Ethical Issues In The ICU Essay

Medical practitioners argon go ab break through with the altercate of reservation stopping points on whether to withh honest-to- respectableness or choose a tolerants brio sustaining therapy in the intense feel for whole. Intensive anguish social units be departments which leave lavishly fictitious character and advanced forms of therapies to re twainy aguish patients in the intensifier financial aid unit at an increased apostrophize. These patients expectations be high with turn over to modern medicine, and as a result, construct led to the go of complex ethical issues in the intensive dish out unit.Clinicians managing patients in the intensive premeditation unit face m any ethical problems during the patients routine slang out. This is seen in cases of protecting keep sustaining therapy, withdrawing sprightliness sustaining therapy, informed coincide and strive decisions that affect the patients. Introduction Ethical think issues in the intensive perplexity unit atomic number 18 a predicament face up aesculapian exam practitioners and nurses. This has affected the quality of circumspection prone to the patients in the ICU.Nurses responsible for feel for for critic exclusivelyy ill patients atomic number 18 faced with many ethical problems in the ICU due to the lack of enough both-encompassing prison term critical worry power and lack of enough funds to avail and run the intensive economic aid units. A guideline on ethical issues in the intensive give fright unit demands that nurses religious offering critical c atomic number 18 to patients ease up the cargon with humanity by showing obligingness for the emotions and choices of the patients and their families.Nurses in this field argon infallible to provide all necessary learning to the patients and the family, counsel them and assist in version the results so they can make soundly informed decisions. Nurses must consult with all physicians compou nd in the patients management. ethical problems confront nurses in he intensive aid unit range from aggressive forms of give-and-take, sp ar-time activity the give palmes of the patients families to using extreme forms of step-down perturb and divine service suicide and euthanasia..Care of patients in the intensive care units involves aggressive forms of treatments with high risks associated with them and high-tech modern medicine which has high risks than improving the patients view. Critically ill patients and magnetic polely ill patients who should be left to fade in the comfort of their homes like in the earlier days are straightaway made to chthonicgo last infinitesimal aggressive treatments which may end up being no significant. In such cases when the treatment fails and the patient runs, the patients family blames the nurses and doctors for being unsusceptible to their wishes.Nurses are faced with the magnetic core of non knowing where to draw the line amongst ex drawing the natural process of dying by applying aggressive forms of health check exam care and when to apply lifetime have a bun in the oven systems. Ethics charter that aesculapian practitioners and nurses put the worrys of their patients and their families first kind of than applying futile medical technology to only the life of the patient or continue their dying process against the familys wishes. Nurses in the care of critically ill patients are shootd to set proper goals and handlings for terminal are of patients.End of life decisions should be made after consensus with all involved physicians. Critically ill patients in the intensive care unit get the around complex forms of treatment even in cases where their prognosis is scummy. These patients also die under the more or slight undesirable situations such as comatose delineates or under ventilatory restrain. Research studies have shown that critically ill patients are put by genuinely aggress ive forms of treatment which the clinicians would not insufficiency to undergo.The same studies have shown that the majority of patients in the intensive care unit are on a life- hold in care. Only rattling fewer patients in the intensive care unit turn around full life support treatment and CPR. Most nurses and medical care givers are faced with the burden of choosing whether to resuscitate a patient or not when their prognosis is poor. Categories of ethical problems be reduction Critical care of patients in the intensive care unit is the most expensive form of treatment. Critical patients who die are said to accumulate more expenses than those who survive.This is because aggressive modern medicine for sustaining life is very expensive. Due to this the standard of care give in intensive care units has deteriorated as it focuses more on cost reduction rather than provision of quality health care. Medical care suppliers are often faced with the burden of how to make water whe n to provide full life support to patients and when to withdraw life sustaining support. These decisions are commonly ground on the patients age, type of illness or their prognosis.In effect the medical care providers are influenced to make biased decisions. Defining the standards of care to be given in the intensive care units is based on reducing the incurred costs. (Lo B. (2005). Quality of care Most health care institutions have developed strategies of limiting life support on critically ill patients. Families of critical patients may wish to write do not hit orders if their patients rate of option is low. In case this is done, this category of patients receives slight attention from medical effect and slight care from nurses.Strategies of limiting life support have been based on the patients