Captain Madwell's Ethical Dilemmas

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

Thank you for the sharing of your personal experience. If I knew, the patient was dying, I would like to contact the patient’s loved one and allow them to have time say goodbye. Death is a process of life. We cannot avoid or run away from it. Therefore, ones need to learn the harmony of life. Grief is unavoidable during the death process. However, if we deal with it well, we can learn and obtain valuable experience on it. Life is sharing and love.

It was a boring, hot afternoon in Blood Gulch. Grif and Simmons were talking like usual, the Blues were spying on them like usual, and Doc was talking to himself in a cave like usual. The only thing out of the ordinary was the plan that Doc was unwillingly being forced to do.

In November of 2014 my aunt tragically took her own life. That day I got a tearful phone call from my dad; I could feel his heart breaking as the words came out of his mouth. I held back tears as I drove to his office to be with him, knowing that in this moment I had to be strong for my dad. Together, heavy-hearted, we went and broke the news to my grandparents. During a time of year when most people prepare to gather together with loved ones to celebrate the holidays, my family and I were unexpectedly thrown into a period of mourning. My grandmother asked again and again why Joanie did what she did. I was at a loss for words. I had no answers. I still don’t.

Have you ever felt so broken and lost that you believed you simply couldn’t keep going on in life, as if the barriers of your life caved in and suffocated the very existence in which you lived? This pain was all that I knew in the months following my grandfather’s loss to cancer in July of 2008. Fighting until his dying breath, it was a moment in my life that rocked and shattered my heart like fragile glass. His death required me to adapt to and appreciate life and showed me that no obstacle is to big overcome if you maintain hope and a positive outlook.

Two years ago, my mother was diagnosed with stage four brain cancer. During this time there were countless visits to the hospital. Typically, a visit would consist of shed tears and painful discussions about the next steps, but not this one. Before I set foot into my mother's room I heard the laughter of my oldest sister, Jojo, and chuckles

Grams finally agreed with her family that it was time to get the cough checked out. Following an X-ray, the doctor diagnosed Grams with phenomena, and she was sent back home with antibiotics. A week later, the cough and back pain were only getting worse, so she went back in. The doctor proceeded with an MRI, and it revealed that a malignant cancer had originated in her lungs and had already spread into her spine. We had embarked on a journey that none of us were ready for. I wanted to put blame on the first doctor who failed to notice her cancerous symptoms. I often wonder to myself how he could have missed it. Would Grams still be alive if the first doctor found it? I truly don’t think so, but the question still perturbs me. Being the naïve child I was, I thought some chemo and radiation would do the trick. Grams followed through with the treatment, but the hospital stay and painful sickness was not how she wanted to live for the rest of her life. During this time, I quickly realized the severity and harsh reality of cancer. I admired my grandma’s strength and cordiality through all of this. She continued to joke around and her laugh, along with her spirit, failed to fade away. Her positive attitude helped our entire family to remain strong. Our family decided hospice would fit Grandma’s wishes, and Grams agreed with “It’s a

Following her diagnosis, we went to the cancer center biweekly. My mother’s continued stoicism in the face of adversity moved me, as did the resolve of the other children who faced pain and uncertainty each day. Their wills inspired me; they adapted to live life to the fullest in spite of their illnesses. I felt my sister would be okay surrounded by others pushing forward. She endured five rough rounds of chemotherapy. The doctors said she had a three percent chance of living, but faith that she’d be healed kept us

In addition, death and dying are a very hard topic many nurses throughout the profession can attest to, but the care that nurses give prior, during, and after this process can be the most beneficial care they receive at such a harsh time in their lives. Nixon, Narayanasamy, and Penny (2013) discussed spiritual care with nurses on a neuro-oncology unit where they spoke of feeling very unprepared and uneasy in providing spiritual care in the fear that they would make a mistake in their approach with these patients, but

Pain medicines were administered at the earlies signed of discomfort or pain. The Doctors and Nurses were readily available. They were there for comfort and opinions sometimes even speculation theories. She was being truly cared for. I would have chosen Hospice much sooner if I had more knowledge on the topic to begin with. I have put a lot of thought into what I want for my remaining loved ones and myself. I don’t have any plans just yet but I know don’t’ want my family to decide what I had to experience personally. ‘The Lord is my Shepherd; I shall not want. He makes me lie down in green pastures. He leads me beside still waters. He restores my soul. He leads me in paths of righteousness for his name’s sake. Even though I walk through the valley of the shadow of death I will fear no evil for you are with me; your rod and your staff, they comfort me. You prepare a table before me in the presence of my enemies; you anoint my head with oil; my cup overflows. Surely goodness and mercy shall follow me all the days of my life, and I shall dwell in the house of the Lord forever.

