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Patient autonomy case
Patient autonomy case
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In the U.S., the trend of traditional deathbed scenario where the dying person is lying at home surrounded by family and friends is breaking. Today, almost 80% of people die in institution among which 63% occurs in hospital and 17% in a long-term care facility (Erber 2013). In modern societies, the advancement of technology in healthcare have attracted many individuals to seek curative treatment. The decision to seek life prolonging measures is often driven by the death anxiety because in some circumstances it may help people to repress, or deny the news about themselves or loved one’s mortality (Kopczuk & Slemrod, 2007). DeSpelder and Strickland (2011) stated that in modern societies, every possible resource to prolong life is a popular coping mechanisms used to avoid death and do not accept death until it is inevitable. The institutionalization of older adults, and human nature of seeking help to prolong life through medical advancement is definitely revolutionizing the traditional deathbed scene. In these scenarios, the healthcare professionals such as doctors and nurses in hospitals, nursing homes, and assisted livings are …show more content…
It also illustrated that the end of life decision is highly impacted by personal characteristics such as age, ethnicity, gender, economic status, and disability. Therefore, the end of life decision making in the cases presented will be different depending upon the patient values and preferences. The ethical principle of autonomy will always take preference and the patient will be the one who will make decision on continuing with their treatment or choose end of life care such as palliative or hospice care. However, autonomy may be lost when a person has diminished decision-making ability. Fry et al. (2011) mentioned
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 Dying of the Light is an article by Dr. Craig Bowron that captures the controversy surrounding the role of medication in prolonging life. The author describes that many medical advancements have become a burden to particularly elderly patients who in most instances are ready to embrace the reality of death. Dr. Bowron believes that dying in these modern times has become a tiring and unnatural process. “Everyone wants to grow old and die in his or her sleep, but the truth is most of us will die in pieces,” Bowron notes (Bowron). The article does not advocate for euthanasia or the management of health care costs due to terminal or chronic illness. Bowron faults humanity for not embracing life and death with dignity as it was in the past. He blames the emergence of modern medical advances and democracy as the sole reason why everyone is pursuing immortality or prolonging of life rather than embracing the natural course of things. The article is very articulate and comes out rather persuasive to its target audience that happens to be health-conscious. Craig Bowron uses effective rhetorical strategies such as logos, ethos, and pathos to pass on his message. The article’s credibility is impeccable due to the author’s authority in health matters as he is a hospital-based internist. A better placed individual to dissect this issue by analyzing his experiences in the healthcare profession. The article incorporates a passionate delivery that appeals to the readers’ hopes, opinions, and imagination.
Several of the main reasons provided are, the state has the commitment to protect life, the medical profession, and vulnerable groups (Washington et al. v. Glucksberg et al., 1997). However, in 2008 the Supreme Courts reversed their previous decision and passed the Death with Dignity Act legalizing PAS for Washington State. This declares that terminally ill individuals in the states of Oregon, Washington, Montana, and Vermont now have the liberty to choose how they will end their lives with either hospice care, palliative care, comfort measures, or PAS. The question remains: will the rest of the United States follow their lead?
Increasingly, people know from their own experience some painful dilemmas involving elderly or handicapped individuals who are in pain. While the achievements of modern medicine have been used to prolong and enhance life for many, they have also helped create an often dreaded context for dying. Costly technology may keep persons alive, but frequently these persons are cut off from meaningful relationships with others and exist with little or no hope for recovery. Many fearfully imagine a situation at the end of their lives where they or their trusted ones will have no say in decisions about their treatment.
gotten to the point where they feel as if there is no point in living.
Physician assisted suicide (PAS) is a very important issue. It is also important tounderstand the terms and distinction between the varying degrees to which a person can be involved in hastening the death of a terminally ill individual. Euthanasia, a word that is often associated with physician assisted suicide, means the act or practice of killing for reasons of mercy. Assisted suicide takes place when a dying person who wishes to precipitate death, requests help in carrying out the act. In euthanasia, the dying patients may or may not be aware of what is happening to them and may or may not have requested to die. In an assisted suicide, the terminally ill person wants to die and has specifically asked for help. Physician-assisted suicide occurs when the individual assisting in the suicide is a doctor rather than a friend or family member. Because doctors are the people most familiar with their patients’ medical condition and have knowledge of and access to the necessary means to cause certain death, terminally ill patients who have made
disease that Stephen Hawking has) 5 years ago. This is a condition that destroys motor nerves, making control of movement impossible, while the mind is virtually unaffected. People with motor neurone disease normally die within 4 years of diagnosis from suffocation due to the inability of the inspiratory muscles to contract. The woman's condition has steadily declined. She is not expected to live through the month, and is worried about the pain that she will face in her final hours. She asks her doctor to give her diamorphine for pain if she begins to suffocate or choke. This will lessen her pain, but it will also hasten her death. About a week later, she falls very ill, and is having trouble breathing.
"With the stroke of a pen, California Gov. Jerry Brown made it legal for physicians in the state to prescribe lethal doses of medications if their terminally ill patients wish to end their lives. Brown signed the "End of Life Act" into law on Monday, and in doing so California joins four other states — Oregon, Washington, Vermont and Montana — where patients' right to choose doctor-assisted death is protected either by law or court order."
Medical science has made great strides to allow us to save more lives than ever before. Through modern medicine, procedures, and technology we have the power to cure or reduce the suffering of people with conditions and diseases that were once thought to be fatal. We have discovered or much rather, we have created the so-called “fountain-of-youth”. Even so, modern medicine cannot treat all forms of pain and suffering. This technology that is seemingly beneficial for us today is also bringing about pain and distress to those who wish to end their prolonged life. One of the most controversial topics discussed this past decade has been that of assisted suicide.
A person’s autonomy is under speculation when euthanasia comes into the picture. Take for instance a situation where a patient is in a coma followed by a brain hemorrhage and the chance of him surviving without the aid of life-support is fifty-fifty. Obviously, the patient is unable to voice his opinion on whether or not he should be euthanized. Thus, this choice will be made either by the doctor or the family. In this situation, the person does not have autonomy. More so, whether or not he can live is a decision made by people who may or may not have his best interest in mind. This gives undue power to the doctor and the
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 National Cancer Institute recorded an estimated 595,690 deaths that occurred from cancer alone in the United States during 2016. Options of care for a multitude of patients who suffer as their body slowly shut down has not increased. Patients have the right to choose the treatment they believe will be the best option for them when their life is about to come to an end. Patients also have the medical right to choose to continue to suffer through their illness for as long as their bodies will allow them. Yet, they should have the choice to end their life if they so desire because they know in the end they are going to pass away in just a few short months. Even with all the various treatments they may be offered. Physician-assisted suicide is an option patients need legalized to end their suffering when they approach their last days of life on Earth.
Diane: A Case of Physician Assisted Suicide. Diane was a patient of Dr. Timothy Quill, who was diagnosed with acute myelomonocytic leukemia. Diane overcame alcoholism and had vaginal cancer in her youth. She had been under his care for a period of 8 years, during which an intimate doctor-patient bond had been established.
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.