Ethical Decision Making With End-of-Life Care

The option of euthanasia for patients suffering from terminal illnesses has become an ethical concern for different stakeholders in the healthcare sector. Patients are considered to have independence and self-determination when receiving care (Patil, 2013). Thus, individuals should be allowed to end life with dignity to prevent severe pain when there is no hope for recovery from a chronic disease.

However, the tenet of autonomy is limited by the fact that the choice for euthanasia by terminally ill patients is often made when in an irrational and unsound mind (Simpson, 2018).

Respect for freedom is crucial but should not be determinative for the use of euthanasia because of other ethical considerations (Simpson, 2018). Health professionals should respect not only the alleviation of suffering but also consider other ethical principles such as non-maleficence.

Other critics of the legal use of euthanasia cite the sacredness of life advocated by different religions that prohibit self-killing. The legitimate use of euthanasia in healthcare settings raises ethical questions on whether a patient seeking to terminate life has autonomy and can benefit from the act (Patil, 2013).

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Health professionals also have a moral obligation to protect patients as defined by the Hippocratic Oath (Patil, 2013). Therefore, the justification of the legal application of euthanasia has elicited ethical debates on autonomy, professional duty, and beneficence.

The ethical justification for the legal use of euthanasia is based on the principle of autonomy and quality of life. Health professionals should alleviate patients’ suffering through different methods, including euthanasia, but there is limited consensus on what constitutes suffering (Karlsson, 2011).

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The use of euthanasia for persons with an advanced terminal disease is observed as an act of compassion that fulfils the duty of non-abandonment by physicians (Sulmasy and Mueller, 2017). However, health caregivers are expected to focus on the care and comfort of patients and thus should not involve themselves in the intentional ending of life.

Ethical Question

Should voluntary euthanasia be a legal option for persons with a terminal illness?

Interview of Parties

Interview 1. (QLD Health RN)

Question: Should voluntary euthanasia be a legal option for persons with a terminal illness?

Interviewee: Yes, people should be allowed to make decisions concerning the quality of their lives and whether to end it. However, the choice for euthanasia should only be allowed for patients with the full mental capacity to make rational decisions (Chapple et al., 2006). Individuals suffering from terminal illnesses such as advanced cancer often experience excruciating pain and should be legally provided with the option of euthanasia to prevent extreme suffering.

Other patients do not wish to be remembered with their family members when sick. Thus, they should be allowed to end life to save their family from suffering when seeing them in severe pain and meeting the burden of medical costs (Chapple et al., 2006). People with severe suffering often feel undervalued and do not want to be a burden to family members. If the usefulness of an individual is lost because of excruciating pain and suffering, there is no justification for delaying death (Chapple et al., 2006). The patient may be concerned about the rising cost of care and the suffering brought to family members who have to work to support them in their clinical condition. There is also often the case in which the family just wants the pain and suffering to end for their loved one.

Interview 2. (An Older Woman Who Does Not Work in the Health Sector)

Question: Should voluntary euthanasia be a legal option for persons with a terminal illness?

Interviewee: No, death should only be decided by God. Allowing patients, the option for euthanasia is likely to support suicide. God offers life, and it is only Him who can choose when to end it. Persons with mental illness and children with suicidal ideas may seek the option of euthanasia, leading to unnecessary deaths (Chapple et al., 2006). Some patients may not be in a position to make rational choices because of their advanced stages of illnesses. The law that regulates the intervention can be abused, resulting in the deliberate killing of persons that do not want to die (Chapple et al., 2006). People may take advantage of euthanasia to get rid of their suffering relatives who are not in a position to express their feelings or to benefit themselves financially.

Analysis of Positions of the Persons Interviewed

Interview 1

The perception of the respondent concerning the legal use of euthanasia relies on the need to respect patient autonomy. The interviewee opines that people have the ability and free will to make choices on the quality of their lives or its termination (Sulmasy and Mueller, 2017). Therefore, they should be assisted to meet the interest of alleviating suffering through euthanasia. However, the consent of the patient is vital when undertaking euthanasia to ensure ethical medical practices (Sulmasy and Mueller, 2017). Health professionals and relatives should act in the best interest of patients by respecting their independence and safeguarding their human dignity (Sulmasy and Mueller, 2017). According to the principle of beneficence, people should adopt the critical moral values in society such as compassion and mercy to prevent the unbearable suffering of patients.

Virtue ethicist theory postulates that the basis for morality is the adoption of virtues such as truthfulness, liberality, and prudence. The framework focuses on the relevance of creating habits such as benevolence rather than relying on learning and defined rules that prohibit killing (Fieser, 2017). Therefore, it is ethical to allow patients to choose euthanasia voluntarily to help them end their suffering and have a dignified death. Physicians should act in the best interests of patients to make decisions on the quality of their lives (Fieser, 2017). Therefore, people should be guided by virtues to respect the autonomy of patients and help them to alleviate suffering when they consent to the use of euthanasia.

Interview 2

The position of the respondent is premised on the religious belief that life is sacred, and only God is allowed to take it. Therefore, the provision of a legal option for euthanasia contravenes both spiritual and societal expectations as it is likely to support the intentional killing of an innocent person (Sulmasy and Mueller, 2017). Euthanasia requires a breach of different prohibitions and obligations of beneficence and non-maleficence that are not consistent with societal morals (Sulmasy and Mueller, 2017). Medical practitioners must protect and improve life rather than participating in taking it away. The principle of non-maleficence requires that people should not harm others. However, the use of euthanasia is likely to be abused, thus causing unnecessary harm to innocent individuals.