January 25th. I was preparing for work, when my mom called me into the room."He 's not responding, maybe he had a stroke"she said. Hiding my own fear,I told her to calm down,while I went to wake him."Dad" I called, shaking his shoulder. I waved my hand over his face to check for a response.He blinked but nothing more. My mother began to panic."What 's wrong with him?". I started to believe maybe he did suffer a stroke or something of that nature.We called the hospice nurse.Once she arrived I asked, "so how will he eat?",still believing what happened to him was something treatable. She lead us into the living room and told us my father was transitioning.His "condition"was not treatable.She informed us that hearing may be the last function to go.Prior to, I was unaware that death was actually a process;not always instantaneous.We said our last words to him while tears rolled down his face. My mom holding one hand, me holding the other. He inhaled deeply, squeezing my hand, never to exhale again.That day changed my outlook on why I wanted to practice medicine. I observed a spinal tap, a leg being amputated, the smell of cauterization,and I even witnessed the amazing wonder of childbirth; but nothing could compare to witnessing the ravaging effects of pancreatic cancer. I wondered if he received the very best medical care.Great physicians were involved in his treatment but a few I could never forget.Those few showed me what I did not want to become.Callous.I reflected on the

September 8, 2013 I spend the day at Whitehorse General Hospital, knowing that in a few short hours I will have to say goodbye to my dad, possibly for the last time. The doctor keeps telling us he is close to dying, it is clear to see. He cannot speak, open his eyes or eat, he lays there near lifeless. His body is withering away. I sit with him and talk to him, hoping that he can hear me. I want him to squeeze my hand and let me know he can hear me. I cannot stop crying. I have no desire to eat, food doesn’t taste good. I am anxious knowing I have to leave, my body is tired from many late nights, little sleep and four days of crying. I have to say goodbye to my dad, I scan the room, it smells of sanitizer and sweat. I hold my dads hand, I kiss him on his forehead, his body is motionless, it feels clammy and cold. His eyes are closed and sunken into his face, his lips parted as he breathes softly, inaudibly. I barely recognize him. I touch his face, it still holds life, even though he is not present I can still feel his love. My tears cloud my vision as I move in closer and put my forehead to his. I whisper “I love you dad, and I will never forget you. If you are ready to go you have my permission. I do not want to see you suffer any longer”. I lay there like this for a few minutes, my tears falling onto his face. I

Facing the death of my sister from a terminal illness altered my life in myriad ways—for evermore. It challenged every platitude—life is fair, everything happens for a reason, what doesn’t kill you makes you stronger—I think not. As the illness consumed her, I grasped at ways to imbue her soul with my unfaltering love, and the pure delight we shared in being sisters.

The next day my mom and I visited her in the ICU. Her normally wrinkly olive skin, was this pale white. Her blue eyes that usually shimmered with life were now this dull midnight blue. This amazing women was so lifeless and confused. Five minutes passed and I needed to leave. The waiting room was filled with anxious people, just as worried for their loved ones. My grandpa who is usually filled with life was filled with anxiety. My uncle, who is this strong no emotion kind of guy, was hurting. You could see it in his eyes, wishing he spent more time with her or said something different. As his look was the same as mine.

On January 10, 2013 my family and I received a devastating phone call during the middle of the night. It was my aunt who informed us that my grandma only had a couple of days to live. She was in her early sixties, had grey hair and whenever she smiled you could see her wrinkles. Also, she was short and loved watching telenovelas with my grandpa. At that moment it seemed like the entire world came crashing down on me. I felt my heart sink and tears started rolling down my face. I went into my room and cried to the point where my head was throbbing. The next morning, I didn’t remember what had happened after, I was clueless. I walked to the kitchen and found my parents having some fresh brewed coffee and I knew they hadn’t slept at all. They looked up when they saw me, but then continued on with their conversation. I could tell my mom was hurting and breaking inside. I wanted to give her a tight hug, but at that moment I couldn’t move. After breakfast, everyone went