Ethics

In the case provided, there is certainly a conflict between the patients family and the attending physician. The sources of the conflict were obvious however, before going to discuss everything it seemed necessary to point out some facts of the case to establish the background. The patient, Mrs. Cranberry is an 84 year old married woman. Prior to her hospital admission due to severe abdominal pain, she was suffering dementia and has recently suffered a decline in both cognition and health. All throughout, her husband was her principal caregiver. Just very recently, she fell while she was trying to get out of bed and suffered broken hip. As a result her health began to rapidly deteriorate. Her physical tests revealed that she had a bowel obstruction to which she was subjected to surgical operation. Four days post-operatively the patient is still on ventilator despite many attempts to wean her from it. Given the patient condition, her husband who is also her of attorney decided to request the physicians attending to his wife to remove the ventilator and let her wife die a peaceful death. But his request was turn down.

In the above situation, the conflict lies in the context of sensitivity and insensitivity on both parts. It appears that the physicians are insensitive to the feelings of the patients family members who cannot afford to see their love one prolong the sufferings in view of what they see as a hopeless condition. They considered further treatment as merely extending the beating of the patient heart but the patient is already brain dead. On the physician side, they would precisely argue that their duty is to save lives even it that life in no longer worth it to live. They do not care about how the patients family looks upon the situation. Apparently the conflict between Mr. Cranberry and the attending physician is there is the way they looked at the patient condition. The patients family insists its hopeless to continue further treatment as the patient is brain dead already, but the physicians argues the patient condition is still treatable.

The source of this conflict is not primarily the sworn in duty versus the moralethical assertion that life is precious and that no one has the right to take it, but God. The potential of the conflicts  includes the physicians sworn duty of course, the notion that it is a crime to take someone elses life, and perhaps the religious ideas that life is sacred on the part of the physicians, versus the power of attorney which Mr. Cranberry has for the patient. Obviously, Mr. Cranberry was prepared for the worst case scenario as he was able to secure such document attesting his wifes wish for her life. This special authority that grants him privilege request for euthanasia seemed is one of the potential source of conflict because it obviously challenged the physicians authority. The challenge that it poses is that, it undermines their authority.  Of course the moralethical issue is also a potential source of conflict because doctors insist life is so precious. This is in conflict with the thoughts and feelings of the patients family members.

The role of potential consultant is very important in this situation because it will facilitate the resolution of the case. Apparently, the conflict lies on moralethical ground which doctors stands for. Both side cannot make a decision as fast as it can without satisfying each requirements because it will only lead to bitter arguments. The case requires potential consultant in order to guide the course of creating solution to the conflict.

This ethical dilemma requires mediation in the since that issue no longer involves who is right and who is wrong as both are right. Physicians are right in the context of their sworn duty but the patients family was also right considering their concern and love for the patient. In mediating to this kind of situation, there are some interests that need to be satisfied before any concrete decision is made.

According to Douglass Noll in his article titled Bioethical Mediation Peacemaking and End of Life Conflicts, decision in this kind of situation is very difficult therefore it should be based on a respect for all of the people affected, respect for their interests, and on the rights of patients and families. Noll explained that mediation on this kind of conflict should bring differences of opinion and belief out on the table where they can be constructively discussed and respected.

This is not to say that the patients family members do not believe in the moralethical argument, rather the issue concerns about their feelings. So the main source of conflict concerns about who really has the right to decide. The doctors argue they are because they have a sworn in duty, while the patients family insists they cannot carry anymore to see their love one suffers more when knowing that her case was already hopeless

In mediating to the conflict between the Cranberry family and the attending physicians it is very important to understand the entire medical situation. The relevant information such as the diagnoses of the patients condition prior to hospital admissions, and during confinement in the hospital regarding her rapid deteriorating health plays an essential rule in the condition being discussed in this paper.  This case is very important to get the side of the patients family and to satisfy them that their story has been told and heard completely, and to try to relate to their feelings. It is also necessary to get the physicians side and try to find common ground between the sides.

In making a decision, it is highly advisable it that the decision maker has as Mark Aulisio noted, a basic familiarity with the clinical context and the local healthcare institution within which consultation takes place (210). This implies the need to consult each party involved in order to make a more informed opinion on the case for actual decision making. David Perlman stressed that the goal of mediation is to transform parties initial positional stances to a conflict or uncertainty into shared opportunities for dialogue and resolution (p. 3). It means that the parties concern will be given sufficient time to narrate their stories with out interruption.

In judging the present condition of Mrs. Cranberry, a careful analysis of the patient condition should be observed. Robert Orr of the University of Vermont asserts that the mediator should pose questions, clarify answers, reframe issues, express empathy or look for creative options for resolution, but assiduously avoids taking sides (45). This made it clear that mediator in such a conflict should be professional and skilled in this aspect. The goal of the mediator should be to help both sides so that they can reach their own resolution on the case.

Going back to the case of Mrs. Cranberry, as mediator, I will faithfully follow the important guiding principles towards coming up with a new resolution. First, I will carefully evaluate each side of the parties involved in the case and let them speak out their arguments. So the question that needs to be answered is that is basically the why.  However, I need to remind my self that where there is interaction between individuals, there is always a potential for conflicts. That is, the goal of letting each party speak up is to find a common ground where their argument can be satisfied. Second, I should explore the concepts of the five layer pyramid in order to form the theoretical basis of the resolution on the conflict identified. This include on the first level, breathing, food, water, sex, sleep, homeostasis, excretion. Indeed the first two levels from the base are the key issues of the conflict that need to be satisfied before making a resolution.

The third lines represent the influences that affect the two parties as they are the strongest consideration to determine the nature of the conflict. The top portion speaks about the high concerns of both sides. Given therefore the context of the pyramid there is great potential that solution to the conflict is easier to apply especially that conflict is now identified. As a mediator however, I understand that my role is not to make a decision for the parties in contention. Bernard Mayer cited that a mediator does not make a decision or impose a solution but rather assists the disputants as they attempts to find their way through the conflict (p. 191).

In other words, my job is simply to guide them towards mutual understanding regarding the issue. The parties involve in this case are both the husband and wife. It can be recalled that the husband carries with him a power of attorney regarding the wishes of his wife which mean that the husband has the right to decide. The power-of-attorney is a public document and therefore its authority emanate from the states. On the other hand, the physicians view that the patients have the rights to life is also true. However the case is not easy as anyone could not just simply tell Mr. Cranberry that everything is alright. Therefore, as mentioned partly earlier, facilitation of the conflict resolution requires certain type of process and impersonal skills for ethics consultation.

Finally, I will attempt to mediate the conflict by consulting with the local state officials and hospitals whether euthanasia is allowed by the state law, or if the hospital allows it. If they dont, it will be a criminal offense to practice euthanasia and therefore punishable by law. In this case there would be no mediation. However if they did, I will consult with the Hospital officials to get their side of the issue, and then talk with the patients family to hear their side, and finally, the doctors. I will evaluate their views and after finding possible point of communication, I will discuss it with them a try again to find a common ground where they can work on some ideas that will help them resolve the issue. In the meantime however, the most important is that they should maintain respect for life, for each other, and for the patient.