Assignment

A patient is in a coma that appears irreversible. His mother, who is his surrogate, firmly believes that he will recover and that God is taking a hand to work a miracle if everyone will just wait long enough. She wants everything done for the patient, including resuscitation if he arrests. She insists that he stay in the hospital, and is very upset that he was transferred out of the ICU and his care was moved to comfort measures, rather than aggressive treatment. The mother does not speak English and is strong in her religious beliefs. The physicians for the patient are very upset and concerned about continuing to provide care that they believe is futile. The patient is developing serious pneumonia, and the mother wants it treated aggressively. The physicians are reluctant. Analyze this case from the ethical principles of justice, benevolence, non-malfeasance, and autonomy.

In this time of limited financial resources and reduced government payments for health care services, what are the ethical issues of limiting care? How much-uncompensated care can hospitals absorb? Where do people with no resources go for care? What is the state's responsibility to ensure health care services? What are the ethical considerations that should be taken into account?

Scenario: A 96-year-old male patient is admitted to the ICU with terminal liver cancer. He is confused and disoriented, very skinny and appears underfed, and is covered with bruises, which are common in patients with liver disorders. His daughter, who is a naturopathic physician, insists that she can cure her father by administering unknown substances, some of which smell like feces and look like tar, down his NG tube. He is clearly in pain after she does this. She insists that these are life-saving interventions on her part, but the nursing and physician staff caring for the patient are very upset and concerned that she is hastening his death. They have come to you for help.