Quality Palliative Care

Imagine laying in a hospital bed living everyday in extreme pain with no hope of getting better. This scenario explains what many people go through everyday, which is a living with a terminal illness. M. Lee, a science historian, and Alexander Stingl a sociologist, define terminal illness as “an illness from which the patient is not expected to recover even with treatment. As the illness progresses death is inevitable” (1). There are not many options for the terminally ill besides dying a slow and painful death, but assisted suicide could be best option for these patients. Assisted suicide is “any case in which a doctor gives a patient (usually someone with a terminal illness) the means to carry out their own suicide by using a lethal dose of medication” (Lee and Stingl 1). Some feel that assisted suicide is unnecessary because it is too great of a controversy and will only cause problems in society. However, assisted suicide should be legal in the United States as long as there are strict regulations to accompany it.

The purpose of this paper is to examine communication strategies related to palliative and end-of-life care with a focus on Aboriginal clients. Firstly, I will explain the role of cultural competence in the nursing care of an Aboriginal client. Secondly, I will argue the cultural challenges a nurse may face when caring and communicating with Aboriginal clients receiving palliative end-of-life care. Thirdly, I will present solutions to the aforementioned communicative challenges. Lastly, I will discuss the impact I believe this experience may have on my future practice.

Over the past five weeks, I have learned what palliative care really is all about. I found that there were areas that really changed my perspective as well, about what palliative care is. Some of these include, but are not limited to, when palliative care is used, how difficult is can be to get patients the pain management they need, as well as how many different complimentary therapies are available to patients.

Have you ever been forced to watch someone that you love dearly fall victim to a terminal illness that diminishes their quality of life a bit more with each day that passes? The illness not only wreaks havoc on the person who is suffering from it, but it also destroys the life of the caregiver. As cruel as it may sound, sometimes the best option is the termination of the poor life that is withering away.

There has been an increase in the interest of euthanasia and assisted suicide for the terminally ill in recent years (Williams 1997). The most obvious reason for someone wanting to end their life is to end the suffering they are going through once the illness goes beyond being bearable.

Many Americans are diagnosed with a terminal illness each day. Hearing that kind of news and knowing there is less than a year left to live and the quality of life would no doubt be heartbreaking. During the last few months of a terminal patient’s life they are often in tremendous pain and suffering. Those with terminal illnesses are treated with life prolonging measures including chemotherapy and radiation. These treatments and the illness itself often leave the patient 's feeling as if they are a shell of who they were and miserable. “Numerous ailments such as certain types of cancer result in a slow, agonizing death” (Messerli, Joe). Physician Assisted Suicide allows

In almost every case of a terminal disease, pain is intolerable and seeing someone in such agony is heartbreaking. For example, Brittany Maynard, a 29 year old brain cancer patient who had to move to Oregon so she can avail of the Death with Dignity act. “Maynard knew that her form of brain cancer would be excruciating. She would endure swelling of the brain that would very likely cause seizures, painful headaches and the gradual loss of bodily function. Doctors know that for about 5 percent of the population, no amount of morphine can block the agonizing pain the terminally ill endure” (EDITORIAL: Dying with dignity). Palliative care can often be provided for the dying patients and alleviating pain to provide comfort for the dying has always been the priority. “Palliative care focuses on relieving the symptoms, particularly the pain, of incurable illness.” (Palliative Care) But, in relieving pain through the prescribed medications there are also side effects that are caused by the prescribed pain suppressors and two examples will be lethargy and it compromises breathing. In most cases the effectivity of the pain medication may no longer alleviate the pain. If a patient will be in such agony for the remaining days or weeks the quality of life is no longer present. The agony of pain prevents a patient from performing even just the bodily functions.

