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Induced Coma essay
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A  barbiturate-induced  coma, is  a  temporary  coma  which  is  brought  through  a  controlled  dose  of  a  barbiturate  drug.Barbiturate  comas  are  used  to  protect  one's  brain  during  major  neurosurgery  (such  as  the  removal  of  arteriovenous  malformations  or  aneurysms)  and  as  a  last  resort  in  certain  cases  of  status  epilepticus. Doctors  induce  coma  by  using  sedatives  to  put  the  brain  to  sleep,  the  patient's  brain  activity  is closely  monitored, and  the  level  of  drugs  adjusted  accordingly, to  guarantee  that  the  brain  stays  " asleep ."When  an  infection  or  disease  is  considered  ultimately  fatal  and  incurable  it  is  considered  to  be  a  terminal  disease. Usually  a  patient  is  recoginized  as  terminally  ill  when  his/her  life  expectancy  is  projected  to  be  six  months  or  less  and  that  person seems  likely  to  die  (because  of  that  disease)  despite  diagnosis  and  treatment. Some  cancers  are  terminal, as  are  the  advanced  stages  of  illness  like  heart  diseases, Pulmonary  Fibrosis,  a  disease  inflicting  the  lung, people  suffering  from this  illness  are  usually  in  their  forties  and  fifties,  and  Accquired Immunodeficiency  Syndrome  (AIDS).Medical  professionals  try  their  utmost  to  spot  and  treat  diseases  during  their  infancy  level.However, sometimes  the  illness  is  detected  during  the  last  stages  or  a  patient  cannot  afford  the  financial  brunt/cost  of  the  treatment. When  it  is  recognized  that  a  disease  cannot  be  cured, attention  is  diverted  to  comfort  or soothe  the dying  patient, and  at  times  treatment  efforts  are  withdrawn. The  decision  to  terminate  the  treatment  is  reached  by  the  patient  and  his  or  her  doctor. Terminal  disease  patients  often  prepare  directives  which  indicates  how  they  wish  to  be  cared  for  at  the  end  of  their  lives, and  asks  a  family  member  or  a  close relative  to  ensure  that  their  wish  is  fulfilled. At  times  these  patients  are  positioned  in  palliative  care, which  mainly  provides  relief  from  pain  and  includes  other  measures  to  make  the  last  stages  as  comfortable  as  possible. The  palliative  care  staff  try  their  level  best  to  ensure  that  their  patient  have  dignified, comfortable, fearless, and  painless death.At  times  an  individual  goes  through  an  aggressive  medical  care, which  receives  the  benefits  of  every  medication, technology, tool  and  trick  that  medical  practioners  can  devise  for  the  treatment  of  the  illness. Surgery, antibiotics, radiation  therapy, chemotherapy, dialysis  or  any  other  interventions  (with  an  aim  of  and   prolonging  life) would  be  termed  as  aggressive  care. In  some  cases  when  a  patient  is  comatose, brain  dead, or  had  acquired  unacceptable  quality  of  life, doctors  may  feel  that  an  aggressive  medical  care  is  futile. Such  patients  may  then   be  recommended  for  palliative  care.

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Medical  expenses  are  on  the  rise  and  are  consuming  a  larger  then  ever  chunk  of  personal  and  national  incomes.Almost  40  years  ago  American  spending   on  medical  care  was  estimated  to  be  5 percent  of  national  income, currently  it  is  calculated  to  be  16.5  percent. Some  observers  are  convinced  that  the  present  American  nation  is  more  meticulous  about  their  health  and, therefore, is  spending  a  bigger  share  of  their  income  on  health  care.The  rising  cost  of  health  care  is  becoming  a  matter  of   growing  concern  for  private  citizens  and  government. U.S.   healthcare  is  presently estimated  to  cost  about $2 trillion per year, out  of  this  a  hefty  $600  billion  is  never  seen  by  recipients. Today, more  than  40  million  U.S  citizens  are  without  health  insurance,  simply  because  of  unemployment  and  very  low  income  level.Therefore,  it  would  be  astute  if  a  patient  seeks  Advanced  Directive,  incase, they  are  suffering  from  a  terminal  illness.Advanced  Directives  are  instructions  in  written  form,  regarding  ones  medical  care preferences. If  an  individual  is  unable  to  make  ones  own  health  care  decisions, the  family  members  or  doctors  will consult  the  Advance  Directives  of  the  patient.Advanced  Directives  assists  in  eliminating  confusion  or  a  disagreement. Anyone  aged  18  or  above  may  prepare  it. Living  wills  are  one  part  of  the  Advanced  Directives  and  spells  out  ones  treatment  preferences  in  end - of - life  situations.In  some  states,  living  wills  are  also  known  as  "health  care  declarations"  or  "health  care  directives."Medical  power  of  attorney  (POA)  also  comes  under  Advanced  Directives,  and  is  a  legal  document  designating  a  person  who  is  one's  health  care  agent  or  proxy. This  selected  individual  makes  medical  decisions  on  behalf  of  the  patient  when  the  concerned    is  unable  to  do  the  task  himself/herself. The  proxy  makes  health  care  decisions  as  long  as  the  patient  is  failing  to  do  so, if  the  patient  regains  this  ability  the  proxy  will no  longer  make  the  decisions. In  the  case  permanent  incapacitation, the  proxy  will go  on  and  make  the  health  care  decisions  as  long  as  the  patient  is  alive, or  until  the  proxy  is  capable  of  carrying  our  the  responsibility. Advanced  Directives  also  include  a  "Do not  resuscitate  (DNR)  order,  which  is  a  request  not  to  have  cardiopulmonary  resuscitation(CPR)if  and  when  the  patients  heart  quit  functioning  or  if  breathing  is  halted.

