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Ethical issues in the end of life decisions
Ethical issues in the end of life decisions
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Introduction Many people are afraid to make decisions concerning their wishes when they die. This includes fear of making wills and making critical decisions that affect lives of others when they are not there. When the patients are terminally ill, they become incapable of making these decisions and they are often assisted or directed by some external forces to make these decisions. This paper exploits options and conditions of different terminally ill patients with a keen look at their mental and health status. It is also going to explore on those patients with DNR (Do not Resuscitate) orders and advance directives. Health and mental status of terminally ill patients Terminal illnesses like cancer, HIV, Ebola Hemorrhagic fever and Lesch-Nyhan syndrome deteriorate the health of the patient to a point of no return. They also cause a lot of pain to the patient. When these patients health deteriorates, their capacity to make sound decision is compromised. Poor health leads to deficiency of minerals that help in thinking, a condition which greatly reduces the capability of decision making. The mental status of terminally ill patients has lesser capacity to make sound decisions as compared to a normal person. When a patient is diagnosed with a terminal illness, the mental status changes and in many cases the patients think negatively of themselves. This compromises their capacities to handle normal activities including decision-making. They sometimes react in a manner that causes outcry to the concerned parties. Some patients have gone to an extent of committing suicide while others act to harm their loved ones. This leaves the patient with little option of making the right decision as their decisions are negatively biased. A terminal... ... middle of paper ... ...vil rights. It includes health care advance directives, health care surrogate, life prolonging procedures and the case of anatomical gifts. It has all the possible outcomes incase a patient decides to pursue any of the above options. Conclusion 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.
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
A living will is a type of advanced health care directive, which states an individual’s wishes for health care treatment when he/she is terminally ill. Living wills are often applied to end-of-life decision making when patients are no longer deemed competent to direct care for themselves. The form of living wills can vary widely. But, most address whether or not to use life-prolong medical treatment such as CPR, respirators, and artificial nutrition and hydration. These documents can also contain information about the importance of quality of life for patients and can name a healthcare proxy to make medical decisions in their place. Having a living will allows individuals to state their
When it comes to a bad diagnosis it is often difficult for doctors to tell their patients this devastating news. The doctor will likely hold back from telling the patient the whole truth about their health because they believe the patient will become depressed. However, Schwartz argues that telling the patient the whole truth about their illness will cause depression and anxiety, but rather telling the patient the whole truth will empower and motivate the patient to make the most of their days. Many doctors will often also prescribe or offer treatment that will likely not help their health, but the doctors do so to make patients feel as though their may be a solution to the problem as they are unaware to the limited number of days they may have left. In comparison, people who are aware there is no cure to their diagnosis and many choose to live their last days not in the hospital or pain free from medications without a treatment holding them back. They can choose to live their last days with their family and will have more time and awareness to handle a will. Schwartz argues the importance of telling patients the truth about their diagnosis and communicating the person’s likely amount of time left as it will affect how the patient chooses to live their limited
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.
Advance directives can become ethical issues especially when a family attempts to enforce their opinions on healthcare instead of what a patient had requested in a living will. Advance directives, sometimes called a living will, are legal documents that allow an individual to spell out your decisions about end-of-life care ahead of time (MedlinePlus, 2014). A living will address which treatments an individual wants if he or she is dying or permanently unconscious (MedlinePlus, 2014). People impacted by this situations was the patient, the patient’s daughter, and all the patient...
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...
Every day, millions of people are being diagnose with terminal illnesses or being seriously injured in accidents. Sometimes, those illnesses and accidents become long and agonizingly painful deaths. Although medication could briefly ease the pain, the long-term agony that the patient has to deal with is ceaseless. Undoubtedly, the human life has an enormous value and is for that reason that it should be preserved in all the possible ways. Nevertheless, when the terminal illness comes to its last stage, or the damage caused for an accident is too much to handle and the only option left is death, shouldn’t it be the patient’s decision to end its suffering and pain in a dignified way? Or in cases where the patient has an impediment to decide, shouldn’t the family have the option to give their loved one an end to its suffer? As part of a free society, euthanasia should be considered as a legal and humane option for patients suffering from terminal diseases and victims of accidents, mainly because is every human right to die in a decent way.
A terminal illness can promote multiple cases of doubt, concern, and terror into any individual, regardless of race, religious conviction, or belief. Death is an inevitable fate. No man can escape death. A normal human being does not want to have his life ended by conditions he cannot control. Nevertheless, disease and illness prevent an individual of sanity and choice throughout the course of his life. Not only does this relate to an individual undergoing a disease, but also consist of the individual's family and acquaintances. The physician's main part is to reconcile and upkeep terminally ill patients, furthermore, the author of this paper does believe assisted suicide should be supplementary within the job description. Presented throughout this writing assignment are the main arguments in the debate over Physician Assisted Suicide.
However it can also make room for medical, legal and ethical dilemmas. Advances in medical technology enable individuals to delay the inevitable fate of death, overcome cancer, diabetes, and various traumatic injuries. Our advances in medical technologies now allow these individuals to do things on their own terms. The “terminally ill” state is described as having an incurable or irreversible condition that has a high probability of causing death within a relatively short time with or without treatment (Guest, p.3, 1998). A wide range of degenerative diseases can fall into either category, ranging from, HIV/AIDS, Alzheimer’s disease and many forms of cancer. This control, however, lays assistance, whether direct or indirect, from a
Regarding legally incompetent patients, these are patients who lack the ability to make legal choices, so that no right to refuse consent is involved. Therefore court-ordered life-saving treatment is not a subordination of patient choice. The court will usually order lifesaving or ordinary care, but treatment that is extraordinary is not required.
Supports argue that patients who are terminally ill and in extreme pain should be able to ask for help from their physicians to seek relief; because it’s their duty to respect the patient’s autonomy. They rather seek a dignified death than live with pain and dependency. Even courts have found that just like how people have the right to refuse a medical treatment, there is a similar right to ask for
Over recent years there have been studies to explain why terminally ill patients wish to die. However, there is a lack of understanding of the importance of a “wish to die”. There is a lack of meaning or reasoning from the patients that “wish to die”. We need a clear distinction of the meaning of a “wish to die” from the patients of the study.
A person who is terminally ill will be able to leave this world without having to go through the process of the intense suffering predicted by a doctor. Why should a human being have to suffer on his/her last days on earth? Would they be truly living, or would they be imprisoned in a hospital room for the remaining days depressed and not in control of their life like they used to? They lose their quality of life. Marc Siegel, a doctor, talks about the two roles of a doctor, to prolong life and to ease suffering. He explains how sometimes they conflict with each other, and how the number one priority is to respect a patient’s wishes. He says that they, “…when pain predominates, when the patient is in agony, when reducing morphine cannot bring back quality of life. When the only choice is pain or death, doctors routinely¬ – with their patients’ advance approval – help them choose death” (821). The terminally ill patient does not suffer at the moment of death like she would if she would let nature take its course. Not only would they have a painless death, they would be able to choose when, where, and with whom they want to die. They will be able to say all the goodbyes they want, they could leave this world having made peace with everyone, and they would have the opportunity to really enjoy their quality of life. They will have the opportunity to not go through all the excruciating mental
Terminal illnesses are most commonly associated with cancer, HIV and/or organ disorders. These diseases are known to debilitate the patient and cause extreme amounts of pain. This decision should be made entirely by the patient, as they are the ones dealing with the effects of these terminal illnesses. We can all understand that families and outsiders object to Euthanasia as an option, but the pain factor m...