End of life care is accorded to patients with the advanced and not curable disease to be in this world comfortable until they pass on. It promotes the palliative and supportive care desires of the family as well as the patient to be acknowledged and satisfied all through the final stage of being into mourning. Nurses are more often in a situation to provide for the families and patients confronting difficult decisions and adjusting to painful realities (Carrese & Rhodes, 1995).
A healthier end of life care is understanding that the process of death and dying is inevitable and is a natural cause of life’s the last stage in person’s life it is exceptionally important time for the individual who is dying and their family as well as well as close friends. Since the goals of an end of life are to maintain the choices, comfort and quality of life of a person in the terminal phase; to care for the spiritual and psychosocial needs of the family and the terminally ill and sustain their individuality. Based on the above, this topic is appropriate while looking into the ethics analysis because lots of decision making often hard ones is made and many times it involves sacrificing some interventions for the greater good .this topic is justifies to be done to reduce burdensome and inappropriate health interventions.[“Write my essay for me?” Get help here.]
Taking a moral position is the willingness to stand and be counted for and acting according to one’s ethical beliefs. When the principles that govern morals are facing threats regardless of actual or perceived risks such as anxiety, stress or isolation from colleagues me as a nurse must have the moral virtue to determine when action is required. I also believe that I am obliged to care for patients with respect and in a nondiscriminatory manner. In the course of these, I recognize that nurses may be limited to some risk of harm nurses are expected to accept as an ethical duty. The damage may include emotional, divine and physical harm.
Ethics is a subdivision of philosophy that dealing with how to appreciate the moral principles of individuals and their decision-making process based on what is acceptable and what is morally correct or wrong (Merriam-Webster, 2014). When families and patients make the decision regarding the care they would accept or not accept in the perspective of the end of life, care there are often ethical issues that can arise. As nurses, our values and morals sometimes are inconsistent with those that the patients under our care have, and this may cause some distress to both parties.[Need an essay writing service? Find help here.]
Patients put a high value on what they would hope to attain regarding their poor health. These goals are patient’s values and moral principles. These goals are often the wishes the patient’s harbor regarding their disease. Often many difficult decisions have to be made as the patient approaches the end of life. Some of these decisions revolve around the kind of treatment they would want. In the clinical setup, it is common to witness the divergence the family and patient wishes. Occasionally, there can be the conflict between what medical practitioner believes compared to what family and the patient wants to. From time to time, the healthcare system and the insurance have guidelines that may not be in line with the values in addition to goals of patients and kin. The story of young Jahi McMath that broke recently in the news is a prime example of how a conflict of interests may arise. In this case, the family wished their young daughter to continue using the ventilator which did not auger well with the wishes of the hospital. Following extensive tests, on the brain of little Jahi McMath, it was diagnosed as dead on and consequently the need for medical interventions was not a priority since there was no evidence of the quality of life (Fox News, 2013).
Nurses need to understand the standard of care and the scope of practice which as stipulated in Code of Ethics for Registered nurse from Canadian Nurses Association (CNA, 2008).This principle of promoting and respecting informed decision making are based on the agreement to comply with the right to individually chat a way forward and to support individuals autonomous rights (CNA, 2008). Many at times it’s difficult to see a patient make decisions that nurses do not personally subscribe to or the nurses feel it’s not the best choice given the patient’s circumstances. As nurses, it’s our obligation to support as well as advocate for the victims’ rights including to be autonomous. For instance cancer patients whom a nurse has been caring for suddenly make a decision to stop chemotherapy and redirect his efforts in bonding with his kin. While the nurse has cultivated a loving relationship with the patient and would not what to see him die, the nurses must respect the wishes of the patient and his choice of medical care.
When assisting the patient in making the difficult decision, the nurse should be aware it’s their obligation not to cause harm but instead, promote well-being and health by working with both the patient and the family. The community should also be involved w to ensure the patient attains their highest possible level of well-being and health (College of Nurses Ontario, 2016). The standard of refraining from causing unnecessary harm is critical while taking care of terminally ill patients. Although it is apparent that some medical and nursing actions cause some damage, nonmaleficence principle seems to take care of these, whereby as providers the priority is providing an action that is of greater good and hence justifying the harm caused (American Nurses Association, 2001). These situations are all too common in end of life clinical set ups such that a patient whose death is imminent requires pain killers to be comfortable. In some cases a patient can be so close to death such that he has irregular respirations and bradycardia, the nurse needs to give pain medication although there is fear that by giving this medication, it may hasten the process of dying. By the Code of Ethics for guiding nurse (ANA, 2015), the nurse may not accelerate the termination of life process. However, the healthcare provider, in this case, the nurse has a duty to relieve suffering in a dying patient although the action taken may speed up the process of dying.
