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Medical Ethics: Disease History



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    The discussion on Patrick Dismuke’s condition concentrated on his incapability to improve. After reviewing his symptoms and considering possible scenarios resulting from certain kinds of treatment, such as the tube that delivered nutrients into his veins that “broke the barrier between blood and air” and became “a bacteria-laden Trojan horse, opening the door to infection”, we attempted to come to a consensus on what would constitute a quality life, as deliberated among the committee. We took into consideration that after every kind of surgery, his status would be temporarily improved but ultimately decline in keeping with his body’s proclivity. We acknowledged that the idea of a successful stomach transplant was remote since, as described, it had only been performed in Russia and a few times in Canada on animals; in addition, Patrick was short of being physically capable in dealing with this sort of procedure.

    For a number of years, these doctors treated Patrick in the hopes of one day seeing him live a life of quality that was tantamount to other people his age. Collectively, we conceded that a life of quality should be extended, but then the question was posed: at the moment, what is the quality of Patrick’s life? We agreed that a lack of an immediate family support structure was a misfortune for him. It was disappointing for his mother to demonstrate passive care and interest for her son. However, he was embraced by the hospital community and this support structure enabled us to think that this relationship compensated for the initial void. For me, it would’ve been easier to think of Patrick as incapable of being an individual comprised with a diverse mix of emotions and ambitions. He assimilated the idea that he could associate with other kids by eating at McDonalds. As the book mentions, just the thought of eating out appealed to him more than actually eating (because, of course, he was unable). He was known as a prankster and sold drawings for a quarter. It was extremely difficult assessing his situation knowing that he was fully aware of his emotions and was routinely in search of a therapeutic outlet. It wasn’t like he was a vegetable. Ostensibly, it would seem that for all intents and purposes, he might have done anything to enhance his livelihood and of those surrounding him. More accurately, however, his actions proved that he wasn’t completely ready to die.

    Patrick’s quality of life was an important issue to understand before determining whether he should have been placed on DNR. Given his status that was detailed within the committee, I felt that Patrick should have been placed on DNR due to linear complications within his body that just prevented him from ever gaining a chance to be at peace. From a series of surgeries that had gradually eaten away at his intestines to a number of feverish reactions to intense medications, Patrick should have been allowed to have the dignity in dying of natural causes. Informing him on this I think would have been an integral part in preserving his dignity, so I believe that he should’ve been subjected to some of the doctors’ plans. However, it should’ve been demonstrated in a way that respectfully avoided direct confirmation. Patrick was 15 and had a rational mind to understand his situation.

    Taylor was a more complicated figure. There was a brief moment where she displayed signs of improvement. Dr. Crandall kept emphasizing that the prognosis was not good, yet it wasn’t impossible for her to make a recovery. Crandall’s approach, I believe, was necessitated by the Poarch family’s unmitigated solidarity that didn’t so much require the assurance of Dr. Adcock (though it was enormously important) as much as they needed a doctor to tell them that he or she was going to do everything he or she could do to save Taylor. As a result, the parents were afforded the time to see whether what they had decided for their child was an appropriate measure. Who’s to say that some of the complications with Taylor weren’t attributable to Dr. Adcock when the book mentioned that Taylor had undergone breathing inconsistencies in the ventilator while under Adcock’s watch? In the end, Crandall proved to be the better care taker, despite her sense of detachment from the family. Supportive Protocol I indicated that Taylor wouldn’t be wean from the vent, wouldn’t receive drugs or CPR if she had gone into cardiac arrest or pulmonary arrest. If, in fact, Dr. Crandall had suggested to them that the prognosis for the baby was steady enough for recovery, any decision to have had Taylor on the Protocol should have been rescinded, initially. However, Taylor’s complications with her lungs triggered the complications with her kidneys, as well as her brain. In the end, if Protocol was enforced, it could’ve possibly interfered with a natural occurrence. The legitimacy in recognizing it as a natural occurrence could’ve possibly segued into debate, however, Taylor’s present condition was unfolding from the moment she was born 25 weeks premature.

    Medical Ethics: Disease History. (2019, Jan 27). Retrieved from

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