One of the principal responsibilities of nurses is an ascertaining of a human life ending. In this connection, the death of the person makes the socio-psychological and ethical impacts on nurses.
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When considering issues of death and dying in modern medicine from the standpoint of the nurses, the concept of the sacredness of life and self-worth of the phenomenon of life should be noted as life is the absolutely highest value in the world. The value of life is paramount even though it is flawed or defective to some extent. Nurses realize that society should value human life and support it. The preservation of lives of frail, terminally ill, elderly, and other disabled persons keeps people together and contributes to the potential goodness and humanity constituting the holistic basis of the existence of any civilized society.
One of the key issues of death and dying associated with nurses is a palliative care that is a qualified medical care for the terminally ill people consisting in pain relief and, if possible, in preventing it along with other syndromes and symptoms accompanying the dying (Peterson, 2010). It includes not only medical interventions but also psychological and social assistance provided primarily by nurses. Accordingly, nurses become the main support of dying people and their families. In the palliative care, the life-sustaining treatment is considered to be one that extends the life of the patient and increase the quality of life to the possible extent.
However, the long-term use of such a treatment will only aggravate patients suffering. The consideration of the concept of life quality in caring for patients with life-threatening or terminal illnesses leads to the idea that some interventions reduce the quality of life of the patient. For instance, the chemotherapy carried out in oncology, the artificial feeding through a nasogastric tube, hydration, and other therapies that have a number of side effects might decrease the patients’ quality of life (Braun, Gordon, & Uziely, 2010). Consequently, the feasibility of use of the above interventions might be discussed in some cases.
The palliative care for dying is based on one of the leading principles of medical practice: nurses, even if they cannot cure patients, are obliged to take all measures to alleviate their suffering and make every effort to extend the life of patients.
The euthanasia is the cessation of the terminally ill patient’s life according to his will. Therefore, the taking of the life of the human, who suffers unbearable physical suffering caused by a curable disease, for example, pain in the spine, cannot be regarded as the euthanasia. The motives of the euthanasia are compassion, pity, and the patient’s right.
The majority of nurses recognize all the forms of euthanasia as contradicting the principles of humanism and purpose of medicine. The value of human life encourages caregivers to fight for it, even contrary to the laws of human nature and in the most hopeless cases, as medical science and practice are rich in cases of healing the most hopeless patients. The American Nurses Association has banned its members from taking part in the euthanasia and put forward the following slogan: “nurses do not have to be the executioners” as the essential role of nurses is to preserve and prolong the life, but not to terminate or shorten it (Inghelbrecht, Bilsen, Mortier, & Deliens, 2009).
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The mentioned fact is of great importance for the activity of nurses as by virtue ethics of their professional duties they are in constant contact with patients, and they may also be requested to provide some tools or information about euthanasia, which can be used for suicide.
The palliative care is a viable alternative to the euthanasia for terminally ill persons. In plenty of countries, the widespread form of the palliative care is a hospice that is a medico-social institution, in which terminally ill patients do not only receive the adequate palliative medical care but also create comfortable social and psychological conditions of life involving the maximum satisfaction of their physical, social, psychological, and spiritual needs.
In hospices, the palliative care focuses on the following principles ensured by nurses: support the life and contribute to the development of attitudes towards death as a natural process; not to accelerate or delay the death; eliminate pain and other distressing symptoms; combine physical and psychological support; maintain an active lifestyle; support the patient’s family. Hospice nurses establish and maintain relationships with patients on the basis of respect for the rights and dignity of the individual.
To conclude, based on the provisions of international ethical and legal documents, the following ethical activities of nurses in providing medical care for the dying patients might be summarized:
- The nurse alleviates the suffering of the dying by all available and allowed means, regardless of the prognosis;
- The nurse provides the dying with all the required information timely as well as with the psychological support;
- The nurse acts according to the Code of Ethics.
Braun, M., Gordon, D., & Uziely, B. (2010). Associations Between Oncology Nurses’ Attitudes Toward Death and Caring for Dying Patients. Oncology Nursing Forum, 37(1), 43-49.
Inghelbrecht, E., Bilsen, J., Mortier, F., & Deliens, L. (2009). Attitudes of nurses towards euthanasia and towards their role in euthanasia: A nationwide study in Flanders, Belgium. International Journal of Nursing Studies, 46(9), 1209-1218.
Peterson, J. L., Johnson, M. A., Halvorsen, B., Apmann, L., Chang, P., Kershek, S.,.. Pincon, D. (2010). Where do nurses go for help? A qualitative study of coping with death and dying. International Journal of Palliative Nursing, 16(9), 432-438.