Life-sustaining technologies are complex and raises ethical concerns in healthcare.
Life support technology is one of these instances that may cause concern. The American
Medical Association (AMA) Code of Medical Ethics sets basic guidelines for how
providers can conduct research on life-sustaining technologies to support advancement in
medicine while protecting their relationships with their patients/families and improving
outcomes (Harbut, 2019).
Life Support replaces a failing physical function and is used for patients with
treatable conditions, temporarily until the illness can be stabilized and the body can
continue normal functioning (Cleveland Clinic, 2016). The issue mainly arises when the
body never recuperates enough to function without life support (Cleveland Clinic, 2016).
The decision about life support can be personal and complex, as it can be beneficial to
restore function and enhance life but can also be considered to cause discomfort and
prolong the dying process (Cleveland Clinic, 2016).
There are mainly two issues: not starting treatment and stopping treatment
(Cleveland Clinic, 2016). As an example, let’s say that a patient’s family wants the patient
placed on life support in the ICU, but the patient is 90 years old, has complex medical
issues and according to the doctor’s, has a very limited chance of recovery. The doctor’s
do not feel life support would be appropriate, but the family has requested this and there
are no advance directives in place. This can be an ethical problem because there is very
limited chance of recovery, if not at all. “Although mechanical ventilation may prolong
life, it would not correct the underlying illness” (Crippen & Hawryluck, 2004).
The thought with some, especially families who do not want to “give up” is that if
the patient is “alive” (on life support), there is still hope – and perhaps a miracle can
happen, whereas if they are dead, there is no hope (Crippen & Hawryluck, 2004). Legally,
life support can be given regardless of prognosis and until the law changes to allow
providers to make this decision based on medical knowledge (and superseded the family’s
decision) it will remain as is (Crippen & Hawryluck, 2004).
Another dilemma with life support is cultural and religious beliefs. In some
cultures, all possible efforts should be made to preserve life, therefore, life support is
used. It is difficult for the provider to continue to respect the patient and families
decisions while also providing medically backed information about the lack of possible
recovery (Crippen & Hawryluck, 2004).
Quality of life must come into play and that is part of the ethical concerns with life
support. If the families demand life support without regard for quality of life, then the
providers are put in a difficult position. Additionally, stopping life support is also very
difficult for families, as mentioned above, “hope” is lost. This ethical dilemma is one that
providers have struggled with and continue to struggle with – the obligation to “do no
harm” is not very clear in this case.
References:
Crippen, David & Hawryluck, Laura. (2004, February 9). Pro/con Clinical Debate: Life
support should have a special status among therapies, and patients or their families
should have a right to insist on this treatment even if it will not improve
outcome.National Library of Medicine.Retrieved
fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC522828/
Harbut, Rachel, F. (2019, May). AMA Code of Medical Ethics’ Opinions Related to Ethics
of Life-Sustaining Technologies.AMA Journal of Ethics.Retrieved
fromhttps://journalofethics.ama-assn.org/article/ama-code-medical-ethics-
opinions-related-ethics-life-sustaining-technologies/2019-05
Life Support Measures. (2016, November 30).Cleveland Clinic.Retrieved
fromhttps://my.clevelandclinic.org/health/treatments/12362-life-support-measures
