In the United States, around 7 million people die every day from various illnesses. Most of the deaths are end-of-life cases. As people age, many ethical dilemmas can affect the elderly population. Ethical dilemmas can be difficult situations that have many biases when making decisions. The ethical dilemma that is an issue for many older adults is end-of-life care. Many elderly patients who have terminal illnesses have end-of-life care that is in their decision-making or their power of attorney. The ethical dilemma with end-of-life care is who is making the decisions (Adkeniz et al., 2021). The goal of end-of-life care is to prevent or relieve suffering while respecting the patient's desire. Many patients who have end-of-life care dilemmas have not placed anything in writing about how they want their end of life to be. Word of mouth is not equivalent to decisions in writing. Family …show more content…
Patients who can still make decisions should be able to maintain their autonomy. Decisions made by the patient should come with every possible option discussed by physicians and nurse practitioners about their current health state and decision to prepare for the end of life care. If the patient cannot make those decisions for themselves, there must be a power of attorney to make decisions on the patient's behalf. Family members can be impacted by end-of-life care if the patient has not appointed a person to make decisions. There have to be plans for healthcare, funeral arrangements, distribution of any monetary assets, and everything else that the patient has of value. The ethical dilemma for the nurse practitioner is making the best decision for the patient while maintaining the integrity and dignity of the patient. NPs play a role in symptom management and can work with doctors in advanced end-of-life situations. The NP can assess and advise on if the patient needs to go to
In What Dying People Want, Kuhl comments, "Dying involves choice"(xviii). People choose what they wear, what they do, and what they will eat on a day to day basis. Choosing how, when, or why sick people die is just like an everyday decision for them. This however, has not been accomplished by some individuals in this Country. Americans have the right of choice. When a patient communicates the desire to die, the inspection of acceptability for palliative care begins instantly. Inspections include evaluation of pain management, depression, anxiety, family burnout, spirituality and other observed issues (Baird and Rosenbaum 100). When working or living with an elder, never ignore the words "I want to die". If this is ignored, that person will not receive their wishes they deserve. Countries are starting to understand that people should be able to die if they choose, "In the United States there are assisted dying laws restricted to terminally ill and mentally competent adults" (Firth). The assisted dying law is only in Oregon, Montana, Washington, Vermont, and California. That is five states out of fifty states. This must be expanded to all fifty states because all individuals have the right of this law. In 2013, Vermont passed an "End of Life Choices" bill. This bill allows terminally ill people to get
The 4th amendment provides citizens protections from unreasonable searches and seizures from law enforcement. Search and seizure cases are governed by the 4th amendment and case law. The United States Supreme Court has crafted exceptions to the 4th amendment where law enforcement would ordinarily need to get a warrant to conduct a search. One of the exceptions to the warrant requirement falls under vehicle stops. Law enforcement can search a vehicle incident to an individual’s arrest if the individual unsecured by the police and is in reaching distance of the passenger compartment. Disjunctive to the first exception a warrantless search can be conducted if there is reasonable belief
We consider the legislation consistent with the principle that "respect for that person [who is capable of participating] mandates that he or she be recognized as the prime decision-maker" in treatment. [2] The patient is a person in relationship, not an isolated individual. Her or his decisions should take others into account and be made in supportive consultation with family members, close friends, pastor, and health care professionals. Christians face end-of-life decisions in all their ambiguity, knowing we are responsible ultimately to God, whose grace comforts, forgives, and frees us in our dilemmas.
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
The American Nurses Association (ANA) thinks that nurses should stay away from doing euthanasia, or assisting in doing euthanasia because it is against the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001; herein referred to as The Code). Overall, nurses are also advised to deliver a quality of care what include respect compassion and dignity to all their patients. For people in end-of-life, nursing care should also focus on the patient’s comfort, when possible the dying patient should be pain free. Nurses have also the obligation to support the patient but also the patient’s family members during these difficult moments. We must work to make sure that patients and family members are well informed about every option that is
The right to assisted suicide is a significant topic that concerns people all over the United States. The debates go back and forth about whether a dying patient has the right to die with the assistance of a physician. Some are against it because of religious and moral reasons. Others are for it because of their compassion and respect for the dying. Physicians are also divided on the issue. They differ where they place the line that separates relief from dying--and killing. For many the main concern with assisted suicide lies with the competence of the terminally ill. Many terminally ill patients who are in the final stages of their lives have requested doctors to aid them in exercising active euthanasia. It is sad to realize that these people are in great agony and that to them the only hope of bringing that agony to a halt is through assisted suicide.When people see the word euthanasia, they see the meaning of the word in two different lights. Euthanasia for some carries a negative connotation; it is the same as murder. For others, however, euthanasia is the act of putting someone to death painlessly, or allowing a person suffering from an incurable and painful disease or condition to die by withholding extreme medical measures. But after studying both sides of the issue, a compassionate individual must conclude that competent terminal patients should be given the right to assisted suicide in order to end their suffering, reduce the damaging financial effects of hospital care on their families, and preserve the individual right of people to determine their own fate.
One of the greatest dangers facing chronic and terminally ill patients is the grey area regarding PAS. In the Netherlands, there are strict criteria for the practice of PAS. Despite such stringencies, the Council on Ethical and Judicial Affairs (1992) found 28% of the PAS cases in the Netherlands did not meet the criteria. The evidence suggests some of the patient’s lives may have ended prematurely or involuntarily. This problem can be addressed via advance directives. These directives would be written by competent individuals explaining their decision to be aided in dying when they are no longer capable of making medical decisions. These interpretations are largely defined by ones morals, understanding of ethics, individual attitudes, religious and cultural values.
It is found that nurses report that their most uncomfortable situations come with prolonging the dying process and some struggle with ethical issues by doing so (Seal, 2007). Studies have shown that implementation of the RPC program and educating nurses have increased the nurses’ confidence in discussing end-of-life plans (Austin, 2006). With confidence, the nurse is able to ask the right questions of the patient and make sure that the patient’s wishes are upheld in the manner that they had wanted, such as to not resuscitate or to make sure their spiritual leader is present when passing (Austin,
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...
The first definition of ethical in the dictionary is “pertaining to, or dealing with morals or the principles of morality; pertaining to right and wrong in conduct.” The first definition Dilemma is defined as “a situation requiring a choice between equally undesirable alternatives.” Using these two definitions, an ethical dilemma can be defined as when a person has to choose a decision that goes against one’s morals. One alternative may have a negative impact on one’s life or another person’s life. Another alternative may be an excellent choice for one person but may have negative impacts as well. Therefore, an ethical dilemma often puts ones morals and values into question. This paper will review a case study of euthanasia,
One of the many concerns is allowing incompetent individuals making this irreversible decision, which is why, “all have agreed that this end-of-life option should apply on to competent individual’s”(113). In addition, people opposed to this method argue that patients demanding this process are suffering from depression and not able to make decisions; yet, Rosenfled explains that practitioners most ensure that patients who consent to this medical intervention do it voluntarily, knowingly and
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
Any discussion that pertains to the topic of euthanasia must first include a clear definition of the key terms and issues. With this in mind, it should be noted that euthanasia includes both what has been called physician-assisted "suicide" and voluntary active euthanasia. Physician-assisted suicide involves providing lethal medication(s) available to the patient to be used at a time of the patient’s own choosing (Boudreau, p.2, 2014). Indifferently, voluntary active euthanasia involves the physician taking an active role in carrying out the patient’s request, and usually involves intravenous delivery of a lethal substance. Physician-assisted suicide is felt to be easier psychologically for the physician and patient than euthanasia because