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Bioethics Case Study Family Wishes and Harm to the Patient Ethical Analysis Situational Awareness We are aware of the following facts in Katherines case 1Katherine is in a comatose state After arresting several times she remained comatose and presumably irreversibly unconscious After other complications her state progressed to slow multisystem failure She was beyond the capability of experiencing the burden of pain by her vegetative state 2Katherine had not made it clear by written directives nor communicated any specific instructions to her family evident by the fact they are in disagreement about withdrawing life-sustaining treatments if she ever became irreversibly unconscious and lost decision-making capacity 3The proxy in this case the family must rely on the reasonable treatment standard because Katherines wishes were never clearly communicated Following the third resuscitation and development of multisystem failure the family disagreed on further treatment determinations The consultation committee clarified options but indecisiveness persisted Agreement was eventually reached 4Proxy decisions regarding life-sustaining treatments were as follows a After second resuscitation and comatose state ventilation tube-feed dependency and long-term care facility for full treatment b Remained comatose and developed slow multisystem failure slow dying process cessation of invasive treatment but continued ventilation and feeding c Development of paralysis of the gut continue feeding 5The provider complied with the familys determinations 6Katherine died from feculent emesis and massive aspiration after only ventilation was exercised and all other treatment terminated We are also aware of the following good and bad features of the case 1Without the life sustaining treatment ie ventilator tube feeding Katherine would die and death is always bad However Katherine is comatose and the bad associated with death is reduced by the brain damage and not experienced in any way 2Life is good yet not for Katherine because her multisystem failure and comatose state effectively prevent her from experiencing life and being aware of life 3The suffering of the family is bad and opposition to any of their
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