I’ll not give because its a direct killing as opioid overdose leads to the life threteaning like severe respiratory depression, confusion, loss of conscious and in codes of ethics we have to regard the human life by not terminating his,her life.
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Evelyn
2/2/2021 07:23:38 am
Ethical dilemma here is regarding patient right to accept treatment that provide relief and harm at the same time. This is related to the ethical principles of autonomy and nonmaleficence.
Autonomy
Autonomy is clearly understood in this patient as she expresses her wishes and values and was made aware of the benefits (pain relief)and risks(hasten death) associated with therapy in a justified manner.
However, it is in conflict with the second principle, nonmaleficence, as the moral rights of patient to choose and follow their own plan of life and action will lead to harm in this patient and breached nonmaleficence, which is why the doctor hesitate and asked for pharmacist's advice.
According to standard 1 for pharmacy professional: providing person-centered care, it is essential to understand what is important to the individual and adapt to meet their needs. It is obvious from patient’s clear and rational expression that comfortable remainder life is more important to her rather than the length of lifetime, thus her choice should be respected and doctor should increase the dose.
Documentation should be done properly stating the reason of this choice and the evidence that patient is given sufficient information to make this informed decision.
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Bill Allen
5/24/2022 07:45:14 am
If the pain medicine is appropriately titrated to increase the dose only until pain relief is reached, there is little risk of inordinate respiratory suppression. This patient is not opioid naive, and probably has developed tolerance, so as long as a dramatic sudden increase is not done, there is little risk of causing death. Even if there were some risk of hastening death, the trade-off is ethically and legally justifiable. Some would rely on the doctrine of double effect to justify this ethically (I personally do not regard the doctrine as necessary). In Washington v. Glucksberg, SCOTUS distinguished this type of action from physician assisted suicide: “The same is true when a doctor provides aggressive palliative care; in some cases, painkilling drugs may hasten a patient’s death, but the physician’s purpose and intent is, or may be, only to ease his patient’s pain.".
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Pharm. Erick Philipo
10/19/2022 04:04:28 am
This is an ethical dilemma involving the patient’s autonomy that contradicts with the law governing standard provision of health services to terminal patients.
In this case a number of ethical principles are involved such as patient autonomy (i.e. the right to determination), non-maleficence (i.e. preventing harm) and finally beneficence (i.e. doing good to the patient).
The physician has given the highest allowable possible dose of the drug to patient trying to do good to the patient so that the patient can be comfortable, but also does not want to exceed this limit because he knows that he will cause harm to the patient.
Furthermore the physician and the pharmacist are both confronted with the law that does not allow them to provide therapy so that to speed the death of a terminally sick patient. They are also faced with the ethical principle that their refusal to meet what the patient wants is also denying the patient the right to decide on her fat, the patient autonomy.
The pharmacist advice to the physician would be to look for an additional anti pain drug to support the prescribed medicine so that the patient can be comfortable rather than increasing the dose above normal level. Such an action would have a legal consequence if the patient dies and somehow someone wants to follow up. The pharmacist and physician should also intensify counselling to assure the patient comfortable.
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myrtle
10/6/2023 03:20:07 am
ethical problem involving autonomy, nomalficence and beneficence
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