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There is a debate over whether individuals should have the right to choose assisted or voluntary euthanasia in the face of unforeseen obstacles like terminal illnesses, severe injuries, and medical issues. This involves administering a lethal substance upon the patient's wish to hasten their death (Tamayo-Velazquez, Simon-Lorda, & Cruz-Piqueras, 2012, p. 678), sparking discussions on whether people should be compelled to endure prolonged suffering or have the choice to end their lives.
The debate on voluntary euthanasia often focuses on the "morality and legality" (Young, 2010) of the issue.
Ethical dilemmas arise when considering whether assisted euthanasia is morally justifiable or if individuals' rights to make decisions about their own lives, including end-of-life choices, take precedence. Nurses play a crucial role in providing end-of-life care to patients and frequently encounter individuals expressing a desire to end their lives. The ethical challenges related to end-of-life care in nursing are currently prominent and would become even more complex and serious if assisted euthanasia were to be legalized worldwide, as nurses would not only provide comfort but also participate in ending life.
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At present, assisted euthanasia is legal in only three countries: the Netherlands, Belgium, and Luxembourg. In all other parts of the world, euthanasia is considered murder ("Assisted Suicide & Death with Dignity," 2013).
Physician Assisted Suicide (PAS) is legal in three states in the United States – Oregon, Montana, and Washington. Referred to as the "Death with Dignity Act," it permits doctors to prescribe a lethal overdose to terminally ill patients with six months or less to live, solely based on patient wishes without informing families.
In other states, assisted suicide is considered manslaughter and subject to legal consequences. The global debate on euthanasia continues to be contentious, with ongoing efforts to pass laws. Nurses may confront moral quandaries when confronted with complex situations involving confidentiality and privacy issues that can lead to uncertainty about the right course of action.
Nurses must have a thorough understanding of patient obligations and laws related to privacy and confidentiality, with the HIPAA law serving as a guide for patient privacy (HIPAA. ORG, 2008). It is crucial for nurses to be well-informed about confidentiality guidelines in order to practice within legal boundaries. The code of ethics emphasizes the nurse's role in advocating for safety, health, and patient rights (ANA, 2010), while deontology theory assists nurses in evaluating the morality of actions based on adherence to rules. Ethicality is determined by intentions rather than outcomes. Beneficence involves showing compassion and taking positive action to help others, embodying the fundamental principle of patient advocacy (Butts, J. B., & Rich, K. L., 2008). Autonomy theory provides support for nurses in honoring patients' rights to make independent decisions.
While the right to autonomy allows nurses to make moral decisions without causing harm, it can also give them a sense of freedom. Voluntary assisted euthanasia may be justified by the Beneficence theory but ethically questionable for nurses. The impact of social values, morals, and norms was evident in the Terry Schiavo case, which brought national attention to the debate over prolonging life in cases of life-altering medical tragedies. Her husband advocated for letting her pass peacefully, while other family members fought to keep her alive, leading to a highly publicized and controversial legal battle.
The case highlighted the "right-to-die" issue, as the absence of a living will left the courts to determine Terri Schiavo's final wishes. The court in Florida legally affirmed that individuals have the right to refuse medical treatment, even in a vegetative state. Given the lack of consensus on Schiavo's preferences, her husband's intimate knowledge of her led the court to ultimately agree that she would have wanted to exercise that right.
The ethical dilemmas presented by the case were challenging for nurses and doctors since they are bound by an oath to prioritize the preservation of life while also honoring patient autonomy. Despite the complexity of the situation, medical professionals were able to adhere to court orders without compromising their commitment to their oath by removing a feeding tube rather than actively causing harm to the patient.
It is important to note that this case was complicated by social and political issues. Pro-life groups advocated for Schiavo's family, and President George W. Bush attempted to intervene. Some believe these actions were intended to make a political statement. When addressing an ethical dilemma, it is crucial to identify the type of ethical problem in order to lay the foundation for a caring response. An ethical theory can then be implemented and followed systematically to reach the best possible outcome. In the Terry Schiavo case, there were uncertainties regarding decision-making authority, leading to the establishment of a locus of authority for this ethical issue, with the Supreme Court serving as the moral agent. With this trajectory in place, the Supreme Court would ultimately be accountable for the outcome of the caring response.
Furthermore, the Courts would likely have to rely on a narrative approach to ethical decision making. Purtilo and Doherty (2011) define the narrative approach as information told through stories that, as a result, affect the human experience. With the barrage of coming from the Schiavo case, the Supreme Court must be sure to gather all the relevant details in order to establish facts, relationships and values. Consequently, this is the first step in many ethical theories as well as Purtilo and Doherty’s (2011, p. 103) six steps to ethical decision making. The determination of an ethical decision is deeply rooted in personal and societal values. The ethical theory provides the framework, but it is the value-laden details that guide the decision (Aulisio & Arnold, 2008). With this said an accurate prediction with regard to cases such as Terry Schiavo would be the immediate intervention of ethics committees to mitigate lengthy legal processes and preserving a caring response.
Nursing ethics play a crucial role when caring for terminally ill patients, as moral and social values are closely linked. Nurses must understand the complexities of assisted euthanasia to adhere to legal and ethical standards. Having a deep understanding of assisted death is essential for nurses to maintain their personal and professional ethics.
Ethical Dilemmas in Euthanasia: Nurses' Role and Responsibilities. (2016, Mar 13). Retrieved from https://studymoose.com/analysis-of-an-ethical-dilemma-essay
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