Ethical Considerations in End-of-Life Care: Key Perspectives and Challenges

Akdeniz Melahat, et al. “Ethical Considerations at the End-of-Life Care.” SAGE Open Medicine, vol. 9, 2021, pp.1-9. Web.

Melahat Akdeniz, Bülent Yardımcı, and Ethem Kavukcu article “Ethical Considerations at the End-of-life Care” explores the ethical challenges physicians face in their quest to prevent and relieve suffering when dealing with dying patients. The source is a journal by Sage Open Medicine published in 2021. The authors find several issues that bring moral complications when dealing with people nearing the end of their lives, such as decisions rated with resuscitation, terminal sedation, withdrawing treatments, euthanasia, physician-assisted suicide, hydration, and artificial nutrition (Akdeniz et al. 1).

The study highlights and discusses the five ethical principles that should guide healthcare providers when dealing with this complex situation. The study shows the importance of understanding Western medicine, which is changing the quality of healthcare provided but has altered how people approach the subject of death. The article concludes that palliative care’s main goal is to alleviate suffering, and medical professionals must encourage open communication among the providers and their patients, thus navigating the dilemmas associated with end-of-life decisions.

Key Quotes

1. “The goal of end-of-life care for dying patients is to prevent or relieve suffering as much as possible while respecting the patients’ desires” (Akdeniz et al. 1).
2. “The main situations that create ethical difficulties for healthcare professionals are the decisions regarding resuscitation, mechanical ventilation, artificial nutrition and hydration, terminal sedation, withholding and withdrawing treatments, euthanasia, and physician-assisted suicide” (Akdeniz et al.1).
3. “The ethical principles are autonomy, beneficence, nonmaleficence, fidelity, and justice” (Akdeniz et al. 2).
4. “Approximately 75% of dying patients experience difficulty breathing or dyspnea” (Akdeniz et al. 4).
5. “Physicians must be aware of their patients’ capacity, beliefs, and preferences, as well as their clinical condition” (Akdeniz et al. 5).

Alkitabi, Abdulaziz, and Saif Nouri. “Euthanasia Between National Legislation and International Human Rights Law.” Alrafidain of Law, vol. 25, no. 82, 2023, pp. 1-29. Web.

Saif Faris Nouri and Abdulaziz Ramadan Ali’s study “Euthanasia Between National Legislation and International Human Rights Law” begins by explaining how humans sometimes depend on other parties, such as during ailments. The source is a journal article by Alrafidain of Law and was released in 2023. The authors portray that such times could include an individual being severely sick and needing to be assisted to end their lives when the chances of their recovery are low. They also narrate how the topic is important as it constitutes a violation of an individual’s right to life.

This study researches various laws regarding euthanasia, for instance, the 2001 legislation in the Netherlands that legalized euthanasia (Alkitabi and Saif 5). A discussion of jurisdictions that allow euthanasia, such as Ireland, Poland, and Greece, is also discussed. In the Arabic world, the authors found that nations such as Iraq, Jordan, Egypt, and Algeria have different legislations regarding euthanasia. The authors suggest that nations must review their legislation regarding euthanasia to bring them in line with international conventions.

Key Quotes

1. “The Netherlands is among the countries that have agreed to euthanasia by passing a law allowing euthanasia” (Alkitabi and Nouri 5).
2. “The general idea in French law is to promote palliative care, prohibit positive euthanasia, and prevent a physician from exercising unreasonable stubbornness” (Alkitabi and Nouri 6).
3. “Algerian law does not allow euthanasia, and there is no text that specifically criminalizes this type of killing” (Alkitabi and Nouri 1)
4. “English law has set special conditions for euthanasia that must be fulfilled by both the physician performing the homicide and the patient in acute pain” (Alkitabi and Nouri 6)
5. “Greek law rejects the idea of euthanasia, and expressly stipulates it in Article 300 of the Penal Code” (Alkitabi and Nouri 7).

Offer-Stark, I. “Designing Medical Law in a Multicultural Society: The Case of Israeli End-of-Life Laws.” Ethics, Medicine and Public Health, vol. 28, 2023, pp. 1-16. Web.

Offer-Stark, a researcher at Kogod Research Center, article titled “Designing Medical Law in a Multicultural Society: The Case of Israeli End-of-Life Laws,” compares the uniform law model and legal pluralism model. This source is a journal article by Ethics, Medicine, and Public Health and was released in 2023. The paper discusses the challenges policymakers face when designing a public health policy in Israel because of the nation’s different cultures.

To compare the two models in the country, the author uses two legislations: The Israel Dying Patient Act and the Israel Brain Respiratory Death Act. The former successfully promises a compromise between positions of disputing factions in the euthanasia debate in Israel, while the latter recognizes the criterion as a legal default (Offer-Stark 1). These two laws advocate for a legal pluralism approach, which the author favors.

Key Quotes

1. “The interplay between multiculturalism and healthcare is complex and loaded with structural contradictions” (Offer-Stark 2).
2. “The Brain-respiratory Death Act was intended to settle the issue of determination of the moment of death” (Offer-Stark 5).
3. “The issue of treatment for terminally ill patients has always raised ethical dilemmas” (Offer-Stark 6).
4. “The Dying Patient Act was intended to settle the thorny ethical issues involved in end-of-life medical treatment” (Offer-Stark 8)
5. “Shaping public policy in a pluralistic multi-cultural society is a challenge that Israel has been grappling with since its establishment.” (Offer-Stark 12)

Sethi, Shubham, and Angad Singh. “Euthanasia: The New Phase of Right to Die.” International Journal of Law Management & Humanities, vol. 4, 2021, pp. 953-963.