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During  the  18th  and  19th  centuries, medical  ethics  were  launched  as  a  self-conscious  discourse, and  authors  such  as  Thomas  Percival  wrote  about  medical  jurisprudence  and  designed  the  phrase  "medical  ethics." Medical  ethics  is  the  duty  and  responsibility  of  physicians  in  antiquity, such  as  the  Hyppocratic  Oath.During  the  1847, the American  Medical  Association  adopted  the  first  code  of  ethics, which  was  based  upon  Percival's  work. Since the  1970s  the  influence  of  ethics  on  contemporary  medicine  is  increasing  and  can  be  used  in  the  Institutional  Review  Boards, which  evaluated  experiments  on  human  subjects, the  establishment  of  hospital  ethics  committees,  the  expansion  of  the  role  of  clinical  ethicist  and  the  integration  of  ethics  into  copious  medical  curriculum.            Euthanasia  is  the  process  of  painlessly  assisting  a  person  (with  terminal  illness)  to  terminate  his  or  her  life, it  is  also  known  as  asissted  suicide  or  mercy  killing, it  is  generally  performed  by  using  lethal  injections. Hyppocrates, the  father  of  modern  medicine, stated  in  400 B.C  that  he  will not  give  deadly  medicine  to  anyone  nor  will  he ever  suggest  any  such  counsel. The  doctors are  still bound  by  this  oath  to  this  date.In  some  countries  euthanasia  is  a  standard/legal  medical  practice.  In  such  states , the  aim  is  to  put  a  final  end  to  the  pain  of  patient's  suffering  fromm terminal  illnesses. Therefore, the  "Primum  no  Nocere"  is  based  on  the  inability  of  the  physician  to  offer  help.Not  responding  on  these  cases  is  considered  to  be  more  disasterous  than  relieving  the  patient  from  the  suffering. The  adequacy  to  help  depends  upon  the  limitation  of  what  the  physician  can  do.Informed  consent  in  ethics  is  the  thought  that  the  patient  must  be  thouroughly  informed  about  the  percievwed  benefits  and  threats  of  their  choice  of  treatment, as  an  uninformed  person  can  mistakenly  make  a  choice  whish  may  not  reflect  his  or  her  values  or  wishes.Terminally  ill elderly  Americans  are  treated  aggressively  and  face  death, they  spend  more  time  in  the  hospital  during  their  final  days, as  a  last  ditch  treatments  that  usually  succeeds  in  grabbing  only  a  few  days  time, and  sky  rockets  the  medical  bills  which  the  relatives  and  the  loved  ones  of  the  deceased  end  up  paying.More  than  80  percent  Americans  die  out  of  a  long  and  progressive  illness  and  above  80  percent  of  such  patients  report  that  they  intend  to  avoid  hospitalization  and  intensive  medical  care  while  they  are  dying(cited  in  the  Dartmouth  Atlas  Project,2005).According  to  Dr.Ira  Bysock,director of Palliative  care  at  Dartmouth  Hitchcock  Medical  Cemtre(2005):As  these  terminally  ill adults  are  in  a  very  ripe  age ( where  one  loses  most  of  the  stamina) , they  get  more  sick  as  they  die  and  the  treatments  become  a  burden  for  them than  the illness.

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