Ethical Issues In Palliative And Hospice Care

In the essay Pulling the plug on capital punishment, Andrew Allentuck uses an antithesis and an appeal to authority to prove his thesis. He believes that Canada should not restore capital punishment because it does not deter murderers, satisfy victims’ families, and protect policemen. The essayist uses an antithesis that he can refute for his thesis. He says, “Policemen claim their work is intrinsically dangerous and their safety requires the death of people who murder police officers.” Allentuck refutes this antithesis by giving a statistic that Canada had the largest number of police murders, 11 in 1962, when capital punishment was still in effect. This statistic helps refute the antithesis because if capital punishment protected policemen,

Autonomy includes three primary conditions: (1) liberty (independence from controlling influences), (2) agency (capacity for intentional action), and (3) understanding (through informed consent) (Beauchamp & Childress, 2009, p. 100). According to Beauchamp & Childress (2009) to respect autonomous agents, one must acknowledge their right to hold views, to make choices, and to take actions based on their personal values and beliefs (p. 103). Respect for autonomy implies thaturges caregivers to respect theassist a patient in achieving? Heed? the autonomous choices of their patients. From there, patients can act intentionally and with full understanding when evaluating medical treatment modalities. Autonomy also includes a set of rules, one of which requires that providers honor patient decision-making rights by providing the truth, also known as veracity (Beauchamp & Childress, 2009, p. 103). In this case, several facets of the principle of respecting autonomy, specifically veracity, informed

The situation in which one can observed unethical behavior would be in a hospital facility, where the wife of a spouse would have the sole priority in the decision making process. Actually, this situation was a dilemma that had happened to the researcher family, where she felt that she was being deprived of her rights to know about her brother’s situation at the hospice care. His wife was in charge when his life started to deteriorate and eventually was put on life support. According to English, Romano-Critchley, and Sommerville (2001), examined the human rights to “moral and legal differences between non treatment and intentionally hastening death of patient” (p. 413) has been an ethical topic for the past few years. The studied have reported

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.

The ethical dilemma encountered by the nurse involved a 69 year-old female patient. This patient had cancer that had metastasized to the bones and brain with a diagnosis of approximately one week to live. This patient was alert and oriented times four but very weak and lethargic. The patient was having difficulty swallowing pills, fluids and food. Therefore her intake was very little. She had no advance directives but was of sound mind and could make her own decisions. The patient’s pain level was 10/10 on a pain scale of 0-10 with 10 being the worst pain. “Even before end of life, nearly half of patients with cancer report moderate to severe pain; up to 30% report the pain as severe; and an estimated 25% will die in pain ("End-of Life Care," 2015)”. The patient’s family did not want the patient to take her pain medication during the day because it would sedate the patient. They wanted to spend every waking moment with their loved one. “Often family members of the dying patient cannot make end-of-life decisions or have conflicting desires about the care that should be provided (Blais &

The patient-provider relationship is at the core of medical ethics and along with it are three major models that determine the medical decision making of each provider. The three models are the paternalistic model, the autonomy model and the deliberative model. The paternalistic model is defined as a patient-provider relationship model that involves the provider's professional knowledge to decide what is best for the patient. The paternalistic model denies the patients right to autonomy and the provider acts as the patient's guardian. The autonomy model is defined as a patient-provider relationship model that gives the patient their full autonomy in deciding what treatment to choose.

Patients are becoming aware of their rights in the decision making process that affects their treatment and health (Pamela and Pamela, 2013) Healthcare professionals are continually faced with series of challenging ethical issues in their everyday clinical practice (Gallagher, 2011). Ethical issues arise as a result of misunderstanding involving patients’ right and the obligation of the healthcare professional (Corey et al., 2014). Therefore, to effectively practice in an ethically sound professional manner, it is imperative to balance professional values with ethical consideration and relevant legislature (Advanced Nursing Practice Toolkit, ANPT, 2012). This essay will critically evaluate and appraise current ethical principle in relation to healthcare practice.

Every patient should have the right to autonomy, to make choices for themselves. Medicine can be a fine line, but ultimately it is the patient that has to live with themselves, not doctors. There are many important aspects to learn from in this case. Three that nurses and other healthcare professionals should understand are good communication, patient relationships, and the concept of autonomy.

In any medical setting, it is essential to respect the patients’ autonomy. Any competent patient has the right to make decisions regarding his or her health. However, the principles of beneficence and non-maleficence also need to be considered. Respecting the patients’ autonomy does not entail a one-size-fits-all approach to truth-telling. Unfettered truthfulness or “truth-dumping” may not be in the patient’s best interest. Moreover, some cultures do not subscribe to the individualistic principle of patient autonomy and family members are significantly involved in the patient’s decision-making.

The ethical principle of autonomy is the freedom that allows a person to express personal opinions and make decisions independently without outside interference. As a patient, he or she has the right to make decisions regarding medical care and health preference, as long as they do not pose any harm to others. The health care professionals have the obligation to respect the patient’s autonomy and support the choices they make regarding treatment options. However, when the patient’s decision is not aligned with what the health care professionals believe are in his or her best interest, the patient’s autonomy will come into inflict with the beneficence of the physician’s duty to save lives.

Ethical dilemmas occur when there is a perceived conflict between the responsibility to preserve life and act in the patients’ best interests. Ethical issues involved in end-of-life care take place “because of the concerns about how much and what kind of care makes sense for someone with a limited life

Autonomy is an essential value in Western medicine and in medical ethics, and encompasses the idea that patients are entitled have a moral claim to direct the course of their own medical care and to be given sufficient information in order to make medical decisions (1, 2). Autonomous decisions have been defined as those made “intentionally and with substantial understanding and freedom from controlling influences”. Considerations of respect for autonomy in the health care context tend to focus on situations in which decisions need to be made about health care interventions. The principle of respect for autonomy is often key to discussions about confidentiality, privacy and truth-telling, but is most strongly associated with the idea that patients should be allowed to make autonomous decisions about their health care (3, 4).

This can be a difficult time not only for the patient but also for the loved ones and family. Sue Ellen, due to the fact that she was in a comatose state isn’t aware that she is possibly living in her final days of her life. During this stage health care professionals try to make the patient as comfortable as possible. The healthcare workers and physicians tried to make Sue Ellen as comfortable as possible. There are several myths about the end of life care that support good health care and good medical ethical practices. During this critical time, ethics, clinical judgement, and the law can run into major conflicts. The patient, families and physician can find themselves considering clinically actions that are ethically appropriate, but could possibly raise legal issues. In this particular case, Sue Ellen family and the healthcare facility are concerned. According to Meisel, Snyder, Quill (2000), “The 7 major legal myths regarding end-of-life-care are: (1) Forgoing life-sustaining treatment for patients without decision-making capacity requires evidence that this was the patients actual wish. Sue Ellen, did not have person that was a designated surrogate. This would play a major factor in my decision as a Health Administrator to have her moved from the AICU to a hospice facility for care. (2) Withholding or withdrawing of artificial fluids and nutrition from terminally ill or permanently unconscious patients is illegal. The only time

Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and

Cancer is difficult. A phrase a parent may utter to quench a child’s curiosity, but it many ways that simple phrase best exemplifies the disease. Albeit from different prospectives, both patients and researchers struggle to deal with cancer, and dealing with it in clinical trials also poses challenges. The deadly nature of cancer introduces additional ethical dilemmas that make the best course of action anything but obvious. One of the biggest ethical issues revolves around the use of placebos for these patients, and thus it questions whether we should alter the typical protocol for clinical trials when dealing with cancer patients. The initial phase of any clinical trial stresses safety of the treatment, but one could argue that the conventional