IToday in the 21st century the options for end of life care is innumerable; nursing homes, hospices, outpatient nurses, live-in aides, family support, etc. are just a few of the possible choices. Techniques and approaches regarding end of life are similar: there is surgical care; there is palliative care, living wills, euthanasia, artificial organs/replacement, “full code” as opposed to “DNR” in hospitals, etc. While some argue that more options can be overwhelming, the quality of life and end of life solutions are undisputedly better than before in American history. (1)
Until the mid 1900’s, end of life could be summarized succinctly: if you were rich and merely elderly rather than infirm, you had the means to hire attendants and support yourself well with material goods. If you were poor, you had to rely on family for care or you would be living a beggar’s life and or dwindling in an almshouse aka poorhouse, where your fellow residents ranged from drug/alcohol addicts, the mentally insane, to homeless, or criminals. In addition, if you were ill coming from a poor background, death was near certain: In 1900, life expectancy was a mere 49 years, even a statistic toward the beginning of life expectancy improvement; life spans were even shorter prior. (1), (2)
Even the rich citizen would be hard pressed to survive if sick. Antibiotics/modern medicine was not developed (Sir Alexander Fleming did not discover penicillin until 1928!) and money could only buy relief rather than remedy to illness. Today we associate churches and religion with health services such as Red Cross, and with concepts such as “sanctuary”. In the past, the church did not provide a general sanctuary to the infirm or the aged for end of life care. Certain privi...
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...ometimes suspect of ethics and morality. For example, some hospital personnel follow an informal “slow code”, where instead of attempting to rescue a patient; delays are made before aid is offered so that the incident becomes finality, avoiding prolonged care, suffering, life, truly whatever interpretation one chooses to make. (8)
Works Cited
1. http://www.4fate.org/history.html
2. http://www.nytimes.com/2006/09/27/business/27leonhardt_sidebar.html
3. http://inventors.about.com/od/pstartinventions/a/Penicillin_2.htm
4. http://www.pitt.edu/~dash/folktexts.html
5. http://www.cdc.gov/nchs/fastats/nursingh.htm
6. http://www.cancer.gov/cancertopics/factsheet/support/end-of-life-care
7. Principles of Biomedical Ethics Beauchamp, T.L.,Childress, J.F., 6th Ed, Oxford Press, 2009
8. http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2004/08/02/MNGMJ816F41.DTL
In short, euthanasia asks questions that cannot be answered from the perspective of medicine alone. The inappropriateness between assisting voluntary death and the professional ethos of physicians may mean that physicians should not assist death, except it does not necessarily settle the argument of whether anyone ever should. Acceptance for palliative care seems to be growing, but support of assisted suicide is growing also, because end of life issues are kept in the public eye. Additional empirical analysis of this situation is important. Furthermore, this debate could continue to yield insights into the issues around suffering at the end of life.
As a result, life-sustaining procedures such as ventilators, feeding tubes, and treatments for infectious and terminal diseases are developing. While these life-sustaining methods have positively influenced modern medicine, they also inadvertently cause terminal patients extensive pain and suffering. Previous to the development of life-sustaining procedures, many people died in the care of their own home, however, today the majority of Americans take their last breath lying in a hospital bed. As the advancement of modern medicine continues, physicians and patients are going to encounter life-altering trials and tribulations. Arguably, the most controversial debate in modern medicine is the discussion of the ethical choice for physician-assisted suicide.
The plague was a source of great anxiety for Christians beginning in the fourteenth century, and, though it had abated by the time of the Reformations, it was still a danger. The high mortality rate of the plague caused the church to react to it in such a way as to serve the dead more than the living (Lindberg 29). The church moved from emphasizing works of mercy to emphasizing m...
To conclude, medicine of this time was so sad that death was inevitable. They couldn’t blame the doctors or even themselves for the cause of all these diseases because they didn’t really know what to do. Doctors were experimenting and taking lives but not learning from their ineffective practices like bleeding or leeching. Religion was probably the best possible choice for that time.
