Ethical Dilemma in Terminally Extubation
Ethical dilemma is a state of urgency where more than one consequences of an ethical decision seem to oppose another (Zastrow & Kirst-Ashman, 2009). In other words, the consequences of making or implementing a certain decision would adversely violate the integrity of a different thing. Ethical dilemma is very difficult for medical officers on especially issues related to poor prognosis of patients in the intensive care unit (ICU) and provision of palliative care for dying patients. The most prominent issue at the ICU is deciding on terminal extubation of patients exhibiting poor prognosis (Curtis & Vincent, 2010; Abernethy, 2012). The complexity of this medical procedure is the existence of different standards that support terminally extubation. Any decision to any standard must be supported with sufficient reasons. Several factors affect all these standards. Some of these factors are beyond the control or knowledge of the physician and are the source of dilemma to physicians. They include right to life, priority to protect the life of the patient, patients’ confusion, vulnerability of the patient, patient wishes, family interference, financial issue, interpretation of the law, and different view of the appropriate decision among physicians (Chotirmall et al., 2010; Lamba and Quest, 2010; Abernethy, 2012). All these issues can affect different decision at different intensities and requires the highest degree of professional skills and ethics to come up with the most appropriate decision (Curtis and Vincent, 2010). Family members always face dilemma when they are required to support the doctors or patients’ decision on terminally extubation or palliative care for dying patients (Lamba and Quest, 2010). Since these factors are many and varied, one may affect the integrity of the other that is equally important resulting to a situation of ethical dilemma/conflict.