...Suicide or Well-Reasoned End-of –Life Decision? In the case of Jason, the 38 year old gay man with AIDS who is considering a rational suicide, there are several ethical and legal issues that the counselor has to consider in order to effectively continue to treat the client. Jason has disclosed to his counselor that he was considering to stop taking his medications which will ultimately end his life. Upon receiving this information from the client , the counselor has to now consider if he or she has any personal, moral issues, or spiritual belief system about the end -of -life decisions that might conflict with what the client has decided. The counselor should consult with a supervisor or some one who has some experience in the area of end-of – life. If there are any conflicts, the counselor can chose to not work with the client and provide him with an adequate referral to make sure he get the help he needs. (Standard A.9.b). A counselor should never impose his or her beliefs, morals or spirituality on their client. This will impede the client’s ability to achieve autonomy and self –determination. According to the ACA Code of Ethics, the counselor has to protect the client’s right to self-determination, ensure that the client has a quality end of life that satisfies their emotional, physical , social and spiritual needs and to ensure that the client is competent to make the competent decisions via assessments. (StandardA...
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...Analysis: Providing Good Care to Dying Patients: Paper 2 Jaime Holtgrewe Chamberlain College of Nursing NR 449 Evidence Based Practice February 2013 Clinical Question In my group, the focus of research is based on the following clinical question: What are the best practices for end of life care? Within the group, research is driven to focus on enhancing care for end of life patient, including collaboration with physicians and surrogate decision makers or a power of attorney (POA), as well as pain management policies. However, all aspects of care for end of life patients are taken into consideration when determining which facet is most important. The group’s research consists of quantitative and qualitative articles focusing on transitioning to hospice programs, new measures of care, acceptance of death and experience of caregivers for the dying patient. According to the Journal of Health Politics, Policy & Law (2008), three of every four Americans do not fear death as much as they fear being in pain at the time of death. End-of-life care can be a challenge requiring the full range of a family physician's skills. Significant pain is common but is often undertreated despite available medications and technology. Physicians must overcome their own fears about using narcotics and allay similar fears in patients, families and communities. Drugs such as corticosteroids, antidepressants and anticonvulsants can also help to alleviate pain. A considerable amount of research...
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...Terminally Ill Patients' and End of Life Care: A Multidisciplinary Concept Analysis Jennifer Thompson UTA Analysis of Theories in Nursing Nurs 5327 Ronda Mintz-Binder, RN, MSN, DNP April 19, 2014 Terminally Ill Patients' and End of Life Care: A Multidisciplinary Concept Analysis With an aging population in our country we are facing an increasing number of patients’ that are coming to the end of their lives and are presenting with terminal illness. As life expectancy increases we are seeing more and more patent that are 65 year old and older in need of end of life care. Research and medical developments have provided a vast array of treatment options available to our patients’. After patients’ have exhausted all available treatment options for their disease processes they face the reality that their life is coming to an end. Patients’ near the end choose between quality of life over quantity of life. One service available to terminal patients’ is hospice care which offers palliative care to patients’ at the end of life. Health care providers must be able to face and appropriately care for patients’ with terminal illness and end of life care. At times it may be difficult for health care providers to face or present the truth to a patient that further treatment is futile and end of life care would be appropriate. Advanced practice nurses’ will face terminal illness and it is required of them to be able to sufficiently treat, manage, and discuss end of life care with these patients...
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...Running head: MEDICAL ETHICS: THE TRUTH BEHIND END OF LIFE MATTER 1 HLST 4010 Professor Geoffrey Reaume Lilyana Nooro 211862935 April 7th, 2015 MEDICAL ETHICS: THE TRUTH BEHIND END OF LIFE MATTER 2 Medical Ethics: The truth behind end of life matter When it comes to death and dying, the medical processes of these notions are highly controversial in ethical means. All forms of end of life are illegal in Canada, whether it is voluntary/non-voluntary euthanasia, assisted suicide, and some cases of refusal of treatment. These procedures affect someone who is terminally ill, undergoing a disease, experiencing severe,...
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...Withdrawing/Withholding Life Support: Pros and Cons November 16, 2012 ABSTRACT When a person is being sustained by life support, families and loved ones are frequently confronted with the resolve about when to terminate these supports (Meeker, 2012). Recently it has turned into “pulling the plug” prior to death regardless of the tubes and machines keeping the patient alive. Withdrawal choices are informal and quietly decided. If these life-ending decisions were standardized and validated, maybe some of these safety measures can be useful to other choices approaching the idea of drawing life to a close, even for those who aren’t dependent on life-supports (Meeker, 2012). As we advance towards the twenty first century, it will become more common for us to be supported by equipment and medications the last few days or weeks of our lives. If some disease or condition that would, as a rule, take months or even years to bring death, the need for life-support could be longer. “Withdrawing life-sustaining treatment such as artificial ventilation means to discontinue it after it has been started. Withholding life-sustaining treatment means never starting it,” (Fremgen, 2012). If in fact we are being kept alive by any form of medical equipment, any choices made about the best time to die and the best means to allow our deaths should contain queries about what to do with the life-support systems in place, sustaining life (Lin, 2003). Withdraw/Withhold Life Support: Pros and Cons ...
