
interest on their behalf, the institution may have to take this for
judicial review and file for guardianship (AMA 2013).
There is no right or wrong answer when it comes to sustaining life
with the use of medical technology, withholding or withdrawing a
life-sustaining treatment is a challenge for health care providers,
patients, and their family/friends, which makes it a controversial
subject.
References
ACLS.(2020). Life Support: Information and Ethics. Retrieved
from https://www.acls.net/information-and-ethics
AMA. (2013). AMA Code of Medical Ethics’ Opinions on Care at the End
of Life. Retrieved from
https://journalofethics.ama-assn.org/article/ama-code-medical-
ethics-opinions-care-end-life/2013-12
