Teenage girl Tonya Archer was brought to the hospital for surgery to repair her ACL tear. She sustained a cardiac arrest during the transfer, and due to the lack of blood flow, she finally died of brain death. The doctors advised removing Tonya from life support since there was little chance of her recovering, but her parents insisted that she was still alive because her body was still warm and her heart was still beating. Hospital managers and medical ethicists said that Tonya’s therapy was fruitless and not in her best interests. This assessment focuses on the ethical and moral issues raised at the end of life situations.

Ethical Principles and Moral Theories

The ethical precepts of autonomy, the beneficence of patients, and applying non-maleficence and justice are at play in Tonya’s situation. Autonomy” refers to the patient’s ability to decide how they will be treated. Tonya’s parents are acting as her advocates since she cannot make choices on her own in this situation. However, parental autonomy does not give them the right to insist on fruitless or harmful therapy. Healthcare professionals must be beneficent to work in the patient’s best interests. As Tonya is not likely to recover and more treatment will only worsen her condition, the physicians have concluded that she is not best served by continuing the current course of therapy. The best course of action is to turn off Tonya’s life support. Healthcare professionals must act without malice and avoid causing injury. Continuing therapy would be detrimental in this situation since it would worsen Tonya’s suffering and not help her. Justice demands that medical decisions be rendered equitably and fairly. In this instance, the medical choice is based solely on solid medical judgment and is unaffected by the family’s socioeconomic standing (Nandifa et al., 2020).

Moral Theory for the Case

One moral theory that applies to Tonya’s case is utilitarianism, which maximizes total pleasure or happiness and minimizes overall pain or suffering. In other words, an activity is ethically correct if it results in the most joy or pleasure for the most individuals. The utilitarian approach in Tonya’s instance would include weighing the probable repercussions of removing her from life support vs. maintaining her on it. Tonya is brain-dead, and the physicians and hospital management have judged that Tonya cannot reasonably be expected to benefit from continuing to use the ventilator and other treatments (Marseille & Kahn, 2019). 

In this case, a utilitarian approach would include evaluating each choice’s possible repercussions. Tonya’s family would undoubtedly suffer a great deal of mental and financial strain if she were to be maintained on life support permanently, and it would take up critical medical resources that might be utilized to treat other patients. Moreover, Tonya could not feel joy or happiness in this situation (Häyry, 2020). On the other hand, removing Tonya’s life support would result in her instantaneous and irrevocable death, bringing her family and loved ones a great deal of anguish and suffering. However, it would also prevent Tonya from continuing to feel any pain or suffering, which would align with the idea of non-maleficence and free up medical resources that might be used to help other patients.

In the end, according to a utilitarian analysis, removing Tonya’s life support would bring the most happiness or pleasure for most people since it would free up medical resources and save Tonya from additional agony or suffering. While it may not be a simple choice, it would align with utilitarian ideals (Vearrier, 2021).

Application of Professional Code of Ethics

Professional codes of ethics that define the duties of healthcare professionals toward their patients serve as the foundation for the medical profession. The Code of Medical Ethics of the American Medical Association may be used in this situation. The principle of non-maleficence, which declares that “a physician must first do no damage,” is one pertinent aspect of the code. Following this rule, Tonya’s medical staff has advised that she be removed from life support since continued treatment will make her suffer longer with no benefit. Autonomy, which allows patients the right to make choices regarding their medical treatment, is another significant value (Mula, 2020). The patient’s surrogate decision-maker, Tonya’s parents, must still act in the patient’s best interests when the patient cannot make choices. The medical staff’s advice to remove Tonya’s life support is supported by their conclusion that Tonya would not benefit from continuing her treatment. The beneficence principle, which mandates that healthcare professionals work in their patient’s best interests, is also applicable. The medical staff has judged that Tonya would not benefit from further therapy; it would only worsen her suffering. The best action is to turn off her life support (Ebbs et al., 2020). The medical staff’s choice to remove Tonya’s life support generally complies with professional ethics rules since it is founded on beneficence, autonomy, and non-maleficence. The medical staff is responsible for acting in Tonya’s best interests and providing treatment based on reasonable medical judgment, even while the parents have the right to advocate for their daughter.

Use of Organizational Documents

In healthcare companies, organizational papers like purpose and value statements provide a framework for decision-making. The hospital’s purpose and values may be used to evaluate the medical staff’s choice to remove Tonya’s life support in this particular instance

PHI FPX 3200 Assessment 5 Tonya’s Case: Ethics and Professional Codes

The hospital’s mission statement strongly emphasizes giving patients high-quality treatment while prioritizing their safety and well-being. This goal statement is supported by Tonya’s removal from life support since continuing her care will only make her suffer longer. The hospital’s values statement could include integrity, respect, and compassion (Minicuci et al., 2020). Given Tonya’s irreparable condition, turning off her life support is a compassionate and respectful decision since it is the most humane course of action. Since they are acting by their professional judgment and ethical beliefs, the medical team’s choice is likewise consistent with the concept of integrity.

The process for making end-of-life choices may also be outlined in the hospital’s rules and procedures, including consultation with ethical committees and participation of the patient’s surrogate decision-maker. The medical team probably decided to remove Tonya’s life support using these rules and procedures (Meza et al., 2021). Ultimately, the medical team can agree upon Tonya’s removal from life support on the hospital’s purpose, beliefs, rules, and procedures. The medical staff should honor the hospital’s dedication to high-quality treatment and patient safety by putting the patient’s needs first and acting in line with professional judgment and ethical standards.