Communitarian ethicist theory suggests that the interests and values of the community should be considered to negotiate ethically optimal decisions such as allowing the legal option of euthanasia for patients (Holm, 2010). The socio-historical perspective, such as religion, culture, and norms, should be emphasized when making decisions on euthanasia to agree on what is worthwhile and valuable for society (Holm, 2010). Most customs and religious doctrines prohibit killing, thus limiting the legal use of euthanasia. The communitarianism approach rejects the definition of ethical truth with dictates of human reason such as the use of euthanasia as a justification for dying with dignity and respect of patient autonomy.

I agree with the view of offering euthanasia to patients suffering from terminal illness because of all the reasons stated in the research. Euthanasia should be used after receiving voluntary requests of patients who experience unbearable pain and have no hope for recovery (Strinic, 2015). Allowing the legal option of euthanasia is considered to prevent unremitting suffering and anxiety, leading to the treatment of patients with human dignity (Strinic, 2015). Legalizing euthanasia is likely to promote a peaceful death and protect vulnerable persons from untimely deaths. Recommending euthanasia should be encouraged to enhance patient autonomy that is a critical ethical principle.

The leading determinants of using euthanasia from a professional perspective are the wishes of patients and their clinical conditions. The intervention should be used as the last resort when there are alternatives to reduce patient suffering (Strinic, 2015). I believe that euthanasia is suitable for ending the suffering of patients, promoting their freedom of choice and enabling them to die with human dignity. The failure to provide the option for legal euthanasia is likely to place patients in terrible pain (Strinic, 2015). As a result, they may commit suicide in a traumatic way resulting in a less dignified death.

Euthanasia also provides opportunities for patients that have terminal illnesses to donate vital organs to save the lives of individuals. Rational and mentally stable people above 18 years have the legal right to refuse treatment when suffering from a terminal illness (Strinic, 2015). Therefore, they have the right to die and can make decisions to donate organs to save the lives of deserving individuals.

The perception of being a burden to others by a patient suffering from a terminal illness may lead them to commit suicide or seek euthanasia. Hence, health professionals should explore different interventions to improve the self-esteem of patients through collaboration with family members and other professionals, such as psychologists (CFPC, 2015). However, euthanasia should be allowed if the competent legal patients persist in seeking euthanasia after exploring all the available options necessary to solve their dignity concerns.

Different challenges are likely to be faced when using euthanasia in practice. The legalisation of euthanasia is expected to cause more unnecessary deaths because physicians may involve in practices that deliberately hasten death. As a result, traditional medical ethics may be undermined, thus affecting the quality of life (Nunes and Rego, 2016). The intervention also erodes the integrity of medicine as it is inconsistent with the Hippocratic Oath taken by healthcare practitioners. The international code of ethics has not evolved to include the use of euthanasia, as many nations prohibit the act (Nunes and Rego, 2016). Therefore, caregivers face a legal and ethical dilemma when using euthanasia in different countries.

References

  1. CFPC. (2015). A Guide for reflection on ethical issues concerning assisted suicide and voluntary euthanasia. Retrieved from https://www.cfpc.ca/uploadedFiles/Health_Policy/_PDFs/Guidefor%20Euthanasia_EN_FInal.pdf
  2. Chapple, A., Ziebland, S., McPherson, A., and Herxheimer, A. (2006). What people close to death say about euthanasia and assisted suicide: a qualitative study. Journal of Medical Ethics, 32(12), 706-710.
  3. Fieser, J. (2017). Ethical theory from moral issues that divide us. Retrieved from https://www.utm.edu/staff/jfieser/class/160/1-ethical-theory.htm
  4. Holm, S. (2010). Ethical issues in geriatric medicine. In Brocklehurst’s Textbook of Geriatric Medicine and Gerontology (pp. 983-987). WB Saunders.
  5. Karlsson, M. (2011). End-of-life care and euthanasia: attitudes of medical students and dying cancer patients. Inst for onkologi-patologi/Dept of Oncology-Pathology.
  6. Nunes, R., and Rego, G. (2016). Euthanasia: A Challenge to Medical Ethics.
  7. Patil, A. (2013). Euthanasia -ethical and legal perspectives. Retrieved from https://www.researchgate.net/publication/295699126_Euthanasia_-Ethical_and_Legal_Perspectives
  8. Simpson, A. I. (2018). Medical assistance in dying and mental health: a legal, ethical, and clinical analysis. The Australian Journal of Psychiatry, 63(2), 80-84.
  9. Strinic, V. (2015). Arguments in Support and Against Euthanasia. Journal of Advances in Medicine and Medical Research, 1-12.
  10. Sulmasy, L. S., and Mueller, P. S. (2017). Ethics and the legalization of physician-assisted suicide: an American College of Physicians position paper. Annals of internal medicine, 167(8), 576-578.

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Ethical Decision Making With End-of-Life Care. (2020, Nov 27). Retrieved from https://studymoose.com/ethical-decision-making-with-end-of-life-care-essay

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