Terminally Ill Patient Ethical Dilemmas

The NMC (2015) are the providers of the Nursing Code of Conduct. The code contains the professional standards to which all nurses must uphold, allowing for accountability of patients that come into their care. As well as the code of conduct, all nursing professionals have a responsibility to develop their knowledge in relation to law within clinical practice, and furthermore, ethical frameworks that are linked to judgment and decision making when providing care (Savage & Moore, 2006). In light of this, the overall aim of this essay is to elaborate on issues surrounding law and ethics in nursing. To do so, a case study has been chosen from a previous clinical experience. The focus of the case study will be on the decision of withdrawal from life sustaining treatment. Emphasis will be largely on the law and ethics concerning the issue of withdrawal from treatment. Moreover, the ethics and law involved in the palliative/advanced end of life care planning and decision making. In order to protect the identity and uphold the confidentiality of the case study, a pseudonym will be used throughout. Hendrick (2005) portrays confidentiality as being ‘one of the most important and well established moral obligations of health-care ethics’.

Lachman explores the ethical alternative to Physician Assisted Suicide (PSA) for patients with a terminal illness. She strongly emphasizes the right of the patients to be fully informed of the other options they have available to them such as Voluntary Stopping of Eating and Drinking. VSED is a legal treatment available in all states unlike PSA which is only legal in five states. Terminally ill patients typically feel that they do not wish to carry out the last moments of their life as a burden to their families and would rather rush their death. In these desperate situations they feel that the death in minutes, provided by the over dosage of prescribed lethal medication, PSA is a better alternative than VSED. Patients are not fully informed of the ethical benefits of VSED. According to Lachman, through VSED the patient dies of terminal dehydration and the discomfort they may feel during the process can be managed with the correct palliative care. By choosing to refuse life sustaining nutrients the patient can die in their own terms while allowing their body to perform a natural form of death. She indicates that VSED is also a form in which the patient will not have to feel the excoriating pain that they fear and will actually lose conscious during their final moments of the 1-3 week

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.

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

The topic for my case study is Physician-Assisted Dying (PAD). PAD allows terminally ill patients to choose to die on their own terms before they become medically and mentally incapable of normal function. However, this option as an End-of-Life (EOL) choice is illegal in most states. There are five states where PAD is legal. These states are: Oregon, Washington, Montana, Vermont, and California (Gostin & Roberts p.250). After a strict screening process to make sure the patient is mentally sound. A medical professional must give the patient a prescription for a lethal dose of medication to be taken at the patients choosing by the patient. There are several ethical arguments when it comes to PAD.

This article begins by explaining that by allowing terminally ill patients to choose media aid in dying, it is part of shared ethical principles. These principles include the respect for autonomy and self determination of the individual. The decision about their own care ca be made by patients who are suffering as they are about to pass away.

In this paper I will defend ethics and palliative care as they pertain to end of life treatment of terminally ill patients. Aggressive medical administration of the terminally ill patient has created critical issues in the morals of end of life consideration. In summary, I will defend this hypothesis by arguing that the following principles, autonomy, beneficence, and justice must all be taken into consideration when treating a terminally ill patient.

Death, dying and other ethical dilemmas are issues that all Intensive Care Units (ICUs) throughout the world have to face and address. In the Current Opinion in Critical Care, Vol 16, No 6, December 2010, p. 640, Dixon-Woods and Bosk, writing on the topic of “Death, dying and other ethical dilemmas” under the journal’s section of ‘Ethical, legal and organizational issues in the ICU’, have stated that “Recent ethnographic work suggests that ethical dilemmas associated with end-of-life care in ICU clearly persist, even if clinicians are now more open about patients’ chances of surviving. An Australian study identified how decisions and actions made

According to the Alzheimer’s Association (AA) (2016), it is estimated that in 2015 nearly 5.3 million Americans have Alzheimer’s disease and of those citizens, 5.1 million were 65 years old or older (“Alzheimer’s Disease Facts and Figures,” 2016). This non-curable form of dementia, a general term for a group of symptoms of declining mental abilities that interfere with daily life, effects and kills 1 in 3 people in the geriatric population (AA: “Alzheimer’s Disease Facts and Figures,” 2016). It is important for nurses to be aware and knowledgeable of this disease because of the huge prevalence of Alzheimer’s in the American population. Nurses should be educated on treating and battling the

The following ethics program will highlight some key ethical issues facing the healthcare industry as a whole, as well as hospice agencies specifically. In this program, I will reference ethical principles used today as well as reference historical ethicists and philosophers that backup the items outlined in this ethics program. There are two major topics to be discussed. The first will be how to treat patients that are at the end of their life, which includes their loved ones as well. A specific issue to be addressed in terms of patient care will be the option of doctor-assisted suicide, often called euthanasia, and why hospice should not support this. The other issue is that of data security and privacy, and how all patient information should be handled in the healthcare environment.

As the role of pharmacists in patient care continues to grow, the ethical challenges they face every day also increases. After the discussion with my preceptor about ethical situations that a pharmacist can experience, we decided to explore further about the controversial topic of end of life care, specifically avoidance of killing.

This paper will provide an overview of Alzheimer’s disease. It will explore its etiology, pathophysiology, risk factors and their modification, diagnostic and medical treatment including pharmacology, health education, and nursing care of Alzheimer’s disease based off nursing literature. It will go into detail of a patient who has experienced Alzheimer’s for 11 years and their specialized plan of care including their medical history, physical assessment, concept mapping, nursing diagnoses, and specific interventions to the identified nursing problems. This plan of care will be evaluated based upon the patient’s responses.

After Alzheimer's is diagnosed in a parent, or other elderly family member, the caregiver has the task of deciding what the best form of care for the patient is. In order to do this they have to fully understand what the disease is, and

With major advancement in medical treatments, it is now possible to keep a patient alive, which would not have been possible in former times. This has made end of life issue one of the most controversial issues in healthcare. Medical improvements have set the stage for ethical and legal controversies about not only the patient’s rights but also the family’s rights and the medical profession’s proper role. It is critical that any decision made in such situation is ethical and legal to preserve the rights of the patient and also protect the healthcare institution involved. It is very important when making decisions to discontinue treatments to make sure all other alternatives have been explored.

Today we are face with death in a different setting then our ancestors, instead of dying at a younger age and dying in our home with our families, people are now dying at a hospital or in a medical setting. We are living longer because of the advances in medicine, this is causing us to develop diseases that our ancestors never had to face. Our ancestors did not live long enough to develop some of the diseases we face today. As Jones (2011) provides, “we don’t just die of different diseases then our ancestors, we also die in different circumstances” (p. 302). The changes in circumstances have caused us to reevaluate what is believed to be ethical when faced with dying. There are many medical options a terminal ill or elderly patient that is dying can choose from, however there is great debate whether some of these options are ethical.