"Family Wishes and Patient Autonomy"¹ Ralph Watkins, a seventy-five-year-old married man, was admitted to the intensive

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Family Wishes And Patient Autonomy Ralph Watkins A Seventy Five Year Old Married Man Was Admitted To The Intensive 1 (260.74 KiB) Viewed 11 times

"Family Wishes and Patient Autonomy"¹ Ralph Watkins, a seventy-five-year-old married man, was admitted to the intensive care unit of a university hospital in acute respiratory distress. He was anxious but fully alert and gasping for help. A retired laborer, Mr. Watkins had been suffering from a chronic pulmonary disease for the past fifteen years. For the past five years he had become progressively debilitated. Prior to admission he had been confined to his home and depended on his wife for the most basic of care: without her assistance he could not dress or feed himself. He had been a fiercely independent man and still enjoyed ordering people around. His wife and married son were totally devoted to him. The diagnosis was bilateral pneumonia, and Mr. Watkins was given antibiotics and put on a mechanical respirator with supplemental oxygen. Within two weeks the pneumonia was largely cleared and Sarah Radburn, his physician, began attempts to wean him from the respirator. Unfortunately, he had become "respirator-dependent" as a result of a combination of poor nutrition, possible new damage to his lungs, weakened respiratory muscles, and fear of breathing on his own. Despite a slow, cautious approach with much reassurance, the weaning attempts repeatedly failed. Mr. Watkins, short of breath and terrified, would demand to be placed back on the respirator. Dr. Radburn rated the ultimate chance for successful weaning as "maybe 20 percent." The patient became more and more discouraged with his lack of progress and the frequent painful medical procedures (constant intravenous feeding, frequent needle punctures for arterial blood gases, suctioning, and so on). After three weeks of unsuccessful efforts, Mr. Watkins refused to cooperate with further attempts at weaning. His wife and son became concerned that he had given up the "will to live." They begged the medical staff to "do something to save him." Although he had become less communicative, he remained alert and aware and, in the opinion of the staff, was fully competent. He told Dr. Radburn he wanted the respirator disconnected. "I want to die," he said.
Case 3 6. Briefly explain what principle might justify disconnecting the respirator and why. 7. Briefly explain what principle might justify denying his request to disconnect the respirator and why. 8. Suppose Dr. Radburn makes the following argument: "At this point, Mr. Watkin's condition will not improve. His condition will only continue to get worse. Therefore, the respirator is not a treatment. It is merely prolonging the dying process." What kind of argument is Dr. Radburn making? Or, to put it another way, this is an argument for...?