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...incurable disease or terminal illness. * Administration of potentially life-ending drugs or lethal doses for the purpose of causing death. * Requires active participation by health care providers. 2. What is the difference between killing and allowing to die? * Killing is an act of commission, the performing of an action to cause death. * Allowing to die is an act of omission, withholding potential life sustaining treatments to bring about death. 3. What is passive euthanasia? * The act of allowing a patient to die primarily by not administering life saving treatments or procedures. * Does not require active participation by health care providers. 4. What is voluntary euthanasia? * The rational decision of a terminally ill person to end their life. * Requires a comprehension of the consequences of their decision. * A person must be able to make competent decisions about their own health care. 5. What is non-voluntary euthanasia? * The decision of someone other than the patient to end that patient’s life. * Usually as a result of the patient’s inability to speak for themselves. * May not be competent to make the decision, (i.e.) Alzheimer’s disease. 6. What is the difference between ordinary treatment and extraordinary treatment? * Ordinary treatment is the application of established and standard medical procedures to sustain life. * Usually offers hope of a cure. * Not typically very expensive...
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...The Supreme Court Ruling on Physician-Assisted Death By The Canadian Nurses Protective Society May 2015 The Carter decision presents a profound change to Canadian law. What does the decision mean for nurses? It is a crime in Canada to assist another person in ending his or her own life. However, the Supreme Court of Canada created an exception, after analyzing Canadian constitutional law in the case of Carter v. Canada (Attorney General), released at the beginning of February 2015. The Supreme Court declared that the prohibition in section 241(b) of the Criminal Code on assisting with suicide is unconstitutional to the extent that it prevents physician-assisted death for “a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.” In creating this exception, the Carter decision represents a profound change to Canadian law. Nurses may now expect to receive more questions from patients and their families related to end-of-life care. It is important for nurses to understand the law and professional nursing standards relating to end-of-life care as they currently exist and as they may develop. The Carter ruling will take effect on Feb. 6, 2016. The Supreme Court suspended the operation of its ruling to allow the federal government time to...
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...Euthanasia could be socially acceptable for patients with chronic illnesses because it is an escape from pain felt from the illness, a decision made between the patient and family members, and the moral consideration of the physician to help end the life of a loved one. The decision by the patient to end their life to relieve their chronic pain and suffering from their illness should be based on knowledge and not emotions. Patients with cancer suffer pain from chemotherapy and radiation. The patient could become ill and unable to function in their everyday life. Choosing to end their life could be a choice made by the patient because of the pain and sickness that they are feeling. The patient should research their options before making...
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...The decision to undergo physician-assisted suicide (PAS) is only legal in two states within the U.S. due to the consistent debate between medical professionals and patients regarding empowerment, choice, and human dignity. As notified by the government, medical professionals of any other state are required to politely decline the patient’s request to purposefully over-dose on medication that could potentially cause harm to any state of their health, and thoroughly explain why the action was declined. As your doctor, I can simply prevent you from participating in PAS within my own office, but cannot stop you from travelling out of the country to complete this procedure in Holland. Although my personal opinions of how to spend the rest of your life have minimal relevance, I would like to highlight that I do not condone participating in PAS, because I do not feel that this is a “dignified” way to die as many people may believe. As technology becomes more advanced, time passes, and the medical field is becoming more and more knowledgeable in end-of-life care. Physicians are becoming better educated and more specifically trained in caring for patients nearing the end of their lives. This is especially important for you, as we have some of the most highly trained, loving, and patient physicians in the country who know and understand your situation, and have dedicated their time and efforts to making the remaining time you have left comfortable and enjoyable. Your life has incredible...
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...End of Life Essay It is very important for people to discuss and manage end of life issues. There are many issues that may need to have resolutions such as life support, curative vs symptom management, courses of treatment. Other issues such as burial plots and funeral arrangements. I have found that many people feel they have more time to discuss end of life issues. They feel that they have plenty of time to discuss their wants and wishes for the death and dying process with their loved ones. It is very important to discuss end of life issues with your significant others, spouses, children because one never knows when the end of life issues may come up. Maybe it is a young mother diagnoses with stage 4 ovarian cancer. Maybe it’s a 76 year old male patient that feels that while he has lived a good life, it is never enough time. Or it could be a 16 year old teenage girl that had a soft tissue sarcoma that wasn’t diagnosed until it had metastases all over her body. I have taken care of all of these patients. It is never too early to discuss end of life issues, but sometimes it can be too late. Death is very personalized such as life. It is important that the individual is allowed to pass in a manner that is important to them and to feel that they have taken care of issues that they may feel need to be resolved. We might think that we know what our loved ones want, but it could be very different from what they actually want. For example we may think that our...
