Palliative Care

I believe you talk about palliative care which health care focuses on relieving and preventing the suffering of patients. In the palliative care, the multidisciplinary team includes physicians, pharmacists, nurses, chaplains, social workers, psychologists, and other allied health professionals in formulating a plan of care to relieve suffering in all areas of a patient's life and to improve a patient's quality of life (Hill, 2007).

In the clinical practice in Intensive Care Unit today, Mr. Zhang, 40 years old Chinese was in a coma and on life support due to a car accident 5 days ago. As the patient's wife approached the bedside, the alarms of the monitors for the cardiac and arterial catheters sounded, indicating a cardiac arrest, and cardiac pulmonary resuscitation (CPR) was initiated. The stunned wife was lead into a private waiting room, although she desperately wanted to stay with her husband. Her request was refused because family members' access to loved ones during CPR is restricted as per hospital policy and procedure in all adult critical care units in Flushing Hospital. Unfortunately, twenty minutes later, Dr. Thomas explained to the patient's wife that Mr. Zhang did not survive despite medical team's efforts. I am a Chinese and total understand that in Chinese Culture, not only do families always stay supporting their love one at the final moment, but it gives survivors peace of mind as their life goes on. The patient's wife was devastated. She passed out. Then, medical team started to work on the wife. Ms. Zhang deeply regrets losing the opportunity to see her husband again before he died. I find myself in the midst of challenging ethical situations that involve conflict between the needs of critically ill patients, the patient's family members and health care providers who initiate and manage resuscitation measures. Family presence during CPR is a relatively new issue in healthcare. Does an overriding obligation exist to honor the desires of the family or the desires of the healthcare providers?

Some patients said that they felt safer and less afraid with family members present. However, other patients reported that they preferred to face death alone and did not want relatives to invade their privacy. From my prospective, patients' preferences are key components within the clinical ethical analysis and should be accounted.

From ethnical perspective, the principle of beneficence refers to do good , no harm. This priority to do good makes an ethical perspective and possible solution to an ethical dilemma acceptable. This principle is also related to the principle of utility, which states that we should attempt generate the largest ratio of good over evil possible in the world. This principle stipulates that ethical theories should strive to achieve the greatest amount of good because people benefit from the most good. Ethical decision making is required