Hospice focuses on end of life care. When patients are facing terminal illness and have an expected life sentence of days to six months or less of life. Care can take place in different milieu including at home, hospice care center, hospital, and skilled nursing facility. Hospice provides patients and family the tool and resources of how to come to the acceptance of death. The goal of care is to help people who are dying have peace, comfort, and dignity. A team of health care providers and volunteers are responsible for providing care. A primary care doctor and a hospice doctor or medical director will patients care. The patient is allowed to decide who their primary doctor will be while receiving hospice care. It may be a primary care physician or a hospice physician. Nurses provide care at home by vising patient at home or in a hospital setting facility. Nurses are responsible for coordination of the hospice care team. Home health aides provide support for daily and routine care ( dressing, bathing, eating and etc). Spiritual counselors, Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family. Social workers provide counseling and support. They can also provide referrals to other support systems. Pharmacists provide medication oversight and suggestions regarding the most effective
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
Palliative care is an essential to the creation of a health and wellbeing continuum for Australians living with a chronic illness. It is an approach of care that seeks to improve the life of patients and family experiencing the effects of chronic illness. Palliative care centres on the relief of the symptoms and effects of disease and incorporate the physical, psychological and social dimensions of a person at the end of life. A recent focus for the delivery of palliative care by nurses to Indigenous communities is the consideration that culture can create barriers to the provision of appropriate and beneficial care for the dying or deceased person. This essay explores the palliative nurse caring for Indigenous communities and the need to consider
Through time, there has always been a question on the idea of another supernatural being, a greater power, or a God. People have grown up and been taught certain beliefs, and some have developed their own beliefs based on this idea of a higher power. There are then those who don’t believe in any such thing; they believe in the facts presented to them. As a whole, the specifics of this idea vary, and as a nurse, understanding of this must be achieved to successfully care for a patient. Hospitals are already known to have a depressing effect on patients, then added onto that are patients who are suffering from acute or terminal illnesses. Their pain in many ways, gets passed on to the nurses who have gotten close with them through the care, with the nurses then trying to reciprocate with comfort and support. Hospitals were developed from religion, emerging from the idea of helping those in need. Through time, hospitals modernized into what is seen today, but specialty areas have still kept the purpose for an improved quality of life then for a cure. These include hospice and palliative care facilities, which are known to support a positive outlook of life during difficult times. It can then be argued that patients turn to the idea of a “higher power” as support, strength, or a peace of mind, when facing the end of their life. This argument can be supported by the behaviors and ideas seen from various religious readings, and studies of hospice and palliative care nurses. Those involved in end of life care turn to “a greater power” for a sense of peace during their lowest, and hardest of times, similar to those in religious texts.
Health care ethics is at its most basic definition is a set of moral principles, beliefs and values that guide the Physician Assistant in making choices about medical care for their patients. The central belief of health care ethics is the sense of right and wrong and the principles about what rights we possess, along with the duties as Physician Assistants we owe our patients. (Opacic, D. A. 2003) One must consider carefully all aspects of health care decisions as it helps us make choices that are just.
During the Industrial Revolution of the Victorian Era, life expectancy was so low due to the lack of sanitation, working conditions, and less medical knowledge that we have now. At the time, the average age people were dying was at 35 years old (Lambert). The age, however, varied depending on where one lived. Normally, people who lived in cities died at a younger age than people who live in rural areas. The class that one was in also greatly impacted a person’s life span. It mainly impacted poor working-class communities, because of the poor conditions that came with being a member of that class (Wilde).
Overall the need for a better based end of life care strategy is warranted globally. More of a focus should be given on care and high quality service for patients. As of now too much decision lies with the healthcare professionals and this can lead to faulty decision making because the health care providers are doing what they believe is in our best interest. In reality the patient or ourselves only have the true idea how we would like our final days to be carried out. By developing and carrying out an end of care plan we can take the decision making out of the family and doctors and place it on the patient. By all counts the need for change is apparent within the healthcare industry in regards to end of life care. By considering this unique change a great deal of improvement can be derived from this decision making process.
As patients come closer to the end of their lives, certain organs stop performing as well as they use to. People are unable to do simple tasks like putting on clothes, going to the restroom without assistance, eat on our own, and sometimes even breathe without the help of a machine. Needing to depend on someone for everything suddenly brings feelings of helplessness much like an infant feels. It is easy to see why some patients with terminal illnesses would seek any type of relief from this hardship, even if that relief is suicide. Euthanasia or assisted suicide is where a physician would give a patient an aid in dying. “Assisted suicide is a controversial medical and ethical issue based on the question of whether, in certain situations, Medical practioners should be allowed to help patients actively determine the time and circumstances of their death” (Lee). “Arguments for and against assisted suicide (sometimes called the “right to die” debate) are complicated by the fact that they come from very many different points of view: medical issues, ethical issues, legal issues, religious issues, and social issues all play a part in shaping people’s opinions on the subject” (Lee). Euthanasia should not be legalized because it is considered murder, it goes against physicians’ Hippocratic Oath, violates the Controlled
The purpose of this essay is to analyse various theories on ageing, death, dying, and end of life issues from different perspectives such as: biophysiological theories, psychosocial theories; and taking in consideration the cultural, historical, and religious implications around the aforementioned life stages. One will also discuss important issues relevant to social work practice such as dignity, autonomy, and their relationship with the concept of a successful ageing and a good death. One considers these areas important since they upheld anti-discriminatory practice and may perhaps promote the development of personalised care pathways, as well as fair and justifiable social policies.
Palliative care involves the holistic care to maintain and improve the quality of life of the patient and family during hospitalisation until the terminal stage. Palliation of care refers to the multidisciplinary approach of providing comfort and support for the terminally ill patient and family, thus has an important role in maintaining and improving the quality of life of the whole family. Chronic illness such as cancer gives a physiologic and emotional burden for the patient and family. Education and counselling of the possible options as well as treatments for pain and other symptoms that could help alleviate anxiety, suffering and discomfort. Palliative care provides assistance for the family as a channel for communication between the
Center for Bioethics: University of Minnesota. End of Life Care: An Ethical Overview. 2005. PDF.