Prolonging Life vs Natural Death Outline - Essay Example

?Prolonging Life vs. Natural Death Outline: Pro-Side Debate I. Introduction As technology advances, it opens uncharted territory with options that can challenge the moral values of the individual, family, and society. One choice that presents as a result of such advancements involves a topic that can bring passion driven debate - prolonging life. The very essence of the debate relays on the question of “what is life?’ Life in its most basic physiological sense is the presence of vital signs. As long as you are breathing, your heart is beating, you are living. Consequently, death is the exact opposite, the absence of vital signs. The days where nothing could be done to stop or slow the occurrence of death are in the past. Now, there are multiple machines and procedures that can slow or even prevent death. These machines can provide us with functions needed for a person to continue living. II. Pro prolonging life opening statement Human beings, with all their abilities to create objects, cannot summon nor command the retrieval of lost lives. Traditionally, perpetuation of life means continuation of generations; while extending life of people means they are given more time to spend their days with their loved ones, regardless of their medical status. There are positive implications associated with prolonging lives, both in general and individual sense. This debate considers prolonging life a valuable right of individuals protected both by law and by moral ethics in existing societies. By preserving life, individuals from any socioeconomic status are given the respect they deserve. Moreover, the sanctity of life is said to be embedded in the clinical practice of health care professionals, where they are in oath in continually preserving lives, and not the way around. III. Arguments in favor of prolonging Life A. Value of prolonging life Life is valued according to inherent traits that man, alone, possessed, including the ability to experience emotions, rational capabilities, and simply having the consciousness seemingly absent in non-moving forms of life (Bayertz, 1996, p. 206). In spite of poor rational capabilities and consciousness possibly exhibited by patients in critical units, their ability to feel is still presumed intact, as such, sanctity of preserving such exclusive attribute is one of the things to be protected. No one have the right to eliminate such valuable feature in every person. B. Cost Factors 1. Prolonging life is never of limited resources Current medical reports demonstrated less significant difference, in terms of cost-containment, in limiting life support utilization for sustenance of critical patients compared with restricting life support utilization as adherence to bedside rationing to priority patients (Luce & White, 2007). The report demonstrated that limiting measures in life support has minimal impact on the so-called cost-efficiency in intensive care units. The act of prolonging life of individuals as means of effective care can even have a constructive impact on program expenditure of hospital institutions. Reduction in death rates as a measure of clinical outcome improvement generates positive hospital revenues, as institutions save from offering services through departmental programs, providing extra finances for other hospital operations (“Financial Results,” 2009). Hospital efficiency and longevity are also secured when the patient has the “appropriate level of care” (Luce & White, 2007, p. 1106). This is one valid proof that substantial reduction in mortality figures by providing effective care through prolonging life can boosts hospital resources. C. Ethical 1) The RIGHT to LIFE is protected by Universal Human Rights As accorded by human rights advocates, the state (including its citizens) must protect life, at all cost. Article 3 in the Preamble of The Universal Declaration of Human Rights (n.d.) had clearly shown its support in preserving to one’s life. Moreover, Cruzan v. Director (1990) is the landmark case that upholds the right to life. There, the Supreme Court prohibited the parents to withdraw the daughter’s life support since “there was no clear and convincing evidence of the daughter’s desire to have life-sustaining treatment withdrawn” (para. 1). Thus, purposeful withdrawal of life support systems that leads to intentional death is punishable as a crime unless there is previous ‘evidence of knowledge’ of the patient’s wishes regarding life-sustaining treatment (“Right to Life,” n.d.). It can also be said that the Supreme Court upheld the person’s right to decide his/her ‘right to life’ as “the legal justification for withholding or withdrawing life-sustaining therapy is the patients’ right to accept or refuse medical interventions” (Luce & White, 2007, p. 1105). As such, legal grounds had shown its stability in preserving the concept of prolonging life, in any given situation. 