Ethics Surrounding Pain and Symptom Management
According to the Cambridge Dictionaries Online, ethics is a system of accepted beliefs that control behavior, especially such a system based on morals ("Cambridge," n.d.). Ethics in health care is aimed at providing guidelines and codes for health care providers for their duty, responsibility, and conduct (Mohanti, 2009). Major ethical issues arise at the end-of-life, this can include aspects in pharmacology, barriers to effective pain management, drug diversion, and the role of the nurse in pain and symptom management. With the many issues surrounding end-of-life, there are also available resources out there to help.
Most often when someone approaches the end-of-life, pain management is a priority. The relief of pain is an important ethical duty in health care. However, relieving pain is easier said than done. The myths about opioid addiction and sedation are some of the complicated hurdles for family member to get over. It is the duty of the health care professionals to educate family that pain relief is necessary for the peaceful passing of their loved one. Providers must dismiss any myths and false facts family may have and reassure them that prescribing sedative and narcotics is ethical. As health care professionals we want what is best for our patients and we do not want to do any harm to those who are at the end of their lives. In my opinion, making the patient comfortable and letting them go in peace is the right
Ethics are rules of conduct and moral principles of an individual which have various origins such as family, culture, and social environment. Given the diversity of people in the healthcare profession and the importance of providing care that is ethically sound
Studies have shown that many factors have been contributing to influence patient’s care in an ethical manner. What factors could affects one decision for their medical care? Does it also included the nurse’s individual views or should consider their moral obligations? But what is ethics really is? Based on the book Nursing Ethics by Butts & Rich, “Ethics is a systematic approach to understand, analyze, and distinguish matters of right and wrong, good and bad, and admirable and deplorable as they relate to the well-being”. Ethics should follow the current AMA guidelines.
The topic of ethics is prevalent in health care and addresses a broad range of topics in nursing. In almost every interaction with a patient there could be a situation that may bring up the question of ethics. Fortunately, there is the realization that placing the nurse in the care of a patient, may put the medical personnel in an environment where the ethics are questioned. There are whole departments dedicated to advising nurses in these situations. There are also ethic committees to help guide you when you find yourself in a situation that may question your practice or circumstances.
There are occasions when medicine is not your friend and the effects of the treatment will only prolong the suffering of the patient. Healthcare professionals must be objective and ask will the end result be changed. We must know when it is appropriate to discuss end of life options and when it is not. According to Adams (2015), most desire to die at home, but less than half are allowed to do so (p. 13). Our responsibility is to allow the client to make an educated decision about all the available service and treatments.
In almost every case of a terminal disease, pain is intolerable and seeing someone in such agony is heartbreaking. For example, Brittany Maynard, a 29 year old brain cancer patient who had to move to Oregon so she can avail of the Death with Dignity act. “Maynard knew that her form of brain cancer would be excruciating. She would endure swelling of the brain that would very likely cause seizures, painful headaches and the gradual loss of bodily function. Doctors know that for about 5 percent of the population, no amount of morphine can block the agonizing pain the terminally ill endure” (EDITORIAL: Dying with dignity). Palliative care can often be provided for the dying patients and alleviating pain to provide comfort for the dying has always been the priority. “Palliative care focuses on relieving the symptoms, particularly the pain, of incurable illness.” (Palliative Care) But, in relieving pain through the prescribed medications there are also side effects that are caused by the prescribed pain suppressors and two examples will be lethargy and it compromises breathing. In most cases the effectivity of the pain medication may no longer alleviate the pain. If a patient will be in such agony for the remaining days or weeks the quality of life is no longer present. The agony of pain prevents a patient from performing even just the bodily functions.
I believe that ethics is the moral compass we use to make decisions for our patient in providing them with safe and quality healthcare. It makes us ask the questions of right and wrong as we advocate for them. The minute we become a nurse, we are constantly faced with ethical dilemmas. Some may be minute in scale but others are on the grand scale, such as end of life issues. It is very important for the nurse to understand their own beliefs and values when we enter into our work environment. There are times when our own opinion is not relevant to the circumstances of the patient and we need to keep them to ourselves. I might have a different view about why some people do or do not get the annual influenza vaccination. Yet there are time
Ethical practice is a type of construct that reflects the values of what is right and what is wrong and adheres to the patient’s best interest in the plan of care. The code of ethics from the American Nurses
Borderline pain management education, misconceptions about hastening death, concerns about appropriate dosing and patient and family influence on opioid administration were merely just a few of the barriers discussed among several of the research articles. With minimal pain management training, it is no surprise that many health care professionals have been led to feel incompetent and unsure in their pain management abilities. Gardiner et al. stated, “ensuring generalist providers have appropriate knowledge and expertise in drug therapy for end-of- life care is key to delivering high-quality patient care” (2012). While many workers are often taught specifics on the job, pain management is something that should be universal and treated in a
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 individuals who reject killing and assisted suicide are likewise less likely to increase the amount of morphine drips a patient in pain can use for relief. This reticence," they note, "probably reflects fear that increasing opioid dose increases the risks for respiratory depression and death and might be construed as a form of euthanasia. This view may be encouraged by proponents of euthanasia who have argued that there is no difference between increasing morphine for pain relief and euthanasia." The authors urge increased efforts "to educate physicians on the ethical and legal acceptability of increasing narcotics for pain control, even at the risk of respiratory depression and death" (E. Emanuel ., "Attitudes and Practices of U.S. Oncologists
The quote” It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience”,was noted to be spoken by Julius Caesar.“ Disease can destroy the body, but pain can destroy the soul”, Professor of theology Edwin Lisson of St. Louis University, once said.
Despite significant advances in the multidisciplinary approach of palliative care and the growing body of evidence-based practice, a multitude of variables continue to interfere with excellence in end-of-life care for everyone (Anonymous, 2007). Because of this the primary nurse must be diligent in administering the proper medications to allow the patient to have minimal pain or suffering and provide emotional support and reassurance to family members, and possibly fellow staff members
In the article “Brief Research Report Defining Chronic Pain Ethics” it discusses the current issues in the diagnosis and treatments of chronic pain. A program called The Pain Action Initiative: A National Strategy (PAINS) conducted several focus groups in five cities of the US. These groups consisted of people with pain, providers, insurance and pharmaceutical industry representatives, law enforcement agents, and advocacy groups who came up with various issues dealing with chronic pain. The groups came up with six main subjects which included: disparities, quality care, trained professionals, chronic pain awareness, opiod use and multimodal therapy.
Ethics is a strongly culturally linked area of philosophy interrelated with what is considered acceptable human conduct. There are two branches of ethics; medical ethics and bioethics. The moral conduct and principles which govern practices of medical and health professionals falls under medical ethics, whereas in biomedicine and the health sciences theorised developments in the study of social and moral issues is considered bioethics(1). There are two philosophical principles within the conduction of health care research these are deontology and utilitarianism. Deontology is an approach to ethics that focuses on the rightness or wrongness of actions themselves, as opposed to the rightness or wrongness of the consequences of those actions (2). Utilitarianism states that the most benefit
Ethics is an essential aspect of health care practice and those working in the nursing profession are often subject to frequent ethical dilemmas. It is essential for all nurses to be aware of the importance of ethics in health care and to practice within the ethico-legal parameters that govern the profession. However, while this is relatively easy in theory, ethics is not a black and white subject and often one’s culture, upbringing, attitudes and beliefs can influence what one views as ethical and this can therefore influence practice. This report will discuss the importance of ethics in nursing practice. The definition of ethics will firstly be presented followed