Withdrawal of Treatment in End-of-Life Care

A physician must understand that when it comes to deciding to withhold or withdraw life sustaining treatment it is ultimately the patient’s decision unless the patient is not competent enough to make this choice. I believe that a person can lose their life at any point. Death is certain and no one can run from it. In my opinion, a patient’s autonomy is of utmost importance anytime during healthcare however the physician can name some recommendations of what would be the best option for the patient. When it comes to patients they deserve to be treated with respect and ultimately be treated as an end not as a means to an end.

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’.

.“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).

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

Very often, deliberate decisions are made which results in the end of a life. For example, a person could be kept on life support, but instead, a family member or other significant person might choose to switch off the life support machine resulting in the official death of a patient. There is also the case that resuscitation of a patient may eventually prove to be trivial and a doctor might suggest just making the patient as comfortable as possible until their eventual passing. In the above situations, a medical professional’s decisions would not be questioned or doubted. It is conventional practice (Warnock and MacDonald 2008).

Imagine a frail elderly woman laying in the nursing home in pain. This woman is 80 years old and has been diagnosed with terminal lung cancer and her heart cannot withstand treatment via radiation or chemotherapy. She has less than six months to live. Day in and day out you pass her room and hear her crying out from the immense pain. The pain medications are no longer working. She’s tired of fighting, tired of hurting, and tired of waiting to die. After consideration and discussions with her family she has decided to ask the doctor to help and end her life. The doctor feels remorse for the elderly lady and wants to help but cannot decide if it is the ethical thing to do because he knows that what he’s

I have specifically identified the three situations above, because I feel only in these cases should the doctor seriously consider the option of PAS, or in the situation of option three, how to alternatively assist a patient who is seriously considering euthanasia. In the first case, I mention the doctor’s patient being in a permanent vegetative state – medically defined as patients who have an irreversible loss of brain damage who are left permanently unaware and extremely unlike to ever recover. The vegetative state case is a vital circumstance in which the doctor should consider euthanasia, because these patients will most likely never function fully as human beings again, therefore never to lead a life worth living. The decision is only to be made by the family, guardian, or caregiver of the patient rather the doctor should end treatment to allow to patient to live. However, this should only be done after six months of complete inactivity of the patient, to secure there is no chance of revival. If the family requests for their loved one to be kept alive after the six month, their wishes must be granted; the doctor shall have no say in the

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.

There are some ethical dilemmas evident in this scenario, starting with an End of life dilemma, refusal of care and informed consent.“End of

The “Right to Die” (Euthanasia) should be further looked into as an option for terminally ill patients and not considered unethical. There has been an issue concerning the topic of “Human Euthanasia” as an acceptable action in society. The research compiled in conjunction with an educated opinion will be the basis for the argument for voluntary Euthanasia in this paper. Patients suffering from an incurable illness, exhausting all medical treatments, should be given the freedom of choice to continue their path of suffering or end it at their own will. “The Right to die” is not suicide, as you are fully aware that death will be certain, as Euthanasia spares the individual of additional pain.

In end-of-life scenarios, where the patient may not be able to communicate their wishes, decisions must be made either by the healthcare professional(s) or family member(s). However, who gets to decide or where the line should be drawn are not always clear. Consequently, not all decisions may be ethically permissible. To illustrate, I will discuss a scenario in which physicians and family are not in agreement. Upon proving a brief summary and explaining the ethical dilemma, I will provide moral reasons for two ethically permissible choices from which, by referencing the principle of autonomy and Utilitarianism, will determine which course of action ought to be carried out.

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.

The deliberate act of ending another 's life, given his or her consent, is formally referred to as euthanasia. At present, euthanasia is one of the most controversial social-ethical issues that we face, in that it deals with a sensitive subject matter where there is much uncertainty as to what position one ought to take. Deliberately killing another person is presumed by most rational people as a fundamental evil act. However, when that person gives his or her consent to do so, this seems to give rise to an exceptional case. This can be illustrated in the most common case of euthanasia, where the person who is willing to die suffers from an illness that causes great pain, and will result in his or her demise in the not-so-distant future.

Such a controversial topic as euthanasia and physician assisted suicide obviously brings about both proponents and opponents. When it comes to the case of a terminally ill person who is fully competent, how can one say no to his desire in having

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.