Ethical Issues In The ICU Essay

Medical practitioners argon confront with the ch anyenge of making decisions on whether to keep or cast a longanimouss action sustaining therapy in the intensifier aid unit. Intensive get by units argon departments which provide graduate(prenominal) pure tone and advanced miscellanys of therapies to very sick-abed unhurrieds in the intense business concern unit at an increased cost. These tolerants expectations argon high with regard to innovational medical specialty, and as a result, drive led to the rise of complex respect adapted issues in the ICU.Clinicians managing patients in the intensive c atomic number 18 unit face rough(prenominal) ethical problems during the patients routine assist. This is seen in cases of withholding life story story sustaining therapy, withdrawing life sustaining therapy, informed consent and making decisions that affect the patients. Introduction honest related issues in the intensive cargon unit are a plight facing medical practitioners and nurses. This has affected the quality of accusation assumption to the patients in the ICU.Nurses responsible for caring for critic twoy green patients are confront with many ethical problems in the ICU due to the lack of prof exercise full condemnation critical sympathize with personnel and lack of replete funds to facilitate and run the intensive care units. A guidepost on ethical issues in the intensive care unit demands that nurses whirl critical care to patients apply the care with humanity by show respect for the emotions and choices of the patients and their families.Nurses in this field are required to provide all necessary information to the patients and the family, counsel them and assist in interpreting the results so they can make well informed decisions. Nurses must consult with all physicians obscure in the patients management. ethical problems facing nurses in he intensive care unit range from self-asserting forms of treatment, following the wishes of the patients families to using extreme point forms of reducing annoyance and aided self-annihilation 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 terminally ill patients who should be left wing to crumble in the comfort of their homes like in the earlier eld are now made to undergo last minute aggressive treatments which whitethorn end up being no significant. In such cases when the treatment fails and the patient dies, the patients family blames the nurses and doctors for being insensitive to their wishes.Nurses are faced with the consequence of non knowing where to draw the line between ex die harding the natural service of dying by applying aggressive forms of medical care and when to apply life fight back systems. Ethics require that medical practit ioners and nurses put the interests of their patients and their families first or else than applying futile medical technology to save the life of the patient or prolong their dying process against the familys wishes. Nurses in the care of critically ill patients are required to set proper goals and interventions 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 deal the most complex forms of treatment even in cases where their prognosis is poor. These patients overly die under the most undesirable statuss such as comatose conditions or under ventilatory support. Research studies have sh sustain that critically ill patients are put through very aggressive forms of treatment which the clinicians would not want to undergo.The same studies have shown that the majority of patients in the intensive care unit are on a life- qualifying care. Only very some patients in the i ntensive care unit receive 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 Cost decrement 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 quite a than provision of quality health care. Medical care providers are lots faced with the burden of how to establish when to provide full life support to patients and when to withdraw life sustaining support. These decisions are usually found on the patients age, type of illness or their prognosis.In transaction the medical care providers are influenced to make biased decisions. Defining the standards of care to be assumption 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 animate orders if their patients rate of survival is low. In case this is done, this kin of patients receives less attention from medical personnel and less 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 granted to them 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 narcoti c analgesics to mitigate pain and sedatives to reduce their suffering.Ethical guidelines urge that all patients be given quality care irrespective of their condition tho 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 practice very few things are of absolute foregone conclusion and so physicians must avoid making decisions based on the futility of the treatment. The core of CPR application cannot be based on whether the patients family signed the Do not Resuscitate order.Every other patient in the intensive care unit should be given quality care based on facts rather than assumptions. Decisions on withholding 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 forget to wa keless litigations. The medical personnel are faced with a dilemma in cases where the patients prognosis is poor and extending the natural process of dying through aggressive treatment would be futile.In such cases some family members could insist on sustaining the patients life. The medical personnel thus have no option in deciding what is beat out 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 principle demands that no form of treatment should be administered to patients without their own approval or that of their family members, except in cases of emergency where immediate intervention is required.Patients and their families have the right to disapprove any form of treatment and their wishes should be respected. These wishes should be indicated on a pen consent in form of advance directive. However, when writing the directive the pati ent may not have anticipated his present condition or he may decide to change his mind. Medical personnel are thus faced with burden of making the best 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 want 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 lethal dose to the patient while in assisted suicide the killing drug is self administered by the patient with the help of a physician.This practice is no widespread, alt hough physicians all over the world are move 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 diet and water is withdrawn. (Morton P. G (2005) Organ donation Patients in the intensive care unit requiring critical care may require an organ remove to assist in sustaining their life.Patients and family members might have advance directives which disapprove the vagary of organ transplants. Medical care givers have a difficult time determining whether a patient should receive an organ donation or not. Performing an organ transplant without the patients or familys consent could lead 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 role of a physician to apply his best judgement for the patients interest is stoped by the patients family which rejects the concept of futility. Such family members impose stupid 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 nursing 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 giving 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 towar ds the patients and the families. Before carrying out any medical treatment and procedure, nurses and doctors should get hold written consents form patients or their immediate family members to avoid ethical dilemmas which may lead to legal litigations.