Case Study:
Mrs. Jansen is a Roman Catholic Christian 58-year-old schoolteacher. Six weeks ago, she suffered a stroke that left her with severe deficits. Her doctor told her family that due to her injury, she will be unable to walk on her own, feed herself, or be independent from full assistance for the remainder of her life. She remains in the hospital and has not communicated with her family in any way since the stroke. She is breathing on her own but will most likely experience unpredictable bouts of respiratory distress for the rest of her life, requiring future mechanical ventilation. She is receiving nutrients through a feeding tube, which was surgically inserted in her stomach.
Her husband wants the doctor to remove the feeding tube and permit the effects of the stroke to take their natural course. He is sure that this is what his wife would want, especially considering the grim diagnosis. He knows this not only from what she has told him in the past but also because of her free and independent character. He believes that she would not want to live like this. The doctor is not comfortable removing the feeding tube because she believes it to be necessary to sustain life.
Questions to consider in the case study:
What can you find in the teaching of the Catholic Church to help inform the patient?s caregivers so that they can decide on a course of action?
Do you think the husband’s request is reasonable? What do you think about the doctor’s response? Can the feeding tube can be removed, and the sanctity of the patient’s life still be recognized?
What course of action should be taken? If you were the husband how would you proceed?
Guidelines
One to two pages double spaced
12 point font
Cite at least two sources
Follow proper APA format and style guidelines including a title page and reference page
Module Readings:
https://www.americamagazine.org/issue/663/article/human-dignity-and-end-life
https://www.franciscanmedia.org/st-anthony-messenger/are-feeding-tubes-morally-obligatory
https://www.vatican.va/archive/ENG0015/__P82.HTM
https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.htmlIntroduction to Healthcare at the End of Life
Not every illness has a cure and all of us, as human beings, will ultimately be subject to death.
But the hope to heal and to save patients? lives is so strong that often the medical profession continues to persist with futile life-prolonging measures which are beyond what may be objectively considered as reasonable. Moral decisions about end-of-life issues are not simply made considering what may be medically or technologically possible.
Withholding (not initiating) or withdrawing (removing or stopping) treatment can be permissible depending upon the circumstances. We cannot make a moral determination without considering each case individually considering the circumstances surrounding the patient and without a respect for and understanding of the clinical reality he or she is facing. It is not only the treatment itself that is the object of moral deliberation, but rather how the treatment affects the whole person. To determine the moral rightness or wrongness of an action, we also need to evaluate the intention of the one performing the action. There is a moral difference between an act of killing a patient, perhaps with a lethal drug injection, and allowing the patient to die by forgoing treatment that is not beneficial or is excessively burdensome. The result of the actions is the same in that the patient dies, but the cause and intention are significantly different. Recall the sources of morality in the Catechism of the Catholic Church (#1750).
One of the most important factors in deciding whether to forgo treatment at the end of life is assessing the likely benefits and burdens associated with the treatment. Burdens and benefits are the main criteria for determining whether treatment is proportionate and thus morally obligatory. We cannot say in advance that a breathing machine or feeding tube, for example, is morally obligatory without considering the overall benefits it provides and burdens it imposes on the person. Ideally, the evaluation of benefits and burdens is done by the patient who decides whether to pursue treatment considering how it will affect her or him holistically? that is physically, emotionally, spiritually, and socially.
It is widely accepted among Catholic theologians and others in the field of medicine that one needs only to use medical means that provide a proportionate hope of benefit without imposing an excessive burden on one’s family or community (disproportionate means).
The language of proportionate and disproportionate means correlates with the ordinary/extraordinary distinction used by moral theologians when discussing means to preserve life and health. Essentially, one is required to take ordinary steps or measures to preserve life and health. However, no one is obligated to use extraordinary means, for example a medical intervention that brings a patient excessive pain, causes a patient grave inconvenience, and causes excessive burden on the patient and/or family including consideration of unmanageable financial burden.
In sum, physical life is a basic good and we have a moral obligation to protect and preserve it. However, this obligation is not absolute, there are limits to this duty. One is not morally obliged to preserve physical life with medical means if the burdens outweigh the benefits. Generally, when serious doubt exists to the overall benefits and burdens of treatment, such doubt should be resolved by deciding in favor of treatment.
