Mr. Martinez was a seventy-five-year-old chronic obstructive pulmonary disease patient. He was in the hospital because of an upper respiratory tract infection. He and his wife had requested that CPR not be performed should he require it. A DNR order was written in the charts. In his room on the hird floor, he was being maintained with antibiotics, fluids, and oxygen and seemed to be doing better. However, Mr. Martinez's oxygen was inadvertently turned up, and this caused him to go into respiratory failure. When found by the therapist, he was in terrible distress and lay gasping in his bed. Reflect on the Case Study: Mr. Martinez media piece. Should Mr. Martinez be transferred to intensive care, where his respiratory failure can be treated by a ventilator, and by CPR if necessary, and his oxygen level can be monitored? Assume that doctors cannot contact Mrs. Martinez and must make this choice on their own. To help you reach an objective, ethically sound decision, draw upon concepts and arguments from your textbook and independent research. Support your decision with clear, concise, and correct examples, weaving and citing the readings and media throughout your answer. Address the following: ● ● ● ● ● ● ● You will be evaluated as to how well you: ● ● ● The patient's directives. The patient's quality of life. The family's stated preferences. The cause of the patient's current respiratory distress. The moral issues associated with limiting life support. The ethical principles most relevant to reaching an ethically sound decision. Important considerations such as implications, justifications, and any conflicts of interest that might arise because of the patient's respiratory failure. ● Articulate the moral issues associated with limiting life support. Demonstrate sound ethical thinking and relevant ethical principles when considering limiting life support. Explain important considerations that arise when contemplating limiting life support. Exhibit proficiency in clear and effective academic writing skills. Assignment Requirements Your paper should meet the following requirements: Written communication: Written communication is free of errors that detract from the overall message. APA formatting: Resources and citations are formatted according to current APA style and formatting guidelines. See the Evidence and APA CitationLinks to an external site. section of the Writing Center for guidance. Length: 3-4 typed, double-spaced pages. Font and font size: Times New Roman, 12 point. Competencies Measured By successfully completing this assignment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria: Competency 1: Articulate ethical issues in health care. O Articulate the moral issues associated with limiting life support. Competency 2: Apply sound ethical thinking related to a health care issue. O Demonstrate sound ethical thinking and relevant ethical principles when considering limiting life support. ● Competency 4: Explain the conceptual framework that health care leaders use to make ethical decisions. o Explain important considerations that arise when contemplating limiting life support. Competency 5: Apply in text the standard writing conventions for the discipline, including structure, voice, person, tone, and citation formatting. Exhibit proficiency in clear and effective academic writing skills. O Chapter below Chapter 7 Euthanasia and Assisted Suicide BRIEFING SESSION Death comes to us all. We hope that when it comes it will be swift and allow us to depart without prolonged suffering, our dignity intact. We also hope that it will not force burdens on our family and friends, making them pay both financially and emotionally by our lingering and hopeless condition. Such considerations give euthanasia a strong appeal. Should we not be able to snip the thread of life when the weight of suffering and hopelessness grows too heavy to bear? The answer to this question is not as easy as it may seem, for hidden within it are a number of complicated moral issues. Just what is euthanasia? The word comes from the Greek for "good death,” and in English it has come to have the meaning "easy death." But this does little to help us understand the concept. For consider these questions: If we give ourselves an easy death, are we committing suicide? If we assist someone else to an easy death (with or without that person's permission), are we committing murder? Anyone who opposed killing (either of oneself or of others) on moral grounds might also consider it necessary to object to euthanasia. It may be, however, that the answer to both questions is no. But if it is, then it is necessary to specify the conditions that distinguish euthanasia from both suicide and murder. Only then would it be possible to argue, without contradiction, that euthanasia is morally acceptable but the other two forms of killing are not. Someone who believes that suicide is morally legitimate would not object to euthanasia carried out by the person herself, but he would still have to deal with the problem posed by the euthanasia/murder issue. Active and Passive Euthanasia We have talked of euthanasia as though it involved directly taking the life of a person, either one's own life or the life of another. However, some philosophers distinguish between "active euthanasia" and "passive euthanasia," which in turn rests on a distinction between killing and letting die. To kill someone (including oneself) is to take a definite action to end his or her life (e.g., administering a lethal injection). To allow someone to die, by contrast, is to take no steps to prolong that person's life when those steps seem called for—failing to give a needed injection of antibiotics, for example. Active euthanasia, then, is direct killing and is an act of commission. Passive euthanasia is an act of omission. This distinction is used in most contemporary codes of medical ethics (e.g., the American Medical Association's Code of Ethics) and is also recognized in the Anglo- American tradition of law. Except in special circumstances, it is illegal to deliberately cause the death of another person. It is not, however, illegal (except in special circumstances) to allow a person to die. Clearly, one might consider active euthanasia morally wrong while recognizing passive euthanasia as morally legitimate. Some philosophers, however, have argued that the active-passive distinction is morally irrelevant with respect to euthanasia. Both are cases of causing death, and it is the circumstances in which death is caused, not the manner of causing it, that is of moral importance. Furthermore, the active-passive distinction is not always clear cut. If a person dies after special life-sustaining equipment has been withdrawn, is this a case of active or passive euthanasia? Is it a case of euthanasia at all? Voluntary, Involuntary, and Nonvoluntary Euthanasia Writers on euthanasia have often thought it important to distinguish among voluntary, involuntary, and nonvoluntary euthanasia. Voluntary euthanasia includes cases in which a person takes his or her own life, either directly or by refusing treatment. But it also includes cases in which a person deputizes another to act in accordance with his wishes. Thus, someone might instruct her family not to permit the use of artificial support systems should she become unconscious, suffer from brain damage, and be unable to speak for herself. Or someone might request that he be given a lethal injection after suffering third-degree burns over most of his body, suffering uncontrollable pain, and being told he has little hope of recovery. Finally, assisted suicide, in which the individual requests the direct help of someone else in ending his life, falls into this category. (Some may think that one or more of the earlier examples are also cases of assisted suicide. What counts as assisted suicide is both conceptually and legally unclear.) That the individual explicitly consents to death is a necessary feature of voluntary euthanasia. Involuntary euthanasia consists in ending the life of someone contrary to that person's wish. The person killed not only fails to give consent, but expresses the desire not to be killed. No one arguing in favor of nonvoluntary euthanasia holds that involuntary euthanasia is justifiable. Those who oppose both voluntary and nonvoluntary euthanasia often argue that to permit either runs the risk of opening the way for involuntary euthanasia. Nonvoluntary euthanasia includes those cases in which the decision about death is not made by the person who is to die. Here the person gives no specific consent or instructions, and the decision is made by family, friends, or physicians. The distinction between voluntary and nonvoluntary euthanasia is not always a clear one. Physicians sometimes assume that people are "asking" to die even when no explicit request has been made. Also, the wishes and attitudes that people express when they are not in extreme life-threatening medical situations may be too vague for us to be certain that they would choose death when they are in such a situation. Is "I never want to be hooked up to one of those machines” an adequate indication that the person who says this does not want to be put on a respirator should she meet with an accident and fall into a comatose state? If the distinctions made here are accepted as legitimate and relevant, we can distinguish eight cases in which euthanasia becomes a moral decision: 1. Self-administered euthanasia a. active b. passive 2. Other-administered euthanasia