Posted: May 27th, 2024

Research Paper: End of Life Ethics in Nursing

End of Life Ethics in Nursing

Ethical matters in palliative care frequently arise as a consequence of concerns regarding how much as well as what type of care seems sensible for an individual with a restricted life expectancy. However, there is frequently disagreement flanked by clinicians, patients, nurses, family members, along with other healthcare providers concerning what represents suitable care, mainly end of life stage (Robinson, 2005).

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For some individuals at the end-of-life, ongoing to suffer may perhaps appear inferior to death. However, observing a dying patient endure can be almost intolerable for relatives and friends. The suffering is capable of being so immense in which the alternative of ending person’s life via either physician-assisted suicide or euthanasia may perhaps appear to be a rational and compassionate choice (Davey, 2012).

Euthanasia is an action where a third-party, more often than not entailed to be a doctor, ends an individual’s life-either inertly or actively. There are some ethical dilemmas surrounding euthanasia, particularly active euthanasia. First, a clinician of responsible healthcare providers may be torn in the fact that termination of a person’s life at his/her request is moral for the reason that it is the decision made by the person. On the other hand, there is an assertion that termination of life may perhaps be acceptable in some circumstances if, and only if, there is convincing evidence in which to go on with life would remain more injurious to the individual than dying. Nevertheless, termination of life remains unethical in these days’ society for the reason that there are insufficient protections, which would permit for justice performance of euthanasia. Lastly, termination of a person’s life is at all times unethical for the reason that it infringes the ethical belief in which life ought to never be taken deliberately or the fundamental human right grants one permission not to be killed (Schneider, 2011).

From a consequentialist perspective, euthanasia is an unethical act because it does not benefit the majority, but only the individual who goes to court filing for it. A non-consequentialist approach to ethics determines the wrongness or rightness of an action based on the natural properties of the action and not its consequences. From this approach, it is ethically sound for an individual to act as he wishes as long as he/she does infringe on the freedom and rights of others. It is evident that the right to dies in itself is not unethical, but a method should be devised to ensure that even patients who are in the vegetative state give consent for euthanasia to be performed on them. This can be done by making people specify in advance in their will if they would like euthanasia carried out on them in case the quality of their life severely deteriorate (Quill, 2012).

With physician-assisted suicide, a physician offers an individual with a recommendation for drugs, in which the person could utilize to terminate his or her life. PA suicide differs from active euthanasia by the fact that the physician is not the individual physically giving the drugs.  PA suicide is merely considered by (and would just be regarded as an alternative for) patients who are cognizant and able to make their choices (Lachman, 2010).

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On the contrary to active euthanasia: -where a doctor would terminate an individual’s life, PA suicide remains a dynamic choice by a person to terminate his/her life.  However, for many people, PA suicide appears to be a practicable alternative, which would permit the chance to relinquish suffering. The main ethical disputes offered to give a good reason for PA suicide are that it: (1) Allows for patient sovereignty and self-empowerment; (2) demonstrates mercy and compassion; and (3) provides liberty from suffering (Jeffrey, 2009).

In the past, suicide has been appreciated by lots of people to be an unethical act in whichever form. However, people who believe that suicide remains an ethical alternative may perhaps still object to PA suicide for the reason that it needs physician participation. They would dispute that doctor are taught to cure illness as well as extend life; as a result, PA suicide infringes their training (Jeffrey, 2009).

Because validation of euthanasia, as well as physician-assisted suicide, has remained rampart in many countries, many authors have sought to address the employment of these methods along with the utilization of life-ending medications with no clear consent from the patient (Battin, 2007). Euthanasia and assisted suicide as well as death with no clear consent occur in diverse patient groups as well as under different events.  This is clearly elicited in many research studies. There were necessities of employment of controls in the research. Cases with no clear patient consent frequently involved those patients with impulsive end-of-life path diseases. However, even though opioids medications were utilized, misconstructions appear to keep on regarding their definite life-shortening impacts. According to Friend (2011), the permission of physician-assisted suicide and euthanasia should not be allowed. (1) It endangers the weak as well as susceptible individuals. (2) It corrupts the medical professionalism and the physician–patient relationship. (3) It compromises the family as well as inter-generational obligations. It remains disloyal to human equality and dignity by law (Friend, 2011).