2) Hippocratic Oath On the clinical side, health care practitioners, especially doctors, had been sworn, through Hippocratic Oath, that they are responsible to always preserve life, keep patient interactions confidential, and not to intentionally inflict any type of harm to their clients (Loefler, 2002). Is it not causing harm and breach of life’s sanctity when health personnel hold back life saving measures, even though there might be slim chances of survival? At all times, the Hippocratic Oath’s primary principles, that have connected generations of physicians since antiquity, must be upheld, as they define what are the duties and responsibilities of health practitioners in health care settings. D. Advancement in Technology 1) Life support by medications People in critical conditions have weaker immune systems; hence, they are more prone to acquire infectious disease, aside from existing conditions. Antibiotic treatments are commonly prescribed as part of life support measures for dying individuals (“End of Life Care,” 2005). Pharmacological advances made it possible for critical patients to extend their lives by either preventing further worsening of conditions or resolving it. This shows that medications updates prolong life, and should be used for that purpose. 2) Artificial support systems project better patient outcomes Artificial support innovations in biomechanics formulate techniques in replacing damaged liver cells in end-stage liver diseases, with biomaterials that extend longevity of liver organs, extending life in the process (Chan, Berthiaume, Nath, Tilles, Toner, & Yarmush, 2004). With the help of better technological methods, patients are given chances to improve their conditions. 3) CPR Resuscitating interventions are said to give twice chance of survival in critical patients, where Cardiopulmonary Resuscitation (CPR) approach sustains respiratory and cardiovascular status (“End of Life Care,” 2005). As such, its strategic use assists dying patients in extending their lives, potentially sustaining them towards recovery phase. E. Family conflict with provider 1) Decision making During patient incompetency, close family member are relegated as proxies. Ruling towards preserving life always takes priority, when desire to withdraw support systems clashes with decisions to remain on it. More importantly, appeals of medical practitioners to withdraw life support measures does not carry weight, hence, only surrogate decision-makers are authorized to do so, but only with valid proof that decisions coincide with patients’ wishes (Mani, 2003). These parameters in determining that decisions are according to patient’s will demonstrate that most settings are in favor of prolonging life, and removing it is the last resort. 2) Denial Several health staff, according to one report by Luce and White (2007), become offended when family members tend to deny that there is no chance for patient survival. As such, perceptual difference on survival rate implications for medical team and family member may aggravate decision conflicts. The medical team may see family reaction as denying the true nature of patient’s condition, while the family sees small survival percentage as glimmer of hope to be grabbed like a lifeline (Luce & White, 2007). Such belief seemed to help families cope, showing the importance of prolonging life for families. 3) Futility Futility serves as therapeutic approach where health teams can justify the soundness of their predictions of patients’ status and need for life support limitations or continuation, and may create discord as medical personnel can use futility to challenge family members who do not agree with the recommendations (Luce & White, 2007). The problem with attempts to foresee the disease course of patients is that these are fraught with preconceived ideals, affecting objective evaluation of patients’ true status (McDermid & Bagshaw, 2009). As such, futility concepts are utilized as professional justification in situations of prognostic uncertainty, and not as evidence-based proactive means in life preservation. This shows clear biases in prognostic abilities of medical practitioners and tendency to paternalism, as they are, after all, human beings. III. Natural death opening Statement IV. Arguments against prolonging life A. Right to die B. Living Will C. Advanced Directive D. Cost 1. Medications 2. Resources E. Futile care 1. Give families false hope F. Quality of life 1. Vegetative state 2. Prolonged pain and suffering 3. Dependency 4. Worthlessness V. Affirmative rebuttal -- (cannot create affirmative rebuttal as refuting opposition’s ideas depend on their ideal defense) VI Opposing rebuttal