The Delivery Of Patient Centered Healthcare

.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).

In today's society, one of the most controversial issues is physician-assisted suicide for the terminally ill. Many people feel that it is wrong for people, regardless of their health condition, to ask their health care provider to end their life; while others feel it is their right to be able to choose how and when they die. When a physician is asked to help a patient into death, they have many responsibilities that come along with that single question. Among those responsibilities are: providing valid information as to the terminal illness the patient is suffering, educating the patient as to what their final options may be, making the decision of whether or not to help the patient into death, and also if they do decide to help,

The importance of end of life issues and decisions are now being discussed at the time of admission to most acute care and long term acute care facilities. More attention is being placed on these specific decisions to ensure that the patient's

A woman is thrashing in bed and crying from the pain her illness is causing her to feel. Her family rushes to find a nurse nearby to administer pain relieving medication. A nurse comes by to give palliative care to the woman that’s in agony. However, the strongest medication that’s at hand cannot relieve the pain without overdosing the patient. The terminally ill patient now has to live with intractable pain for the remaining days of her life. Physician Assisted Death is sometimes necessary in case state-of-the-art palliative care no longer works on the cancer patient. Terminal patients should have the option to control the circumstances surrounding their inevitable deaths with Physician Assisted Death to treat the pain.

The healthcare system is complex with nearly every decision made posing an ethical dilemma for patients, providers, and healthcare leaders. With an influx of new medical knowledge from evidence based practices and new technologies more decisions are being made available to patients and families. Terminally ill patients for instance are faced with numerous options when it comes to treatment including whether or not they end their life by terminating treatment altogether or seek controversial options such as Physician’s Assisted Suicide. The topic of Physician’s Assisted Suicide or (PAS) is very intricate with numerous pros and cons, moral ethics, and ways to address the issue within the healthcare practice.

End of Life Care Planning is a controversial topic that is huge dilemma in healthcare. The average Medicare expenditures per person over the last two years of life was $102, 939.00 (Harter, 2015). One quarter of traditional Medicare spending for health care is for services provided to Medicare beneficiaries in their last year of life (The Henry J. Kaiser Family Foundation, 2016). Nurses deal with ethical dilemmas when caring for patients at the end of life. Nurses are responsible in minimizing unwanted treatment and patient suffering, which can sometimes be interfered by what family members want and the patient wishes (American Nurses Association [ANA], 2012). This paper will go over why end of life care planning should and should be covered as a covered expense.

I t is important that end of life care is delivered in respect of patients Autonomy, Beneficence, and in a Truthful way. In what follows I argue that we as nurses need to fulfill obligation to support and assist the dying patient and his family’s right to self-determination as it relates to end of life care. I believe that we have made headway but still have much to achieve. Education and research in these areas by and for health care workers and the general population would do much to improve the quality of end of life care.

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

According to Thelen (2005), one of the prevalent ethical issues physicians and nurses face in clinical practice has got to do with end-of-life decision making. Common dilemmas in this case as I have already pointed out in the introductory section include decisions revolving around the withdrawal of treatment in the end-of-life care. From an ethical and medical perspective, withdrawing treatment in end-of-life care can in some instances be considered both acceptable

When caring for a terminally ill patient, each member of the health care team contributes in providing end-of-life (EOL) care. In order to know our role in the care, it is important to understand the legal rights of the patient. In 1991, the United States legislated the Patient Self-Determination Act (PSDA) in regards to EOL decision-making. According to our textbook, the PDSA “relies on state laws related to EOL care and was designed to encourage communication about end of life issues” (Grace, 2013, p. 123). This act helps ensure that patients receive adequate information regarding advanced directives and offers protection of their right to self-determination in health care decisions (K, 1992).

Making decisions for patients are difficult in general, but the decisions for end-of-life is the most challenging because it is tough and it involves family. Although we want to remain the autonomy of the patient, but I can empathize the hardship of the loved ones being able to let go. As a healthcare provider, the reasonable and ethical thing to do is to be completely honest about their condition and prognosis, then assist them to the best of our capabilities. I agree with Gawande (2014) that there is always something we can do. Whether the patient decides to fight the battle or to manage their symptoms to treasure the remaining time, nurses should and will respect their decisions.

Many nurses are regularly confronted with the hopelessness and exhaustion of patients and their families making it difficult for them to find balance between the preservation of life and the enablement of a dignified death. Nurses must acknowledge their own feelings of sorrow, fear, dismay and helplessness and recognize the impact of these emotions in clinical decision making. These distressing pressures may cause a nurse to contemplate intentionally assist in ending a patient's life as a humane and compassionate answer, however; the conventional goals and standards of the nursing profession mitigate against it.

Nurses have been at the bedside of the dying since the beginning of the profession. At any given time a nurse may face someone in the last stages of life, whether they are newly diagnosed with a terminal illness, currently fighting a terminal illness, in a traumatic accident, etc. Since end of life care has been a controversial issue, many laws have been enacted to protect health care professionals and to respect the wishes of the patient. End-of-life choices are a quality of life issue. Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care, including the promotion of comfort, relief of pain, and support for patients, families, and their surrogates when a decision has been made

The American Nurses Association regards active euthanasia inconsistent with the Code for Nurses and is considered ethically unacceptable. It has been the role of a nurse to promote, preserve, and protect human life. As members of the profession, nurses are obligated to offer end of life care, which includes the promotion of comfort for pain and suffering, and foregoing life sustaining treatments. Care does not include deliberately terminating life.

With the many debates on what is and is not ethical with the end of life care, humans are faced with more ethical issues. All humans have an idea of what they believe to be moral or ethical. Looking at ethical concepts helps us as a society determined what treatment may be ethical or moral for a person during a chronic or terminal stage in their life. One ethical concept that plays a large role in death and dying is autonomy. The freedom for a patient to have control over their own health care decisions. If a patient has the ability to make informed