The process of justice governs social fairness. Justice involves determining if someone is entitled to privileges. The Code of Ethics of Registered Nurses (CNA, 2008) spells out that a nurse should uphold justice by promoting equity and fairness, human rights and promoting the public good. Necessary interventions are directed to the person disserving regardless of patient’s’ economic or social status. As with Jahi McMath continuing to put her in the ventilator would be futile with her brain death as there is no hope for recuperation. So the option of removing her from the life support machine was considered no based on her economic, social or demographic status but purely based on the medical diagnosis.
Medical assisted dying is the process of hastening deliberately individuals by use of the lethal substance or drug (College of Nurses Ontario, 2016). Under this description, two different subcategories consist of assisted suicide and active euthanasia. In the case of assisted suicide, the patient means to carry out suicide, and the nurse provides a lethal dose of medication for the patient to use on himself. In active euthanasia, another person terminates the patient’s life (Volker, 2010).The Codes of Ethics from several nurses’ organization forbid nurses in assisting patients to die. College of Nurse in Ontario, recognizes the nurse’s conscience freedom, such that due to the different values and beliefs of the nurse he/she may not be comfortable with participating. The law does not compile anybody to participate in assisted dying, However, if a nurse is not willing to participate, they can work together with the healthcare facility to find n alternative person.
Caring for terminally ill patients places a nurse in a unique position of witnessing the complex decisions that families and patients make. Even though the practitioners of nursing have their principals they sometimes cause conflict with their patient’s values and beliefs and an internal disagreement for the nurse can develop. It’s the obligation of the nurse to show leadership and show the patient the greater good rather than co-centering on the interventions that may be the beginning of a conflict. Such reactions include in withholding/withdrawing of medical interventions and when not attempt resuscitation .at this juncture it’s the nurse in his wisdom to assess and do what is beneficial to the patient in spite of any attachments to the patient.[Click Essay Writer to order your essay]
In conclusion, the principles that govern ethical principles are very significant in the nursing practice as it guides the nurse to make everyday decisions. By understanding the issues that may emerge while caring for the terminally ill patients as articulated above, the nurse is will be ready to rise to the occasion when confronted with this ethical dilemmas with respect and in a nondiscriminatory manner. Palliative care nursing engages a person’s way of life and his experiences It also calls for an approach and attitude that goes beyond the immediate medical diagnosis. Attaining this require something extra that goes beyond the daily nursing routine that governs the daily interactions between the patients and the nurse. It is both art and science that gives regards to the overall well-being of an individual. Values are molded through owns perceptions and experiences about life such that it is a cross between set values and the ultimate goal one desires to achieve in a particular manner. Most importantly it’s a necessary quality that governs practice conducts all the time a nurse works with a patient nearing an end of life (Becker et al., 2004).
American Nurses Association. (2001).Code of Ethics for Nurses with interpretive statements Silver Spring, MD: American Nurses Publishing.
American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements.
Becker, l (2004) Fundamental Aspects of Palliative Care Nursing. Salisbury: Quay Books. Commission for Health Improvement, Audit Commission (2001) National Service Framework AssessmentsNo 1: NHS Cancer Care in England and Wales.
Canadian Nurses Association.(2008). Code of Ethics for registered Nurses.
Carrese, J. A., & Rhodes, L. A. (1995). Western bioethics on the Navajo reservation. JAMA, 274, 826-829.
College of nurses Ontario. (2016).Guidance On Nurses Roles In Medical Assistance In Dying.Pub; 41056 ISN 978-1-77116-046-9
Ethics [Def. 1]. (n.d.). Merriam-Webster Online. In Merriam-Webster.
Fox News. (2013). Jahi McMath’s case: Hospital won’t aid teen’s transfer.
Volker, D. L. (2010). Palliative care and requests for assistance in dying. In B. R. Ferrell & N. Coyle (Eds.), Oxford Textbook of Palliative Nursing (pp. 1185-1192). New York: Oxford University Press