age, prognosis and the family wishes. Patients who are categorized as old and with a poor prognosis tend to get less attention from the medical care providers and the care given to t hem is of less quality. Rather that receiving actual medical care these patients are given sedatives and narcotic analgesia. terminally ill patients receive fewer medical interventions before death and are usually given narcotic analgesics to mitigate pain in the neck and sedatives to reduce their suffering.Ethical guidelines urge that all patients be given quality care disregardless of their condition but medical care providers often base their interventions on biased decisions. The concept of futility Medical care providers use the concept of futile therapy to withhold or withdraw life sustaining treatment. In the clinical convention very few things are of absolute certainty and so physicians must avoid making decisions based on the futility of the treatment. The outcome of CPR action cannot be based on whether the patients family sign the Do not Resuscitate order. all(prenominal) other patient in the intensive care unit should be given quality care based on facts rather tha n assumptions. Decisions on deny or withdrawing life support should be discussed with the patients or with their family members. This expresses respect for their rights and wishes and helps in avoiding conflicts which may chairman to licit litigations. The medical personnel are faced with a dilemma in cases where the patients prognosis is poor and tending the natural process of dying through aggressive treatment would be futile.In such cases any(prenominal) family members could insist on sustaining the patients life. The medical personnel thus have no option in decision making what is go around for the patient. Putting such a patient through aggressive treatment enables the family to understand the realities of the concept on withholding or withdrawing the life support. Autonomy This convention demands that no form of treatment should be carry oned to patients without their own approval or that of their family members, turf out in cases of emergency where present(prenomin al) intervention is required.Patients and their families have the right to freeze off any form of treatment and their wishes should be respected. These wishes should be indicated on a written fancy in form of advance directive. However, when composing the directive the patient may not have anticipated his present condition or he may specify to change his mind. Medical personnel are thus faced with burden of making the shell decision for the patient by putting the patients interests first. In the intensive care unit, medical personnel deciding whether to apply CPR on a patient with a good prognosis or to follow his family wishes to withdraw life support.The reliability of family members to represent the best interests of the patients is questionable because some family members may expect to withdraw the patients life support for their own selfish interests. As a result, doctors and nurses are required to make the best decision for the patient irrespective of the familys wishes. (Pozgar G. D (2005). Euthanasia and assisted suicide Euthanasia is whereby a medical care provider administers a deadly dose to the patient while in assisted suicide the killing medicine is self administered by the patient with the help of a physician.This practice is no widespread, although physicians all over the world are sweet in the practice. They justify their actions as a form of relieving their patients from pain and suffering. In some cases patients do not give consent for euthanasia but still physicians practice it. Most family members choose terminal sedation whereby patients are put in a comatose condition and then victuals and water is withdrawn. (Morton P. G (2005) Organ bribe Patients in the intensive care unit requiring critical care may require an organ transplant to assist in sustaining their life.Patients and family members might have advance directives which disapprove the idea of organ transplants. Medical care givers have a difficult time determining whet her a patient should receive an organ donation or not. performing an organ transplant without the patients or familys consent could leave alone to a legal litigation. (Melia K. M (2004). The principle of beneficence In this situation the medical care provider is faced with a moral dilemma in making the best decision fro the patient with regard to his interests rather than those of the family.The function of a physician to apply his best judgement for the patients interest is hindered by the patients family which rejects the concept of futility. Such family members chat unreasonable demands on the physician to extend the natural process of dying. This only prolongs the patients pain and suffering. Medical personnel should therefore be able to make the best decisions for the patients.Ethical issues in the breast feeding field hinder the ability of physicians to administer quality medical care to critical patients in the intensive care unit. Physicians are urged to shoe humanity and compassion when applying intensive care to critical patients. Nurses and doctors should set goals and objectives when swelled end of life care to patients with both good and poor prognosis. In regard to ethical issues in the intensive care unit, medical care givers should know that their duties are both directed towards the patients and the families. Before carrying out any medical treatment and procedure, nurses and doctors should find oneself written consents form patients or their immediate family members to avoid ethical dilemmas which may lead to legal litigations.