Preview

End-of-life Care

Good Essays
Open Document
Open Document
819 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
End-of-life Care
Ethical Dilemma Debate
George-Ann Wood
Midway College
Nursing 460
March 01, 2011

Ethical Dilemma Debate
As the population ages in America, the dilemma of end-of-life care becomes an important issue for the professional nurse. As reported in Evidence-Based Geriatric Nursing Protocols for Best Practice, the Patient Self Determination Act (PSDA) of 1991 establishes advance directives and decision making for those when capacity to make their own health care decisions is impaired (Capezuti 2010). In light of this PDSA, nurses often find themselves involved in end-of-life situations that conflict with patient’s wishes for themselves and family’s wishes for the patient. The dilemma presents itself in this area of conflict between the conflicting desires of patient and family. The nurse must completely support the patient’s wishes while assisting the family to do the same. The nurse is advocate for the patient, educator of the family, and liaison between the interdisciplinary team.
The debate arises within those conflicts; the ANA Code of Ethics binds nurses to respect the autonomy of each patient and their decision to choose the healthcare options they believe are correct for them based on their religious, social, cultural and personal desires for end-of –life care (ANA Code of Ethics 2001). Nurses are also bound to participate in advocating for the patient to alleviate unnecessary treatment for the patient who has designated they do not want treatments that doctors and/or families may be advocating for the patient against that patients wishes (ANA Code of Ethics 2001). The nurse must be familiar with the end-of-life wishes of their patients otherwise; the patient looses a valuable advocate to assist in achieving their goals for end-of-life care. Nurses must also be aware of their own personal values and beliefs surrounding end-of-life care for their patients’ choices to advocate adequately.
The dilemma during end-of-life issues arise when there are differing



References: http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/CCode-of-Ethics.aspx REGISTERED NURSES’ ROLES AND RESPONSIBILITIES IN PROVIDING EXPERT CARE AND COUNSELING AT THE END OF LIFE http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Ethics-Position-Statements/etpain14426.aspx Mauk, Kristen L. (2010). Gerontological Nursing Competencies for Care. Massachusetts: Jones and Bartlett

You May Also Find These Documents Helpful

  • Good Essays

    According to the article, in a survey, of the physicians who agreed to an AID request from patients, one-third asked to have the euthanasia administered by their nurse (Connolly, Keller, Leever, and White, p. 313). The article argues against the four moral objections that The American Nurses’ Association has about nurses’ involvement in AID. The American Nurses’ Association beliefs that nurses have a duty to “do no harm,” a social obligation that is based on trust, the capability to deny patient and family wishes in order to satisfy the moral obligations of the profession, and lastly that abuse is possible when defenseless patients are involved (Connolly et al., p.…

    • 696 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    Within the profession of Nursing there are many decisions and clinical vignettes that will play out. This paper will depict an end of life case study, which will be explored. When reviewing each case study there are two nursing actions for how end of life care is viewed and carried out, according to the American Association Code of Nursing Ethics. Throughout the ethics code it explains how a nurse who does not abide by the standards would be handled.…

    • 1637 Words
    • 7 Pages
    Powerful Essays
  • Satisfactory Essays

    The team should be knowledgeable to give proactive care, understand the patient's preferences and forgive conflicts. The process of truth telling in advanced cancer or any other terminal illness can be a difficult task. Whenever a patient is too moribund and not in a suitable mental stage, the family carers are required to give informed consent. The doctor and nurse in the palliative care team have to build the communication with a responsible family carer so that confidentiality and dignity for patient's last stage are maintained.[1,2] Communication is meant to deal with ethical questions regarding two fundamental aspects of Palliative Care: To explain the concept of a good death and to resolve the conflicting needs of patient vis-à-vis family.[8]…

    • 183 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    Ilene, many of the ethical dilemmas faced by nurses could be eliminated if people would take the time to let their family know what interventions they would want in situations like this. End-of-life planning and advanced care directives will increase the quality of life of a dying patient, ease the ethical decisions having to be made by family members, and will ensure that personal wishes will be abided by (Eggertson, 2013, p. E617). Many people talk about what they do and do not want but never write them down. This leaves the family, doctors, and other health care members second-guessing the wishes of the patient whenever they are too ill or sick to make decisions themselves. If your patient had made these decisions earlier and made it…

    • 140 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    It is a necessity that nurses recognize their own feelings regarding death and dying and have a strong ethical framework in order to support the end-of-life wishes of their patients (Butts & Rich, 2013). Even if one is resolute in their own moral standing, cases such as Mr. T.’s may be emotionally exhausting.…

    • 478 Words
    • 2 Pages
    Good Essays
  • Better Essays

    Who has the right to decide when to end life sustaining measures? Is it the individual, the health care provider, or the government? This has been an ongoing debate for many decades in the healthcare field. Advanced directives were suppose to be the simple solution to this dilemma. However, this simple solution has become very complicated and has evolved over the years. According to Watson et al. (2010) end-of-life care highlights the following issues: competency, persistent vegetative state, living wills, best interest standards. Oftentimes people, including nurses have a difficult time speaking about end-of-life care. Advanced directives should be a legal document that allows a person to decide their wishes about…

    • 1334 Words
    • 6 Pages
    Better Essays
  • Good Essays

    The nurse has an ethical responsibility to respect the patients care choices related to palliative care in opposition to traditional treatment. Holistic and patient-centered care focuses on understanding and prioritizing the patient/family’s wishes and ensuring that they are making informed decisions regarding care decisions. Often times, when the patient or the healthcare proxy has elected palliative care, other family members may disagree with this choice. The family may ask the nurse to help convince the patient/healthcare proxy that traditional treatment the most appropriate choice. The nurse would have an ethical dilemma and must be nonbiased and follow the patient’s decision, as long as the decision does not…