VII. Overview of debate On the pro side, human rights laws, moral and medical ethics, while duly reinforced by concepts in technological health innovations, had supported the act of sanctifying the lives of critically ill patients. Extending life is highly valued by family members, to a point where a single survival percentage serves as hope that there are still possibilities of recovery. Therapeutic futility seemed to create clash with several family members, as medical predictions are seemingly subjective and tainted with preconceived prejudice on how long patients may last. With these being the case, prolonging life is the safest and more prudent approach in the face of uncertainties. VIII. Conclusion Man is created to live life the fullest, yet, it seems that human beings have incorporated in their roles as judges to determine who shall die and who can have a chance to life. Eliminating the lives of others, no matter what the reasons are behind such act, goes out of boundaries with man’s vital role to procreate and preserve life. Life can never be recreated nor retrieved once it is lost, so it should not be wasted because others deemed it hopeless to prolong. Individuals have different outlooks in life, and the decision to withhold life support measures must not be according to perceptual standards of others, but in accordance with doing everything humanly possible to save lives, as vital part of health professionals’ presence in clinical settings, and not the other way around. References Bayertz, K. (Ed.). (1996). Sanctity of life and human dignity. London: Kluwer Academic Publishers. Chan, C., Berthiaume, F., Nath, B. D., Tilles, A. W., Toner, M., & Yarmush, M. L. (2004). Hepatic tissue engineering for adjunct therapy and temporary life support: Critical technologies. Liver Transplantation, 10 (11), 1331-1342. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/lt.20229/pdf Center for Bioethics .(2005). End of life care: An ethical overview. Center for Bioethics. Retrieved from http://www.ahc.umn.edu/img/assets/26104/End_of_Life.pdf Cruzan v. Director, Missouri Department of Health, (88-1503), 497 U.S. 261 (1990). Cornell University Law School Retrieved from http://www.law.cornell.edu/supct/html/88-1503.ZO.html Financial Results. (2009). Advanced ICU Care. Retrieved from http://www.icumedicine.com/financial-reports.html Loefler, I. (2002). Why the Hippocratic ideals are dead. BMJ, 324, 1463. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123413/pdf/1463.pdf Luce, J.M., & White, D.B. (2007). The pressure to withhold or withdraw life-sustaining therapy from critically ill patients in the United States. American Journal of Respiratory Critical Care Medicine, 175, 1104-1108. Retrieved from http://171.66.122.149/cgi/reprint/175/11/1104 Mani, R. (2003). Limitation of life support in the ICU: Ethical issues relating to end of life care. Indian Journal of Critical Care Medicine, 7 (2), 1112-1117.Retrieved from http://www.ijccm.org/article.asp?issn=0972-5229;year=2003;volume=7;issue=2;spage=112;epage=117;aulast=Mani McDermid, R. C., & Bagshaw, S. M. (2009). Prolonging life and delaying death: The role of physician in the context of limited intensive care resources. Retrieved from Biomed Central Ltd; http://www.peh-med.com/content/4/1/3 Right to Life. (n.d.). Equality and Human Rights Commission. Retrieved from http://www.equalityhumanrights.com/human-rights/what-are-human-rights/the-human-rights-act/right-to-life/ The Universal Declaration of Human Rights. (n.d.). United Nations. Retrieved from http://www.un.org/en/documents/udhr/index.shtml#atop Pro side of debates questions 1. How is rapidly changing health care science and technology affecting the nature of the discussion regarding prolonging life? 2. How does one determine that a patient’s life is no longer sufficiently precious to take all actions necessary to prolong that life? 3. Can survival and outcome be predicted? 4. Are withdrawing and withholding therapies always morally equivalent? 5. How do we withdraw or withhold life sustaining therapy? 6. How does one accurately predict the future of how patients and families will actually feel about not using technology to prolong life when technology could possibly provide time? 7. If prolonging life will permit a patient or loved one such experience as the sight of his or her first grandchild but it also will results in prolonged pain and disability for another month, week, or even one more day, how does one determine that prolonging life should not be pursued? 8. Decisions involving artificial nutrition or hydration may be particularly difficult and/or contentious. How would you make these decisions when the benefits and burdens of either nutrition or hydration may not be well known and involve difficult assessments of the patient? Read More