Introduction
Ethical issues require actual decision-making for professionals to be able to make the required conclusions in the line of work. Ethics are guidelines that control what people do in their everyday lives more so in the line of work. It is reported that every day, families, patients, and healthcare workers encounter legal and ethical decisions (Pirschel, 2016). One of the important things that are evident in ethical decisions is the involvement of dilemma. The difficulty in choosing among a raft of options may concern the treatment procedures, health practice, managing healthcare personnel and resources, and other issues that any healthcare institution may realize.
The purpose of this paper is to analyze end-of-life issues in the medical field that require a comprehensive and wise decision when delivering services during the line of work. The paper discusses hospitals’ stance on the matter and the possible resolution by using the relevant terminologies in the context of ethical decision-making in the medical field. The ethical decision-making process will be revealed through the paper by showing the challenges that may occur when there is a need to terminate life ethically. The content is based on a rare occasion of patients who may want to terminate their life or if the family members decide to end the life of their kin.
Description of the Situation
Some patients have specific wishes on how they would want their life to end either when ill or in a critical condition. Additionally, end-of-life issues may be a decision by family members after considering factors that affect the patient or the family. When patients perceive that they may not recover, they involve medical practitioners to end their lives by administration of poisonous drugs that make them die gradually. In other cases, family members may see a possible occurrence of death and decide to end life of their kin to evade what they term as incurring of unnecessary costs. The challenging bit on the issue of end-of-life decision by either family or patient comes under various conditions.
First, if a patient wishes to terminate their life, the family members will probably be against the decision. Secondly, if the family members are the decision-makers on whether or not to end life, the patient may have a contrary opinion. Third, in any case, the decision is made, medical practitioners may be torn between performing the wish or keeping their faith about life, especially under the pressure of religion (Pirschel, 2016). In that situation, the bioethical decision-making process is involved since the healthcare worker’s norms, and beliefs in the profession are put at stake. End-of-life decisions have been a key ethical issue because the healthcare workers need to be ready to handle the issue (Karnik & Kanekar, 2016). There might be problems to encounter on such occasions, especially if dealing with elderly or mentally handicapped patients who may not be capable of making rational decisions.
Ethical Issues Experienced in End-Of-Life Decisions
Communication is a key issue under end-of-life care because conversations with the patient and family about death and the available choices on the unique care are never easy. Nurses can involve family and the patient about the goals of end-of-life decisions outcome to both the patient and the caregiver (Karnik & Kanekar, 2016). At this point, it becomes difficult for the three parties to agree on the best and recommended way to end life in critical care. Communication becomes an ethically important consideration because medical palliative healthcare workers can decide to clarify the process or conceal and leave it as a normal occurrence.
The other challenging issue about end-of-life care is the compromise of patient autonomy. The Patient Self-Determination Act (PSDA) offers a chance to increase medical practitioners and patients’ ability to communicate (Pirschel, 2016). Under the act, patients are given the right to voice their options on end-of-life treatment. Therefore, nurses must respect the patient’s decisions while in the line of duty, as it is vital to obey the ethical code of conduct in such situations (Pirschel, 2016). Nurses are encouraged to discuss the issues with the caregivers and the patients on the action that fits the situation. Under PSDA, if a patient decides to choose to end their life, nurses should not dispute based on saving a life or obeying their religious norms in that case.
Shared decision-making is another ethical challenge when carrying out end-of-life decisions. The problem arises when more than one party must be involved. When the significant others, such as the family, go against the patient’s request, the nurses are torn between listening to the other parties or respecting the patient’s desire (Karnik & Kanekar, 2016). Under this circumstance, advance guidelines such as medical power of attorney, living will, and Orders for Life-Sustaining Treatment must be considered prior to the decision-making process.
Ethical Decision-Making Process That Can Be Involved in End-Of-Life Situation
There are basic principles that can guide nurses and doctors during end-of-life care for critical patients. They include autonomy, nonmaleficence, beneficence, and justice, which apply in all cases that people’s rights have to be protected. Respect for autonomy means nurses have to give liberty for patients to self-determine the desired course of action in their life (Karnik & Kanekar, 2016). Nurses may not agree when patients want their life to be terminated because of the possible chance of recovering or violating the specific moral concepts. A nurse is required to support the decision that a patient wishes at any given time. However, the nurse supports the decision but involves other parties like the doctor and the close family members.
Beneficence calls for nurses to do good by having various considerations. First, not to inflict harm, bar harm or evil from happening, remove harm, and promote or do good. Under this context, doing good and doing no harm are different things (Karnik & Kanekar, 2016). When a doctor performs a medical procedure to end life, they harm the patients, but they are doing a decent action as per the beneficence decision-making guideline. The patient is favored when their wish to end life is honored because suffering, pain, and stigma come to an end for the patient. Nonmaleficence allows medical practitioners to justify why the harm was caused to the patient (Pirschel, 2016). In this case, the harm is done to prevent the patient from long-term harm, but they must have consent. The Justice principle guides palliative healthcare workers to determine whether or not the patient’s life should be ended. However, the principle involves the other three guidelines in ethical decision-making in healthcare.
It is recommended for palliative healthcare workers to analyze the situation before making a final decision on the patient or the family’s end-of-life desire. It is against the ethics in medical care for any nursing practitioner to perform the process without considering factors such as communication, the patient’s autonomy, and the need to do according to the nursing standards in medical care. There are four principles that medical care professionals use in decision making, namely, beneficence, nonmaleficence, autonomy, and justice. Ethical issues involving end-of-life processes are common in nursing practice because of the prevailing dilemmas that are involved.
References
Karnik, S., & Kanekar, A. (2016). Ethical issues surrounding end-of-life care: A narrative review. Healthcare, 4(2), 24-26.
Pirschel, C. (2016). Ethical dilemmas at the end of life. ONS Voice.