Hospice Ethical Issues

The term “hospice” goes back to medieval times where it was referred to as a place of shelter and rest for the ill or weary travelers on a long journey (NHPCO, 2016). In 1948, the term was referenced to by Dame Cicely Saunders, a physician, for dying patients (NHPCO, 2017). Saunders created the first modern hospice program, St. Christopher’s Hospice, located in a suburb of London. However, it wasn’t until a visit to Yale University, in 1963, Saunder’s gave a lecture on the concept of hospice care. During the lecture, she emphasizes the differences before and after symptom control care. Thus, this lecture was the stepping stone for the advancement of hospice care.

Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and

Many terminally-ill patients give up hope when treatments are no longer available to help them and hospice care is given to them as an option. However, hospice care has proven itself to provide the best quality care for the last six months of the dying. The purpose of hospice is to provide the best care for terminally-ill patients at the end stage of their lives. Hospice offer services to support too many aspects a patient’s life such as medical, legal, spiritual care. Hospice includes art therapists, music therapists, and certified chaplains on the palliative team.

Hospice is a special healthcare option for patients and families faced with a terminal illness. At Hospice there’s a multidisciplinary team of physicians, nurses social workers, bereavement counselors and volunteers that work together to address the physical, social, emotional and spiritual needs of each patient and

An ethical dilemma is a difficult situation that usually involves a conflict between moral obligations, in which to obey one would result in disobeying another (Murphy, 1997). Sedation is an ethical dilemma in palliative care because on one side it helps to relieve suffering for patients who are terminally ill and almost at the end of their lives. However, at the same time, sedation is making the patient deprived of certain bioethical principles such as autonomy, the main issue with palliative sedation is that it prohibits the patient from changing his or her decision, once sedation is commenced and informed consent also becomes complex (Cooney, 2005). The writer is in the favour of palliative sedation because it is an effective symptom controlled strategy for the patients who are nearly at the end of their lives. Moreover, it is believed that by providing sedation to a patient induce unconsciousness, which makes the patient completely unaware of the external world and tend to reduce the suffering by considering ethical and moral principles. However, some people think palliative sedation as euthanasia, which cause death because of making the patient deprive of nutrition and hydration while giving sedation. Ethical principles are going to be discussed in this essay such as autonomy, beneficence, non- maleficence and justice. Moreover, this essay also going to put light on current research

What was once believed to be a form of neglect has resulted in a change in practice with the idea that doing less is more. Culture is an important factor in how care is rendered and thus, the limitations of palliative and hospice care lie within the desires of the family and patients. A thorough understanding of our surrounding demographics helps to ensure a seamless approach to providing care without bias or imposition of ones beliefs. However, just as with all things, providing care for the sick and comforting the dying should be rendered in moderation as to prevent the effects of burn out. Likewise, the same effects occur in the caregivers who sacrifice their responsibilities in order to care for their love ones. Finally, and with some closing thoughts, the writer wishes to express with gratitude the benefit of having taken this course to better understand oneself and others in the realm of healthcare. The lessons learned throughout have expanded this writer's knowledge and understanding of the human desire to make a connection through communication, emotion, compassion, and spiritually - the platform from which this writer wishes to continue seeking further knowledge and

Occasionally, the best care a nurse can provide is providing their patient the ability to have a good death. In a survey of acute care nurses conducted by Becker, Wright, & Schmitt (2016) it was found that dying well was

The article points out how the American Nurses Association (ANA), the Hospice and Palliative Nurse Association (HPNA), and Oncology Nursing Society (ONS) do not support the use of assisted dying. However, due to recent law changes, the organizations are reevaluating their position on dying with dignity. The article talks about the countries and states that have legalized assisted dying and who can qualify to obtain the prescription. It also points out that nurses who live in these countries and states are more likely to be uncomfortable to talk about this subject with their patients. Either way, patients need to be educated and advocated for while following the code of ethics when dealing with the subject of assisted dying. The article also points out how a nurse needs to be a tentative listener to further assess why the option of assisted dying is being considered. A brief case study demonstrates how a good nurse can reveal the true motives behind choosing the assisted dying as an option. Finally, the article talks about different communication techniques and approaches a nurse can use when discussing the subject of

End of life care is something that is becoming extremely prevalent today. This end of life care is referred to as Hospice. Here, patients who are terminally ill may be placed in Hospice care, where they will be under constant supervision and will be cared for. However, although Hospice is an ongoing process that exists everyday, there are few people who really know exactly what Hospice is and what it consists of. Upon further reading, it is hopeful that one will get a better sense of understanding about Hospice.

CNA announces that they will work with Canada’s nurse regulators to define the implications on nursing practice keeping with the code of ethics for registered nurse. CNA focuses more on improving palliative or end-of-life care and advocate that everyone should be able to access it. Also, they believe through the therapeutic relationship with patient and family, Registered Nurses [RNs] can help individuals prepare and share their wishes with others at the needed time. CNA’s role is “to support RNs as they assist patients and families, by informing them of their options, helping them communicate with one another and guiding them to their best decisions” (CNA,

Hospice services are paid by most insurance companies as well as Medicare and Medicaid. Patients and families deserve to have the best care possible even at the end of life. Senthilkumar, Ganesan, and Kavitha (2010), describe hospice care is directed to quality of life when a person is anticipated to have less than six months to live. A devoted hospice unit will provide an atmosphere that will help support meaningful time with patients and their families. Specialized trained staff can deliver a customized approach to therapy programs tailor-made to the patient and the family. With this would allow for concentrated personal care, exclusively for end of life.

Hospice care enables patients to spend the last moments of their life with dignity and comfort.

If you were terminally ill, and on the last phase of an incurable disease, would you want to spend your last final months in a cold, busy, noisy hospital room, being awakened every hour by hospital noise, or would you rather spend your last few months living your life in the comfort of your own home, with your familiar surroundings? This is why Hospice care has come into existence. Hospice care is for any ill patients, regardless of age, gender, race and nationality; who have a very serious chronic medical condition and often it’s when a physician thinks that dying is a possibility within a six-month time period. It doesn’t necessarily mean that a chronically ill patient will die within six-months’ time, but it could be for a patient that has cancer, kidney failure, heart problems, dementia, etc.

While there is a significant increase in the training of palliative care professionals as well as the development of the infrastructure for providing such care, there is an issue with the availability of resources in the current Indian environment which is building a barrier in the improvement of such professional care to people who require it the most.

Care of the dying has become one of the richest and most demanding parts of clinical life. End-of-life issues have become a challenging topic due to the complications that result when dealing with the final stages. These issues can be difficult to both the patient and the practitioner and refer to the inevitable outcomes that a patient may have to face in such situation. These outcomes include pain, depression, coping, dignity, and the need for control. In a medical environment, these outcomes are added to the stressors that may affect the attending medical practitioner. These include inadequate training, insufficient compensation (when altruism eventually confronts financial realities), and personal discomfort with death (Woo, 2006).