Doctors and nurses are continuously involved in a variety of scenarios, some of which can be difficult to describe. One such condition is brain death, in which the patient's brain no longer functions. Given the centrality of the brain in the human body, such a circumstance is more likely to result in death. In the provided circumstance, however, the patient sustained severe brain injury but is not yet deemed brain dead. The following apply to further assess the scenario.
Ethical Problems
There are ethical problems to address in practically every brain death circumstance. Sethi & Sethi (2014) explains that the most prevailing issue in this situation is that of religious beliefs and morals. The family of the patient is most likely to consider what his religious practices call for in areas where death is pending but is yet to occur. As such, give that the patient is yet to meet the criteria for complete brain death; it will be unethical to consider him dead from a religious point of view. Still, in regards to the above, it is important to acknowledge the moral obligations that the hospital has towards the patient. It is the medical and nursing staff to take into account the patient's situation as uniquely as possible thus doing all they could to save him from being brain dead. It is only ethical that those who are in a position to save a life should do so. However, one also has to consider the quality of life for the patient. Sethi & Sethi (2014) emphasize that human beings, we all have an ethical right to live the best quality of life. The near brain death situation means the patient's quality of life is reduced significantly as there are several things that they cannot do for themselves thus are dependent on others.
Legal Issues
Legal issues play the important role of emancipating medical practitioners from any obligation or legal case that may arise from the manner in which they handle a brain dead patient. When a brain damaged patient is pronounced brain dead, doctors and nurses are allowed and protected by the law to stop further treatment and to withdraw the ventilation support systems (Burkle & Pope, 2015). This means that by law, a brain dead person is basically considered dead and as such, the medical staff has no obligation to retain treatment with the hopes of recovery. Furthermore, Burkle & Pope (2015) explains that legally, doctors have the right to withdraw all life support systems without consultation with family members. However, most will take into account what the family has to say because it is only ethically right of them. Given the understanding of the situation from the case, legally, the patient is not yet dead because he is only suffering from severe brain damage and not brain death. As such, the hospital has no legal obligation to withdraw the support system as per the wishes of some of his relatives.
Medical Care Issues
The one issue that is of concerned when it comes to medical care is when exactly one considered brain is dead. Sethi & Sethi (2014) explains that this is a complicated yet delicate matter and as such, can be a bit difficult to understand and treat. By not carefully reflecting on the patient's situation and available possibilities, medical care can either be overwhelming or short to meet the needed demands for effective recovery. It thus becomes a medical issue when determining the proper line of treatment that the hospital should give to the patient. In addition to this, there is the issue of medical care resources. The staff constantly has to consider the most effective way of implementing medical resources so as to maximize their benefits. At times, it is argued that resources can be too scarce to dedicate them in the treatment of a near or complete brain dead patient while there is another who will fully benefit from the same resources. As such, it becomes an issue when choosing how to balance which recourses to dedicate to patients such as the one in the case study and others who show positive chances of complete recovery.
Action to Take
As the hospital administrator, the actions I would take is to have the patient retained in the ICU unit with every available life support system. This is because the patient is not yet brain dead and there is always the possibility of such patients making a recovery. Therefore, it would be the right and just thing to ensure that the patient is given a chance to recover through the implementation of necessary medical treatment. At this point, I would have the finest doctors and nursing staff assigned to the patient thus leaving nothing to chance. As this is being done, I would also seek the help of a clinical psychiatrist to work with the family members. This should allow for the division to be addressed and more importantly, for them to make better decisions as a unit, should it come to the point of the patient not recovering but being pronounced brain dead. If the latter is to occur, I would like for the psychiatrist to help prepare the family to understand and accept the situation as it is. This is very important more so when children are involved thus ensuring that their own psychological well-being is taken care of.
Resources
To achieve the above, I will have to tap into the life support resources as available in the hospital. According to Goila & Pawar (2009), there are both physical and machine tests that are conducted in brain dead situation. As such, these tests will be taken on regular occasions just to monitor any form of progress from the patient. A great example is the performance of a complete neurological examination that should allow for the analysis of movements, seizures, verbal stimuli and much more (Goila & Pawar, 2009). I would also need the resource of the resident clinic psychiatrist attached to the hospital so that he/she can be readily available to attend to the family. Out of all the needed resources, the most important will be ventilation tubes and machines to help the patient breathe and thus sustain his life. At some given point, feeding tubes should be added to supply nutrients to the patient. Because he is only brain damage and his body is still functioning although not at a hundred percent, supplying it with nutrients is important so as to keep the other body cells alive and functioning.
References
Burkle, C. & Pope, T. (2015). Brain Death: Legal Obligations and the Courts. Retrieved from http://www.medscape.com/viewarticle/845463_3
Goila, A. & Pawar, M. (2009). The Diagnosis of Brain Death. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772257/
Sethi, N. & Sethi, P. (2014). Medical, legal and ethical issues surrounding brain death-the physician’s perspective. Retrieved from https://braindiseases.wordpress.com/2014/03/10/medical-legal-and-ethical-issues-surrounding-brain-death-the-physicians-perspective/