    • 382 Words
    • 2 Pages
    Good Essays
  • Powerful Essays

    Palliative care is one of the most sensitive specialists in nursing today. Hence the guidance published in nursing times [2012]recommends that trusts draws up a plan to raise awareness of end of life issues in all wards as to improve rapid discharge process for patients who choose to die at home, as it is becoming common nowadays for end of life to occur within the hospital settings [Main, 2002]. The National Institute for Health and Clinical Excellence, 2004 b, p20, defined palliative care,…

    • 2685 Words
    • 11 Pages
    Powerful Essays
  • Powerful Essays

    End of life care is relevant to nursing because nurses are with their patients for most of the time and play a major role in how patient’s lives will end. However, nurses encounter some challenges while choosing care for their patients. With advancement of technology, nurses face the dilemma whether the wishes of the patient regarding withhold or withdraw the treatment in end of life should be followed, or the wishes of family should override the wishes of a patient when parents consider physical existence with help of technology and advanced treatment is worth living (Azotam, 2012, p.…

    • 1284 Words
    • 6 Pages
    Powerful Essays
  • Powerful Essays

    Palliative Care

    • 1775 Words
    • 8 Pages

    Culture is a fundamental part of one’s being which along with spirituality play a significant role in a person’s journey through life. Health beliefs may be strongly tied to a person’s cultural background and spiritual or religious affiliation. Palliative care is the active holistic care of terminally ill patients which demands to maintain the quality of life addressing physical symptoms as well as emotional, spiritual and social needs. This very nature of the palliative care poses challenges to health care workers when addressing a culturally diverse population. Australia is the most multicultural country in the world where its population ranges from the descendants of Aboriginal and Torres Strait Islander people to migrants or of descendants of migrants from more than 200 countries. The aim of this essay is to discuss the importance of providing spiritually and culturally competent care for a person and their family receiving palliation. This essay also discusses how importance is to focus these principles to the culture of Aboriginal and Torres Strait Islander people with regards to death and dying.…

    • 1775 Words
    • 8 Pages
    Powerful Essays
  • Good Essays

    Code Of Ethics In Nursing

    • 551 Words
    • 3 Pages

    Nurses must consider the needs and respect the values of every patient. The nine provisions of the Code of Ethics for Nurses establishes guidelines to ensures that every patient is treated with dignity, respect and decisions being made on behalf of the patient conform to ethical standards. To promote dignity and respect, nurses need to communicate openly, honestly, and sincerely to gain the trust of their patients and provide care without prejudgment. Factors that may impact decision making of the Practical Nurse include lifestyle, disability, disease, culture, values, religion, and social support. When providing care, all of these factors should be considered. However, nurses are obligated to promote health, address problems and respect patient decisions. Nurses should respect the rights of all patients regardless of these factors. Nurses should respect patient dignity and their right to self-determination. Patients have the right to control what will be done to their own body. Patients also have the right to be given all necessary information in a way…

    • 551 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Ethics is extremely important in any professional job, especially that of healthcare providers. Ethics, related to the medical field, looks at six key aspects. According to Ethics in palliative care the six components include autonomy, beneficence, non-maleficence, justice, dignity, and honesty (Mohanti, 2009). It is important to note that these components are pertinent in all of ethical nursing care, and not just palliative care.…

    • 899 Words
    • 4 Pages
    Good Essays
  • Better Essays

    Some feel that a terminally ill patient should have a legal right to control the manner in which they die. Physicians and nurses have fought for the right to aid a patient in their death. Many families of the terminally ill have exhausted all of their funds caring for a dying patient and would prefer the option of assisted suicide to bankruptcy. While there are many strong opposing viewpoints, one of the strongest is that the terminally ill patient has the right in a humane, dignified manner. However, dignity in dying is not necessarily assured when a trusted doctor, whose professional…

    • 1423 Words
    • 6 Pages
    Better Essays
  • Good Essays

    Euthanasia

    • 390 Words
    • 2 Pages

    Nurses have a responsibility to examine how they feel about euthanasia, about the processes available today for extending life, and whether their patients have a right to choose their own fate. Although nurses worldwide are confronted with euthanasia requests from patients under their care, rarely are their opinions considered in the decision making process. “To develop clear guidelines on the role of nurses in euthanasia, it is essential to consider fully the viewpoint of nurses, given their daily interactions with dying patients and their expertise in caring for them” (Verpoort & Gastmans, 2006, p. 188) Nurses are involved in various phases of the euthanasia process such as viewing the request for euthanasia, managing decision making, discharging out euthanasia, and the aftercare for the patient’s family. Nurses have a professional responsibility to stay reliably informed about the ethical, legal, cultural and clinical implications of euthanasia.…

    • 390 Words
    • 2 Pages
    Good Essays
  • Good Essays

    End Of Life Care Analysis

    • 837 Words
    • 4 Pages

    “End of Life Care” is the active total care of patients whose disease is no longer responsive to curative treatment. Through practicing holistic and palliative care to dying patients can help improve the remainder of their lives, adding quality to their days (Fielding, R., & Chan, C., 2000, p. 17). However, the “End of Life Care” services provided are still not adequate enough for patients, although Hong Kong has already practiced. Different factors, like lacking of knowledge in end of life care, result in lagging in such development. Thus, this essay aims at discussing ways in enhancing “End of Life Care” in Hong Kong society, thereby allowing dying patients to pass away with less discomfort and in peace. In the following paragraphs, the four ways will…

    • 837 Words
    • 4 Pages
    Good Essays