Role of Accrediting Bodies

Accreditation agencies are essential to guarantee that healthcare companies give patients safe, efficient, and high-quality treatment. These groups establish criteria and carry out assessments to see whether healthcare institutions adhere to them. The hospital’s accreditation status in Tonya’s situation can be important when deciding whether to remove her from life support. The Joint Commission, which assesses healthcare organizations in the United States, is one example of an accrediting agency. The Joint Commission establishes patient care, safety, and quality standards and conducts on-site audits to determine how well those criteria are followed. A healthcare organization receives accreditation if it satisfies the requirements (Gulati et al., 2021).

The hospital’s accreditation status in Tonya’s situation can be important when deciding whether to remove her from life support. In order to receive accreditation from the Joint Commission, a hospital must demonstrate that it complies with its standards for end-of-life care, including a policy for deciding whether or not to withdraw life-sustaining treatments. Given that the medical staff is working in line with their professional judgment and ethical values, their choice to remove Tonya’s life support would be compatible with those standards (Foglia et al., 2019). Making choices concerning end-of-life care still requires considering the requirements established by accrediting organizations, even if the hospital is certified. These requirements, intended to guarantee that patients get safe, efficient, and high-quality treatment, are based on industry best practices. The medical staff’s choice to remove Tonya’s life support in this circumstance is consistent with the ethical duty to prevent harm and the tenants of patient-centered care (Gulati et al., 2021).

Conclusion

Given the contrasting values and views around what defines life and death in Tonya’s situation, removing her from life support is difficult and emotionally taxing. Healthcare practitioners and organizations, however, may find assistance in such selections from ethical principles and professional standards of behavior. Healthcare professionals are expected to behave in their patient’s best interests while respecting their preferences and beliefs per these principles, which strongly emphasize the individual’s autonomy and the virtues of beneficence, non-maleficence, and justice.

References

Ebbs, P., Carver, H., & Moritz, D. (2020). Principlism in paramedicine: An examination of applied healthcare ethics. Journal of Paramedic Practice, 12(8), 1–6. https://doi.org/10.12968/jpar.2020.12.8.cpd1 

Foglia, M. B., Lowery, J., Sharpe, V. A., Tompkins, P., & Fox, E. (2019). A comprehensive approach to eliciting, documenting, and honoring patient wishes for care near the end of life: The veteran’s health administration’s life-sustaining treatment decisions initiative. The Joint Commission Journal on Quality and Patient Safety, 45(1), 47–56.
https://doi.org/10.1016/j.jcjq.2018.04.007 

Gulati, M., Levy, P. D., Mukherjee, D., Amsterdam, E., Bhatt, D. L., Birtcher, K. K., Blankstein, R., Boyd, J., Bullock-Palmer, R. P., Conejo, T., Diercks, D. B., Gentile, F., Greenwood, J. P., Hess, E. P., Hollenberg, S. M., Jaber, W. A., Jneid, H., Joglar, J. A., Morrow, D. A., & O’Connor, R. E. (2021). 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain. Journal of the American College of Cardiology, 78(22). https://doi.org/10.1016/j.jacc.2021.07.053 

Häyry, M. (2020). Just better utilitarianism. Cambridge Quarterly of Healthcare Ethics, 30(2), 1–25.
https://doi.org/10.1017/S0963180120000882 

Luna-Meza, A., Godoy-Casasbuenas, N., Calvache, J. A., Díaz-Amado, E., Gempeler Rueda, F. E., Morales, O., Leal, F., Gómez-Restrepo, C., & de Vries, E. (2021). Decision making in the end-of-life care of patients who are terminally ill with cancer: A qualitative descriptive study with a phenomenological approach from the experience of healthcare workers. BMC Palliative Care, 20(1).
https://doi.org/10.1186/s12904-021-00768-5 

Marseille, E., & Kahn, J. G. (2019). Utilitarianism and the ethical foundations of cost-effectiveness analysis in resource allocation for global health. Philosophy, Ethics, and Humanities in Medicine, 14(1), 1–7.
https://doi.org/10.1186/s13010-019-0074-7 

Minicuci, N., Giorato, C., Rocco, I., Lloyd-Sherlock, P., Avruscio, G., & Cardin, F. (2020). Survey of doctors’ perception of professional values. PLoS ONE, 15(12). https://doi.org/10.1371/journal.pone.0244303 

Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International Journal of Environmental Research and Public Health, 17(3), 835. https://doi.org/10.3390/ijerph17030835 

Nandifa, V. N. P., Jena, Y., & Joewana, S. (2020). Beneficence is the highest moral imperative of a doctor dealing with the poor quality of patient autonomy. Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education, 9(1), 44. https://doi.org/10.22146/jpki.44511 

Vearrier, L., & Henderson, C. M. (2021). Utilitarian principlism as a framework for crisis healthcare ethics. HEC Forum, 33(1), 45–60. https://doi.org/10.1007/s10730-020-09431-7 

PHI FPX 3200 Assessment 5 Tonya’s Case: Ethics and Professional Codes