Nonbeneficial Treatment and Conflict Resolution: Building Consensus

Nelson, Craig M.; Nazareth, Blanca Arriola

doi:10.7812/tpp/12-124

Cited by 9 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If the decision is against the wishes of the health care proxy, they are given the option of transferring the patient to another facility. If the decision is against a certain provider’s recommendation, the patient may be transferred to the care of another provider in the same facility [18]. Unfortunately, no such clear guidelines were set before this case.…”

Section: Discussionmentioning

confidence: 99%

Pain Management in a Terminally Ill Patient with a Surrogate Decision-maker: A Challenge

Syed

Mansourian

Tirumanisetty

et al. 2019

Cureus

View full text Add to dashboard Cite

When health care proxies are in charge of pain management, it may become very difficult to address the patient’s pain if the health care proxy has misconceptions about analgesics.We report a case of an 87-year-old lady who was found to be pulseless, and after successful cardiopulmonary resuscitation (CPR), was intubated and remained so for over a month in the intensive care unit (ICU). The medical team could not provide the patient with pain medication, as the daughter who was the surrogate decision-maker did not allow the administration of any pain medication in the false belief that it would kill the patient.This case helps us to shed light on the surrogate decision-maker and pain management and how medical professionals can solve similar issues in the future. Early consultation with palliative care may be beneficial. For continued disagreement, the ethics committee should be consulted.

show abstract

Section: Discussionmentioning

confidence: 99%

Pain Management in a Terminally Ill Patient with a Surrogate Decision-maker: A Challenge

Syed

Mansourian

Tirumanisetty

et al. 2019

Cureus

View full text Add to dashboard Cite

show abstract

“…It goes without saying that the first course of action should be to direct effort into consensus building which would lead to the resolution of discord, thus leading to least anguish experienced by everybody; indeed, much previous work has studied how this challenge should be approached best and what particular concerns tend to create the greatest contention. [58][59][60] My focus here is on the problem which presents itself when this resolution proves impossible.…”

Section: Divergence Of Views Within the Patient's Kinmentioning

confidence: 99%

Resolving the ethical quagmire of the persistent vegetative state

Arandjelović

2023

Evaluation Clinical Practice

View full text Add to dashboard Cite

BackgroundA patient is diagnosed with the persistent vegetative state (PVS) when they show no evidence of the awareness of the self or the environment for an extended period of time. The chance of recovery of any mental function or the ability to interact in a meaningful way is low. Though rare, the condition, considering its nature as a state outwith the realm of the conscious, coupled with the trauma experienced by the patient's kin as well as health care staff confronted with painful decisions regarding the patient's care, has attracted a considerable amount of discussion within the bioethics community.AimsAt present, there is a wealth of literature that discusses the relevant neurology, that elucidates the plethora of ethical challenges in understanding and dealing with the condition, and that analyses the real‐world cases which have prominently featured in the mainstream media as a result of emotionally charged, divergent views concerning the provision of care to the patient. However, there is scarcely anything in the published scholarly literature that proposes concrete and practically actionable solutions to the now widely recognized moral conundrums. The present article describes a step in that direction.Materials & MethodsI start from the very foundations, laying out a sentientist approach which serves as the basis for the consequent moral decision‐making, and then proceed to systematically identify and deconstruct the different cases of discord, using the aforementioned foundations as the basis for their resolution.ResultsA major intellectual contribution concerns the fluidity of the duty of care which I argue is demanded by the sentientist focus.DiscussionThe said duty is shown initially to have for its object the patient, which depending on the circumstances, can change to the patient's kin, or the health care staff themselves.ConclusionIn conclusion, the proposed framework represents the first comprehensive proposal regarding the decision‐making processes involved in the deliberation on the provision of life sustaining treatment to a patient in a PVS.

show abstract

“…It goes without saying that the first course of action should be to direct effort into consensus building which would lead to the resolution of discord, thus leading to least anguish experienced by everybody; indeed, much previous work has studied how this challenge should be approached best and what particular concerns tend to create the greatest contention (Buckley et al, 2004;Nelson and Nazareth, 2013;Graham et al, 2015). My focus here is on the problem which presents itself when this resolution proves impossible.…”

Section: Divergence Of Views Within the Patient's Kinmentioning

confidence: 99%

Resolving the Ethical Quagmire of the Persistent Vegetative State

Arandjelović¹

2023

Preprint

View full text Add to dashboard Cite

A patient is diagnosed with the persistent vegetative state (PVS) when they show no evidence of the awareness of the self or the environment for an extended period of time. The chance of recovery of any mental function or the ability to interact in a meaningful way is low. Though rare, the condition, considering its nature as a state outwith the realm of the conscious, coupled with the trauma experienced by the patient's kin as well as health care staff confronted with painful decisions regarding the patient's care, has attracted a considerable amount of discussion within the bioethics community. At present, there is a wealth of literature that discusses the relevant neurology, that elucidates the plethora of ethical challenges in understanding and dealing with the condition, and that analyses the real-world cases which have prominently featured in the mainstream media as a result of emotionally charged, divergent views concerning the provision of care to the patient. However, there is scarcely anything in the published scholarly literature that proposes concrete and practically actionable solutions to the now widely recognized moral conundrums. The present article describes a step in that direction. I start from the very foundations, laying out a sentientist approach which serves as the basis for the consequent moral decision-making, and then proceed to systematically identify and deconstruct the different cases of discord, using the aforementioned foundations as the basis for their resolution. A major intellectual contribution concerns the fluidity of the duty of care which I argue is demanded by the sentientist focus. The said duty is shown initially to have for its object the patient, which depending on the circumstances, can change to the patient's kin, or the health care staff themselves. In conclusion, the proposed framework represents the first comprehensive proposal regarding the decision-making processes involved in the deliberation on the provision of life sustaining treatment to a patient in a PVS.

show abstract

Nonbeneficial Treatment and Conflict Resolution: Building Consensus

Cited by 9 publications

References 10 publications

Pain Management in a Terminally Ill Patient with a Surrogate Decision-maker: A Challenge

Pain Management in a Terminally Ill Patient with a Surrogate Decision-maker: A Challenge

Resolving the ethical quagmire of the persistent vegetative state

Resolving the Ethical Quagmire of the Persistent Vegetative State

Contact Info

Product

Resources

About