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Annotated Bibliography

Jeffrey, D. (2009). Against physician assisted suicide a palliative care perspective. Oxford, United Kingdom: Radcliffe.

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This book articulates scrutiny on the reason why PAS (Physician Assisted Suicide) should not be allowed in England. The author considers that PAS is unnecessarily a distinguished mode of dying. The author elaborates on the anguish that patients experience during PAS. Jeffrey describes the way PAS infringes healthcare ethics as well as how the process may be misused by healthcare providers if permitted. To support his points, then author gives cases of terminally ill patients of the reasons for choosing PAS. This book remains important on the reasons why PAS should be criminalized (Jeffrey, 2009).

Lachman, V. (2010). Physician-assisted suicide: Compassionate liberation or murder. MEDSURG Nursing, 19(2), 121-125.

The author of this article elaborates on the significance of PAS. Lachman evaluates the way PAS will impact on nurses’ morals. She asserts that most nurses respect patient’s life while some it is patient’s right to end his or her life.  This article remains significant for both side’s argument of PAS (Lachman, 2010).

Battin, M. P. (2007). Legal Physician-Assisted Dying in Oregon and the Netherlands: Evidence Concerning the Impact on Patients in "Vulnerable" Groups. Journal of Medical Ethics 33, 591.

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This article talks about the impact of authorizing PAS. The journal relates this to the Oregon state and Holland where this process is legalized. It is clear that there is no risk for aged, uneducated or those with low education, HIV patients, and women. In my opinion, this article demonstrates enough evidence for the negative effects of PAS legalization. This journal remains useful as a critical resource for the PAS authorization (Battin, 2007).

Friend, M. (2011). Physician-Assisted Suicide: Death with Dignity? Journal of Nursing Law 14(3), 110-116.

Friend summarizes what PAS is as well as the insinuations of this process form the viewpoint of nurses. Also, the author provides analysis on the way this thought was even planned. The article portrays how the U.S. might soon be like the Holland in the authorization of this process entirely. This piece of writing will give grounds why people disprove PAS. The article gives more present outlooks and analysis on PAS (Friend, 2011).

Schneider, K. (2011, June). Dr. Jack Kevorkian Dies at 83; a Doctor Who Helped End Lives. The New York Times.

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Schneider narrates Jack Kevorkian’s life, a physician who is perceived as an imperative figure in the PAS debate, after he assisted many patients die. This piece of writing tells of the time the physician first turned out to be renowned, more than a few individuals that he assisted in dying and the numerous trials he was assumed that led for his conviction in the year 1999.  This article remains important in the argument of PAS for the reason that it illustrates the way PAS first turned out to be a popular debate (Schneider, 2011).

Quill, T. E. (2012). Physicians should “assist in suicide” when it is appropriate. The Journal of Law, Medicine & Ethics, 40(1), 57-65.

This article covers the state that Physicians Assist Suicide (PAS) is supposed to be permitted at the time the suitable period is reached. The source offers five important grounds why PAS is supposed to be consented to be employed in specific states. Timothy E. Quill is this article’s writer. However, his career has incorporated being employed as a PHC (primary Health care) doctor and has as well aided numerous patients to die peacefully. I have chosen this article for the reason that it offers as firsthand opinion of a doctor who has aided many patients in the committing suicides. On the other hand, the article offers proof, which assists in supporting the thesis of general authorization of PAS. Also, it provides within proof in contradicting my notion. The source remains tremendously current that offers a number of the up-to-date proof in PAS. This currency has to do with my proposition for the reason that it offers definite indication from a doctor who has done aided suicide to terminally ill patients and maintains the entitlement for PAS. In actual fact, I found this article by searching in the EBSCOHOST database with the use of the keyword physician assisted suicide.