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...news on Dr. Jack Kevorkian assisting terminally ill patients in their death and the controversy on it. The dilemma is whether or not a physician should be allowed to assist a person in ending their life even if they are terminally ill. According to a recent article on The New York Times website, New Mexico just legalized Physician-Assisted Suicide for terminally ill patients. This ruling would make New Mexico the fifth state to allow physicians to prescribe to their terminally ill patients a fatal dose of medications to end their life (Eckholm, 2014). Proponents of Physician-Assisted Suicide believe that terminally ill people should have the right to choose go to the doctors and ask for their help to end their lives and stop their suffering. Of course there would have to be certain steps taken to make sure they were making the right choice. Many supporters of Physician-Assisted Suicide believe that there should be some psychiatric evaluation to make sure that the patient is of a sound mind in their decision to end their life. Opponents of Physician-Assisted Suicide believe that a person does not have a right to end their own life and that it goes against the oath a doctor takes to keep people healthy. Many also believe that it is against God’s will to take their own life even if it physician-assisted because God should be in full control of the moment a person takes their last breathe. In this paper I will discuss the problems that many people have with physician...
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...the implementation of practices such as physician-assisted suicide and euthanasia. * Social justice is the primary form of justice, but it encompasses other types of justice such as commutative, restorative, distributive, and contributive. * The four types of social justice are significant as they cover all the human entitlements. The social work department incorporates human rights in the creation and implementation of policies dealing with end of life decisions. * Euthanasia has evolved to become an important ethical concern especially for the elderly. * Many individuals in the recent times have changed their outlook regarding the issue of physically assisted death. Main ethical concerns * Euthanasia is a Greek word, which implies a ‘good death.’ * In the contemporary world, euthanasia is the compassionate activity of ending the life of a terminally ill patient. * Conversely, physician-assisted death occurs when a doctor provides the means of suicide to a patient who has chosen to end their life. * There are two categories of euthanasia, which are active and passive. * Active euthanasia involves the activity by a physician to fasten the death process such as administering of a lethal injection. * Passive euthanasia involves the behavior of withholding the essential care that leads to survival such as refusing to administer the necessary medications. * Active and passive euthanasia can either be voluntary, involuntary or...
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...Week 5 What are the implications and effect of tough ethical beginning-of-life and end-of-life decisions? How do these decisions affect the individual, the family, society, and health care providers? The care of beginning-of-life and end-of-life decisions for patients has shifted from family, to community, to health care professionals. Medical professionals have sought ways to improve quality of life from a newborn to a person approaching the end of his or her life’s journey (Carrese & Rhodes, 1995). The effects of such situations on the families, community and health care professionals, can be a difficult decision regarding a patient’s medical treatment. These decisions can cause conflict between family members and health care professionals and community because of religious beliefs, moral principles and professional guidelines. These types of ethical issues arise when individuals are unclear about what is best for a patient and his or her quality of life. This is why it is important for a patient to have an advance directive in place so that he or she can communicate all end of life wishes. Family members should not be left with having to arrive at an appropriate decision When a decision pertains to a beginning-of-life dilemma the ethical principal of autonomy should be applied. A parent’s decision regarding the care and treatment of their newborn should be based off what is best for the child and not on the parent’s personal morals or religious beliefs...
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...End-of-life care in social work is a continuously growing and evolving field; the social work profession has embraced the challenge that comes from interaction with the dying process across multiple systems levels. A report from The Social Work in Hospice and Palliative Care Network stated the important role social work plays in end of life care: “Given the broad scope of practice and unique perspective, social workers bring to the field of palliative and end of life care, and to multidisciplinary teams their unique expertise in ethnic, cultural, and economic diversity; family dynamics; and social support networks. Their expertise in this field includes interventions for dealing with advanced chronic illness, trauma, grief, bereavement,...
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...End of Life Nursing Donnie Barnes Oklahoma Wesleyan University End of Life Nursing Every life will end in death. It can happen anywhere or anytime along the human lifespan, but it will definitely happen. Death is never an event in life that is encouraged or hope for, however when faced with impending end of life circumstances, it can be faced with dignity and decency. Many people associate end-of-life care with treating physical pain and discomfort. While that is an important part, complete end-of-life (EOL) care also includes helping the dying person manage mental and emotional distress. An elder who is nearing the end of life who is alert might understandably feel depressed or anxious. Encourage conversations, so the elder has an opportunity to talk about their feelings. You might want to contact a counselor, possibly one familiar with end-of-life issues. If the depression or anxiety is severe, medicine might provide relief. A dying person might also have some specific fears and concerns. He or she may fear the unknown or worry about those left behind. Some people are afraid of being alone at the very end. This feeling can be made worse by the understandable reactions of family, friends, and even the medical team. For example, when family and friends do not know how to help or what to say, sometimes they stop visiting. Or, someone who is already beginning to grieve may withdraw. Doctors may become discouraged because they can't cure their patient and feel helpless...
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