Physician-assisted suicide enables terminally ill patients to die comfortably and peacefully in their own homes. Terminally ill patients suffer through constant pain in their final months, and there remains a “residual obligation to relieve suffering” when palliative and hospice care reach a stagnant point (Quill). Patients will reach a point where the value of life weighs against the consistent suffering they endure on daily basis. Those seeking physician assisted suicide maintain the ability to forcibly starve themselves by declining food and drink. It takes more energy for terminally ill patients to push themselves to

Voluntary Euthanasia has been considered a controversial topic for many decades. The idea of committing an act that involves the taking of human life is not one that many people would care to discuss openly. The main argument is that a person who has been diagnosed with an incurable illness and is in extreme pain and their ability to move has been limited, while that person still has control over their destiney should they be allowed take their own life (Bowie, R.2001). The worldwide debate weather one should be allowed to end a life is still one of the biggest ethical issues. The attempt to providing the rights of the individual is in conflict with the moral values of society. Voluntary Euthanasia has been highly rejected by many religious and pro-life institutions.

Individuals with a terminal illness will typically go through the seven emotional stages of while coming to terms with their condition; shock, denial, bargaining, guilt, anger, depression, and acceptance. Acceptance varies by the individual and has many different meanings. Some individuals try to make the time they have left last as long as possible while others focus on completing goals previously set in their life time. Some will seek forgiveness whether it be from their god(s) or from family and friends. But for a select few, acceptance means that they will try to take control of when they will pass away. To take control of something so trivial, they may look to family, friends, or even their physician. The act of voluntary termination of one’s life with the assistance of a medical care personal is referred to as physician assisted suicide, physician assisted death, or euthanasia. Physician assisted suicide allows patients to take control of what happens before and after death. It allows the patient to enjoy the dwindling life they have left and can be regulated by the government.

Death and dying has changed drastically in the past hundred years. In the past, most deaths occurred without warning mostly due to infectious diseases. Back then, medicine could do little to cure illness or extend life (NCBI, 1997). Most deaths occurred in the home surrounded by family. Today, death usually happens to older people following a long-term illness. The dying patient is usually in a hospital or heath care institution of some kind (Carr, 2003). The dying process is now more controlled by the ill patient and their family (Carr, 2003). “The Patient Self Determination Act, passed by Congress in 1990, requires all government-funded health providers to give patients the opportunity to formally articulate their end of life treatment

Deterioration of the quality of life for terminally ill patients is a heartbreaking burden suffered by the family. As mentioned in the article “Assisted Suicide” by Reed Karaim, the deterioration of severe illness such as brain cancer can cause not only the patient suffering but the family as well (451). Families stand ready to help but at times can feel weighted down by the required attention these patients may need. Patients are confined to little or no mobility making it extremely difficult for private patient care like hospice to provide adequate service to the patients. These situations leave the families no other option except for 24 hour hospitalization or medically assisted housing alternatives. As the patient’s conditions worsen more medications are needed to relieve pain, provide comfort and treat illness. These medications may cause serious side-effects making conditions worse. Freedom is lost when

Why is it that people, in general, do not want to think about the end of their life journey?

Freedom, independence and self-autonomy are fundamental rights of a human, This directly pertains to the central notion of an individual's right to live and right to die. A terminally ill patient should not suffer through excruciating pain and discomfort but rather embrace a timely and dignified death, this is implicit in the concept of liberty and self-determination. Despite rapid advancement in medical technology and modern palliative care, some patients suffer from incurable terminal diseases which inflicts destructive pain upon the patient both physically and mentally. They are unable to seek the compassionate relief of pain and suffering that they wish to

Most adults diagnosed with cancer undergo years of treatment in attempts to cure that cancer. However, sometimes these treatments may not work, or the cancer is found too late in a patient to be stopped, and a patient’s cancer can be determined terminal, which means that the cancer can not be cured and will lead to death. If cancer is determined terminal, end-of-life care can be administered patients to control lasting pains, including shortness of breath, nausea, and constipation. However, this treatment does not cure the cancer, and will not prevent death in a terminally ill cancer patient. In some cases, patients decide that receiving end-of-life treatment is not worth it if the treatment does not prevent death. Terminally ill cancer patients may also continue to experience unbearable suffering, despite end-of-life treatments, as it is not always effective. These factors may push some terminally ill cancer patients to request to be actively euthanized. Active euthanasia is the merciful ending of a patient’s life through a single act, such as an injection. Terminally ill cancer patients should have the right to determine if they are actively euthanized. However, only patients who consider their suffering unbearable should have the right to be euthanized.