Having six months or less to live or having an illness in which patients finds themselves faced with a decision on how they are going to spend those remaining days are issues that arise in the healthcare setting. For some it is making lasting memories with their loved ones, while for others it is trying to hasten their own death. Dilemmas have been encountered by hospice workers concerning the ethical and unethical issues of patients they are caring for when choosing alternatives rather than palliative. Palliative care is specialized medical care for people with serious illnesses. It is focused on providing patients with relief from the symptoms of pain and stress of their illness while providing comfort measures. The goal is to improve quality of life for both the patient and their family Making the Case (2014) Retrieved from http:www.capc.org. Palliative care is provided in a hospice setting or in one’s own home during his or her dying days. In a study of end-of-life care done in the United States it was found that patients in hospitals often do not have their needs for pain management or treatments provided to their full potential (Connor, 2007-2008, P.93). When a patient is suffering or they just don’t want to deal with waiting to die, they choose to take matters into their own hands by either Voluntarily Stop Eating and Drinking (VSED) or Patient Assisted Suicide (PAS). This paper will explain the ethical and unethical dilemmas that are presented in a hospice environment when dealing with VSED and PAS.
Cicely Saunders helped launch the first U.S. hospice in Branford, Connecticut. In 1973 it started treating patients at home. Hospice care has been considered as “appropriate care” with both palliative care and medications. Ph...
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...urary/February). The Continuing Challenge of Assisted Death. Journal Of Hospice And Palliative Nursing, 6, 46-59.
Harvath, T.A., Miller, L.L., Smith, K.A., Clark, L.D., & Jackson, A. (2006). Dilemmas Encountered by Hospice Workers When Patients Wish to Hasten Death. Journal Of Hospice And Palliative Nursing, 8.
Landrigan, B. (2012). Health providers need to stress importance of advance care planning. Clinical Journal of Oncology Nursing.
Oregon Death With Dignity Act-2013. (n.d.). Retrieved April 1, 2014, from Oregon Public Health Division website: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year16.pdf
Schwartz, J. (2007). Exploring the Option of Voluntarily Stopping Eating and Drinking within the Context of a Suffering Patient’s Request for a Hastened Death. Journal Of Palliative Medicine, 10, 1288-1297.
The boundaries of right to die with dignity are hard to determine. Keeping the terminal patient comfortable is the purpose of comfort care, however there could be a very thin line between what we consider terminal sedation and euthanasia. In theory, comfort care is quite different from euthanasia. Keeping the patient comfortable and letting the nature take its course is at the core of comfort measures (Gamliel, 2012). Yet, the line between keeping comfortable and facilitating death is often blurry. Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering (Gamliel, 2012). The purpose of this paper is to highlight the ethical issue of keeping comfortable vs. hastening death, and the ethical principles involved. Facilitating or hastening death is considered unethical or even illegal.
In 1994, Oregon passed the Death with Dignity Act. This law states that Oregon residents, who have been diagnosed with a life ending disease and have less than six months to live, may obtain a lethal medicine prescribed by a physician, which would end their life when and where they chose to do so. This law or act requires the collection of data from patients and physicians and publishes it in an annual r...
Being in hospice care is a better alternative than being stuck in the hospital to try to avoid the unavoidable. Common misconceptions about Hospice could include that hospice makes life more miserable; however, a physician expressed his findings in Hospice,“You can only fail a patient if you fail to understand and respond to their needs. We may not be able to cure all of our patients, but if we can make them comfortable in the last moments of their lives, we will not have failed them”..Hospice care gradually emerged in the 1970s, when groups like the National Hospice Organization were formed “in response to the unmet needs of dying patients and their families for whom traditional medical care was no longer effective.”Herbert Hendin, an executive director of the American Suicide Foundations illustrates a story of a young man diagnosed with acute myelocytic leukemia and was expected to have only a few months before he died. He persistently asked the doctor to assist him, but he eventually accepted the medical treatment. His doctor told him he can use his time wisely to become close to his family. Two days before he died, Tim talked about what he would have missed without the opportunity for a
Office of Disease Prevention and Epidemiology. (n.d.). Frequently Asked Questions: Death with Dignity Act. Oregon Health Authority. Retrieved October 7, 2011, from http://public.health.oregon.gov/PROVIDERPARTNERRESOURCES/
Imagine, if you will, that you have just found out you have a terminal medical condition. Doesn’t matter which one, it’s terminal. Over the 6 months you have to live you experience unmeasurable amounts of pain, and when your free of your pain the medication you’re under renders you in an impaired sense of consciousness. Towards the 4th month, you begin to believe all this suffering is pointless, you are to die anyways, why not with a little dignity. You begin to consider Physician-Assisted Suicide (PAS). In this essay I will explain the ethical decisions and dilemmas one may face when deciding to accept the idea of Physician-Assisted Suicide. I will also provide factual information pertaining to the subject of PAS and testimony from some that advocate for legalization of PAS. PAS is not to be taken lightly. It is the decision to end one’s life with the aid of a medical physician. Merriam-Webster’s Dictionary states that PAS is “Suicide by a patient facilitated by means (as a drug prescription) or by information (as an indication of a lethal dosage) provided by a physician aware of the patient’s intent.” PAS is considered, by our textbook – Doing Ethics by Lewis Vaughn, an active voluntary form of euthanasia. There are other forms of euthanasia such as non-voluntary, involuntary, and passive. This essay is focusing on PAS, an active voluntary form of euthanasia. PAS is commonly known as “Dying/Death with Dignity.” The most recent publicized case of PAS is the case of Brittany Maynard. She was diagnosed with terminal brain cancer in California, where she lived. At the time California didn’t have Legislative right to allow Brittany the right to commit PAS so she was transported to Oregon where PAS is legal....
Terminally ill patients deserve the right to have a dignified death. These patients should not be forced to suffer and be in agony their lasting days. The terminally ill should have this choice, because it is the only way to end their excruciating pain. These patients don’t have
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 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.
Even when regulations are present, they are not always followed. The Oregon Department of Human Services’ Death with Dignity Act (2007) requires a patient be referred to a psychiatrist or psychologist for treatment ...
In today's society, one of the most controversial health-care-related ethical issues is assisted suicide for terminally ill patients. Assisted suicide is not to be confused with ethically justified end-of-life decisions and actions. Nurses have a responsibility to deliver comprehensive and benevol...
The approach of physician-assisted suicide respects an individual’s need for personal dignity. It does not force the terminally ill patient to linger hopelessly, and helplessly, often at great cost to their psyche. It drive’s people mad knowing they are going to die in a short period of time, suffering while they wait in a hospital bed.
Currently, Oregon is the only state that has legalized assisted suicide. The Oregon statute, which came into e...
In recent years the media has shifted more focus on the hot topic of physician assisted suicide. This expanded coverage has caused an ever widening gap on both sides of the debate because of the ethical concerns that come along with this act. Due in part to the advancements in modern medicine, assisted suicide should be viewed as a morally correct decision for individuals to make for themselves when there is no overcoming a life impairing mental or physical ailment. This form of medicine should only be used when the individuals have exhausted all possible procedures and options and the have a bleak chance on being healthy once again. The results of assisted suicide can be viewed as morally correct in regards to consequentialism, social contract theory, as well as deontological ethics. The act of assisted suicide can be viewed as selfless if one does not ultimately want to be a physical or monetary burden on other individuals. A patient can also help to save others in regards of organ donations. We as a country need to learn to observe the choices of the terminally ill patients and understand when they want to concede in their battle. If a person chooses to end their life, it should not be viewed as a sign of weakness, but rather as a statement that this individual does not want to suffer anymore.
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