Shubham Sethi and Angad Singh explore the topic of euthanasia in their article titled “Euthanasia: The New Phase of Right to Die.” The source is a journal article published by the International Journal of Law Management and Humanities and was released in 2021. The authors conduct a deep analysis of the subject with the aim of understanding if voluntary killing should be allowed or not and, if it should be allowed, on what conditions. The article focuses on euthanasia in India, but it also focuses narrowly on the legality of euthanasia in other parts of the world, such as Japan, Luxemburg, USA, Australia, Switzerland, Belgium, the Netherlands, and Canada.

The study looks at the topic from a religious point of view, finding that various religions forbid euthanasia since it is a form of killing and that human life should be considered sacred. According to the article, the advantages of the practice of ending life aided by a physician are that it gives individuals autonomy for their lives, reduces financial burdens, and ends people’s suffering (Sethi and Singh 961). However, the authors find that euthanasia has various disadvantages, such as being challenged by moral and religious principles, encouraging doctors to be corrupt, some physicians being unwilling to perform the practice, and ignoring the fact that some patients could miraculously recover.

Key Quotes

1. “Euthanasia, in simple terms, means mercy killing, one of the most debated topics so far” (Sethi and Singh 953).
2. “The first countries to legalize Euthanasia were the Netherlands in 2001 and Belgium in 2002” (Sethi and Singh 954).
3. “Religions are opposed to euthanasia for a number of reasons, some of which are that god has forbidden it. In various scriptures, it was mentioned that you must not kill (Sethi and Singh 960).
4. “The idea of Euthanasia is not new it dates back to 1935 when the organized movement of legalizing of euthanasia started” (Sethi and Singh 954).
5. “There is no statutory law regarding the legality of euthanasia in Japan” (Sethi and Singh 955).

Young, Robert. “Voluntary Euthanasia.” Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, The Metaphysics Research Lab, Department of Philosophy, Stanford University, Stanford, CA 94305, 2022, pp. 1-33.

The article “Voluntary Euthanasia,” authored by Robert Young in 1996 and revised in 2022, looks at ethical and moral aspects surrounding the topic of euthanasia. The source is a scholarly article from the Stanford Encyclopedia of Philosophy, a summer 2022 edition. The author explores situations that could make a patient to be an eligible candidate for euthanasia. The study also critically analyzes the moral cases that favor euthanasia and those opposed to its moral acceptability.

The five conditions that make a patient be allowed for euthanasia are terminal illness, unavailability of beneficial cures, intolerable suffering, voluntary wish to end the life, and the inability of the individual to end their own life (Young 7). The moral philosophy that allows individuals to be allowed to perform euthanasia, according to this study, is that people need to be given autonomy in how they live as long as they do not harm other people. The article also presents objectives against this assisted killing, saying that palliative care institutions can reduce pain, skepticism surrounding the topic, and the risk of non-voluntary euthanasia being performed on patients.

Key Quotes

1. “The motive of the person who performs an act of euthanasia is to benefit the one whose death is brought about” (Young 1).
2. “In Oregon in the United States, legislation was introduced in 1997 to permit physician-assisted suicide after a referendum strongly endorsed the proposed legislation” (Young 5).
3. “Is unlikely to benefit from the discovery of a cure for that illness during what remains of her life expectancy” (Young 7).
4. “It is certainly true that a request to die may not reflect an enduring desire to die” (Young 16)
5. “Opponents of voluntary euthanasia claim, however, that the difference between active and passive euthanasia is to be found in the agent’s intention” (Young 20).

Zhou, Yan Ming Jane, and Wayne Shelton. “Physicians’ End of Life Discussions with Patients: Is There an Ethical Obligation to Discuss Aid in Dying?” HEC Forum, vol. 32. no. 3, 2020, pp. 227–238. Web.

Yan Ming Jane Zhou and Wayne Shelton’s article titled “Physicians’ End of Life Discussions with Patients: Is There an Ethical Obligation to Discuss Aid in Dying?” discusses the importance of discussing with patients Aid in Dying processes amidst wide acceptance by several states for euthanasia. This source is an academic journal article published in the journal of HEC Forum in September 2020. The paper argues that medical physicians have the role of informing some clients about Aid in Dying, focusing on patients’ autonomy and giving informed consent.

The authors start by providing a background of study on how Aid in Dying has emerged to become one of the most debated topics. It is argued in the study that doctors have the responsibility of making the diagnosis and prognosis and informing the patients when the available treatment options cannot cure or alleviate suffering in the patient. Assimilating knowledge from other studies, the authors show that the best approach when doctors are presenting Discuss Aid in Dying should be presenting the client with all the available about the issue and then remaining neutral.

Key Quotes

1. “Patients have the right to make informed decisions about their health” (Zhou and Shelton 227).
2. “Physicians have an obligation to discuss with and inform patients of the options that will accomplish the patients’ goals of care” (Zhou and Shelton 227).
3. “Studies conducted on Oregon physicians who care for the terminally-ill and experienced physicians in handling AID requests have shown that physicians still have varying opinions about the act of carrying out AID” (Zhou and Shelton 232).
4. “Having this choice at the end one’s life has become incredibly important” (Zhou and Shelton 238).
5. “Some physicians have reported that being asked to participate in AID elicited intense emotions” (Zhou and Shelton 232).