Davey, M. (October 24, 2012). Doctor slams 'arrogance' on euthanasia. Sydney Morning Herald, Sydney, Australia. Retrieved on Sep 27, 2016 from www.smh.com.au/federal-politics/political-news/doctor-slams-arrogance-on-euthanasia-20121023-283l8.html

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A primary Health Care (PHC) doctor in Sydney outlined Julia Gillard, the Prime Minister and Barry O’Farrell, the New South Wales (NSW) Premier, as arrogant. However, his claim was supported by a board member, David Leaf, in decriminalizing euthanasia. He specified that aided dying programs functioned, devoid of indication of discriminating threat for groups well thought-out as susceptible to euthanasia, comprising of uninsured, the elderly, underprivileged, physically incapacitated and psychologically ill. On the same note, Mr. O’Farrell intensely was against euthanasia besides Ms. Gillard was concerned that it would lead to the mistreatment and conceivably heartlessness on persons in the EOL (end stage of life). The latter also supposed that there were unsuitable protections to guard susceptible persons from employing euthanasia as a way to get them out of their “miserable” states. In a number of the United States, for instance Oregon, Washington State, and countries like Belgium, the Netherlands, Switzerland, Luxembourg, and Montana are the single state and nation, which has legalized euthanasia. Furthermore, they entirely have safe laws. Many people have extremely diminutive acknowledge of the matter but then they have a duty-bound to appreciate the subject as a minimum get it from a therapeutic point of view. This article demonstrates that many persons do not understand what euthanasia is as well as what it is capable of doing for the future.

Robinson, B.A. (2005). Euthanasia and Terri Schiavo. Religious Tolerance, Ontario Consultants on Religious Tolerance. Retrieved on Sep 27, 2016 from http://www.religioustolerance.org/schiavo6.htm

The author in this article brings up a 41-year-old Terri Schiavo who is incapacitated living in Florida, the U.S. The author points out that Schiavo was the centerpiece on euthanasia matter. The entire emphasis remained on whether to leave her alive or let her to die. Robinson (2005) elucidates what resulted to her disability, the management then, and up to the supposition that kind led entirely types of impediment. Physicians supposed that Schiavo was in a tenacious vegetative state, stating that patients in this condition lack cohesive purpose of the cerebral cortex at the same time as remembering instinctive reflexes of brainstem, which control circulatory, heart rate, sleep, and digestive besides other involuntary functions. In actual fact, their conducts are involuntary, non-decisive, dissolute reflexes no longer controlled by higher brain-centers. The article demonstrates an instance of euthanasia. It continues to show the way it is hard for healthcare practitioners at the time of making decisions, particularly of another person. In case somebody is in this dilemma, the best solution is to let the individuals die, no matter hurtful it will be.

 

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References

Battin, M. P. (2007). Legal Physician-Assisted Dying in Oregon and the Netherlands: Evidence Concerning the Impact on Patients in "Vulnerable" Groups. Journal of Medical Ethics 33, 591.

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Davey, M. (October 24, 2012). Doctor slams 'arrogance' on euthanasia. Sydney Morning Herald, Sydney, Australia. Retrieved on Sep 27, 2016 from www.smh.com.au/federal-politics/political-news/doctor-slams-arrogance-on-euthanasia-20121023-283l8.html

Friend, M. (2011). Physician-Assisted Suicide: Death with Dignity? Journal of Nursing Law 14(3), 110-116.

Jeffrey, D. (2009). Against physician assisted suicide a palliative care perspective. Oxford, United Kingdom: Radcliffe.

Lachman, V. (2010). Physician-assisted suicide: Compassionate liberation or murder. MEDSURG Nursing, 19(2), 121-125. Quill, T. E. (2012). Physicians Should "Assist In Suicide" When It Is Appropriate. The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 40(1), 57-65.

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Quill, T. E. (2012). Physicians should “assist in suicide” when it is appropriate. The Journal of Law, Medicine & Ethics, 40(1), 57-65.

Robinson, B.A. (2005). Euthanasia and Terri Schiavo. Religious Tolerance, Ontario Consultants on Religious Tolerance. Retrieved on Sep 27, 2016 from http://www.religioustolerance.org/schiavo6.htm

Ruth, C. (2012). Encyclopedia of science, technology, and ethics: Euthanasia. Ed. Carl Mitcham. Vol.2. Detroit, MI: Macmillan Reference USA.

Schneider, K. (2011, June). Dr. Jack Kevorkian Dies at 83; a Doctor Who Helped End Lives. The New York Times.

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