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Posted on September 3rd, 2012, by

On analyzing the case of Marianne, a 79-year-old woman with a hemorrhagic stroke, it is important to lay emphasis that health care professionals and relatives of Marianne face an ethical dilemma concerning the further treatment of the woman. On the one hand, there is the option to keep Marianne alive, but with the little hope that she will recover all functions, while, on the other hand, there is the option of inaction that will definitely lead to the ongoing deterioration of the patient’s state and the lethal outcome. The different views of relatives on the proposed actions of health care professionals raise a number of concerns because relatives have antagonistic views and health care professionals have to make the right choice, taking into consideration not only the position of relatives, but also their professional ethics. In such a context, it is obvious that the surgery may be the best solution, but it is necessary to take into consideration the probability of the recovery of the patient after the surgery because, under certain circumstances, as children of Marianne believe the surgery is pointless.

In fact, the case of Marianne raises a number of ethical issues, but from the standpoint of health care professionals, they have to choose the proper way of action to meet the interests of the patient and her relatives. In this regard, it should be said that health care professionals have a few options, namely two options. First, the surgery can prolong the life of the patient because it can stop the progress of the disease and revive the patient for certain period. However, the patient will survive physically, but it is unlikely that Marianne will be able to recover her functions. In other words she would be hardly be able to lead a normal life and what is more, she would hardly be able to perceive adequately the surrounding world to the extent that, whereas her body will stay alive, her mind and soul will not perceive the surrounding world. From this standpoint she would be rather dead than alive. Second, the inaction, i.e. the avoidance of the surgery, is likely to lead to the death of the patient. In such a situation, health care professionals should be very careful because as long as there is a chance for the survival of the patient and her recovery, they sill have to take the chance. In other words, they should assess the probability of the recovery of Marianne’s functions accurately because, in case of error and refusal from the surgery, their actions may lead to professional negligence.

Therefore, the decision concerning the surgery should be taken only on the detailed examination and analysis of the findings by health care professionals after consultations with relatives.

At the same time, it is important to take into consideration feelings and emotions of relatives because they may play the determinant role in the decision to be taken. In this regard, both the husband and the children of Marianne do wish the best for the patient, but they have different solutions determined by different emotions. On the one hand, the husband wants his wife to survive at any cost and whatever the outcome of the survival will be. In this regard, he seems to be a bit egoistic because he wants his wife to stay alive because of his love and attachment to her, but he does not seem to assess outcomes of the surgery adequately. At any rate, he does not think about effects of the surgery on his wife. On the other hand, the children do love their mother, but they focus on the effects of the surgery and believe the surgery to be pointless. Moreover, they primarily remember about Marianne’s considerations because their position mirrors the will of Marianne.

As far as the children know their mother, she would not want to live the life she could live after the surgery. In such a way, they suppress their feelings, their love to their mother and they are ready to take a brave decision.

Furthermore, health care professionals should take into consideration their professional principles and professional ethics. In this regard, they should take care of patients, do their best for the health and life of patients. In such a context, the case of Marianne is quite controversial because health care professionals have to do the surgery to save the life of the patient. However, the surgery may prolong the sufferings of the patient and her relatives that makes the surgery pointless. In such a situation, health care professionals should focus on the position of relatives and assess adequately the outcomes of the surgery. The latter is pointless if the surgery cannot improve the health of patients and if it cannot return the patient to the normal life. To put it in simple words, the surgery is useless of the patient turns into a “plant”¯ after the surgery, instead of conscious human.

In such a situation, the benefits of the patient should be the primary concern of the health care professionals. Naturally, the husband wants to save the life of her wife because he loves her and he does not want to stay alone. On the other hand, children do know Marianne’s personal philosophy, according to which she would not like to undergo the surgery. As a result, health care professionals should act in accordance with benefits of the patient and if the surgery will not help Marianne than it will be useless.

In addition, it is important to take into consideration some alternatives. For instance, the original forecast of health care professionals may be inaccurate and probably Marianne will recover after the surgery. Therefore, health care professionals will need to conduct detailed examination to take the decision. Furthermore, probably Marianne has a will, which defines clearly her wishes concerning the actions of health care professionals in case of serious health problems, as the one discussed in the case.

In such a situation health care professionals should think of the best solution and the potential outcomes of the surgery. In this respect, it is important to focus not only on the outcomes but also on the surgery itself. For instance, health care professionals should think of the involvement of more specialists who are more qualified in such cases and probably, they will find a better solution for Marianne.

Thus, in conclusion, it is important to lay emphasis on the fact that the decision concerning the surgery should be taken by health care professionals and relatives on the ground of the careful analysis of the current state of the patient and possible alternatives to the suggested treatment.

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