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Is medical futility ethical
Ethical dilemmas end of life care nurses
Chapter 38 end-of-life care
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The End of Life: In Comfort and Care video deals with various instances where patients are on their end of life journey and must make important choices, often with the support from their loved ones (End of Life: In Comfort and Care, 1999). These decisions include having the autonomy to select where they wish to pass away, whether it be in a hospital or their home, as well as if they would like to be resuscitated or be kept alive through the use of machinery. Patients may also choose if they would like to take an aggressive medical approach and attempt to prolong their life or decide against doing so. Although many patients from the End of Life: In Comfort and Care video wished to live out their last days in the comfort of their own homes surrounded by the ones they love, the …show more content…
Referring to the Medical Futility: Its Meaning and Ethical Implications journal by Nancy Jecker and Albert Jonsen, when judging medical futility, it is vital that physicians differentiate between effect and benefit in the instances of end of life care and should practice medical futility with a teleologic view in mind. Nurses and doctors have a responsibility of developing a form of logic when dealing with the frail emotions of a patient and their loved ones. Forming an idea of the way a patient perceives death is vital when assessing how the patient’s end-of-life journey should be handled. At the end of their lives, some patients may be more comfortable and accepting of the idea of dying, while others may not feel the same way. Thus, it is highly important for caregivers to figure out their patient’s thought process in order to make dealing with the process of dying a smoother
As a nursing student, I have had some exposure to death during patient care. My first encounter with direct death was witnessing a patient after attempted resuscitation efforts die in the emergency department. As I observed others reactions, I noticed I was the only one who seemed fazed by the preceding events and the end result, although I didn’t show it outwardly. During my Aging and End of life clinical rotation, I have been exposed to a near death experience with a family and I had the rewarding experience of forming a relationship with the patient’s wife during the short hour I was in their home. From reading the accounts in this book, it confirmed to me the importance of catering to the needs of the family and the dying as an important issue to address as they are critical to overall care.
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
Dealing with death on a regular basis can take a toll on a person. Being a hospice nurse will never be easy and is certainly not for the faint of heart. A hospice nurse watches patient’s health decline, often times very rapidly, and many times sit by the patient’s side as they pass away. It can be exhausting both emotionally and physically. You need to have a big heart and a strong will to help those in need for the occupation. Sara Schmidt certainly never saw herself in the profession, but discovered that she has a true love for helping people.
Through reading the essay-interview, "The Long Goodbye" by Sam Mowe, you become exposed to Katy Butler 's view on medical care and how she feels the decision-making process of end of life events should occur. Katy has experienced the death of her parents in two very different manners and used those struggles to explain her views. She believes that many people are kept alive past the point that they can live a meaningful life. Katy also expresses her opinion that palliative care is a necessity in these end of life situations so that more appropriate decisions can occur when death is near. This article also touches on how Katy Butler feels that with there being so much money in health care, personal care takes a back seat
It is important that patients and family members understand the conditions under which the patient is suffering from. People have an obligation of preparing themselves for end of live. This can be done by writing a will or an Advance Directive to guide the medical personnel and family members on what the patient wants. It can also be done by assigning a medical care proxy to decide on the patients behalf (Groopman and Hartzband, 2011). Medical personnel need to consider the patients wish and act as per the law when deciding on end-life options. Most of the decisions made by terminally ill patients are biased and compromised.
When you think of home care for a loved one, you want comfort and convenience with quality of life. A misconception of palliative care is that it is equivalent to hospice care, which concentrates on end of life. However, palliative care is now being offered to patients whether it begins early at diagnosis or throughout ongoing treatment. It is no longer limited to medical settings as more health care agencies are now offering it in home care. Think of palliative care as “comfort” care during any stage of illness.
Nonetheless, the practice of euthanasia could result in subtle pressures from those who are involved in the care of the terminally ill patients, leading to the altruistic choice of accepting it from a feeling of guilt for using scarce resources or being a burden to the family. Moreover, it is difficult to be absolutely accurate about a patient’s prognosis, even impossible to predict death scientifically. Withholding maximum treatment efforts from the terminally ill patients will result in losing the occasional patient who could have been saved, or one who could live substantially longer (Foye, 1972). Doctors have always been associated with saving lives. Administering euthanasia will compromise this role, creating fear and distrust among
End of life care in the Intensive Care Unit (ICU) can be very stressful for ICU nurses due their need to rapidly transition from curative care to end of life care, therefore the interventions they choose are very important. The qualitative study “A Study of the Lived Experiences of Registered Nurses who have Provided End-of-Life Care Within an Intensive Care Unit,” by Holms (2014), explores the experiences of ICU nurses who have provided end of life care to dying patients and their families in the ICU. End of life care according to Radbruch and Payne, is “synonymous with palliative care yet it is more specific to acutely unwell patients who require palliative care in the last few hours, days or weeks of their lives” (As cited in Homs, 2014, p. 549). Sadly, patients in the ICU are critically or terminally ill, and most are unable to plan their own end of life care. Therefore, nurses in the ICU are needed to help guide patients and family members through this process. According to Wright, “95% of patients within the ICU may not have the ability to make informed decisions” (As cited in Holms, 2014, p. 549). The discussion of end of life care in the ICU continues to be a very controversial because care is highly inconsistent due to conflicting opinions on what to base the care for the patient.
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
Euthanasia is one of the most complicated issues in the medical field due to the debate of whether or not it is morally right. Today, the lives of many patients can be saved with the latest discoveries in medicine and technology. But we are still unable to find cures to all illnesses, and patients have to go through extremely painful treatments only to live a little bit longer. These patients struggle with physical and psychological pain. Dr. Martin Luther King Jr. discusses the topic of just and unjust laws in his “Letter from Birmingham Jail” which brings into question whether it is just to kill a patient who is suffering or unjust to take that person’s life even if that person is suffering. In my opinion people should have the right, with certain restrictions, to end their lives in the way they see fit if they are suffering from endless pain.
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 care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
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 subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.
Euthanasia is ending the life of a person deliberately to relieve their pain. It usually happens when a person is terminally ill or is suffering from a lot of pain and there is no other option to relieve the pain.