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Ethical Issues Surrounding End-of-Life

Nurses are each day surrounded by situations that lack the right answers. This is especially true

to the end-of-life (EOL) care. Under this situation, both the patient and the caregiver experience

an instance of emotional grief. In EOL care, the ethical dilemma also arises from the

circumstances surrounding the autonomy of the patient and shared decision-making. The biggest

challenge arises from making a decision on whether to continue life limit or even withdraw the

life-sustaining treatments. The principal contention is whether to use medical technologies to

support life or let the natural death take place by withdrawing the treatment options.

The first side of the argument is that technology should be used to prolong life. The recent

innovations in the healthcare sector currently reshape the decision to be undertaken in EOL care.

These technologies can be used to inhibit the natural death process from occurring quickly. The

healthcare professionals are presented with the challenge of using these technologies, making the

decision-making process ethically tricky. The rise of these technologies has increased the

number of people seeking long-term care, who would practically have succumbed to natural

death. This means that the technologies have resulted in a low death rate and increase in the older

population. The challenge with this fact is that there will be more people needing long-term

medical care due to a decreased death rate.

These technologies practically increase the cost of healthcare and promote inequitable

healthcare. However, nurses should respect the patient autonomy to continue using the expensive

treatment and technologies to prolong life, despite the treatment being futile. In support of this

argument, I believe that autonomy should override the practitioner’s determination of futile

treatment. It is upon the doctors to provide care that will make the patient comfortable, despite

there being no hope of recovery. This is essential to make the dying process smooth for both the

patient and their families.

I also believe that the goal of hospitals is to provide healthcare services, without necessarily

determining whether they are necessary. Most of people will not understand why there is a

concept of limited treatment. The person close to the patient will also not comprehend the futile

cases. Hence, it will be unethical for the nurses to withdraw support to the patient, in a situation

where the family members would not comprehend the reason for such measures.

In opposition to this argument, the decision to refuse to prolong life should be made by the

patient. I believe that a patient has the right to choose to live or not. Hence, their consent is

essential in this dilemma. Where the patient has chosen death over a life that is not quality, this

decision should prevail.

The second side of the argument is that healthcare practitioners should let natural death take

place. Based on the fact that the healthcare cost is skyrocketing in the U.S., withdrawing the

treatment options to allow natural death to take place is justified. Rationally, carrying out a futile

treatment should not be allowed as it compromise provision of affordable care. However, the

physicians have a decision as per the deontological theory, based on their duty to inform the

patients about the benefits of withdrawing the treatment. In this way, the physicians would be

gaining the most significant goods. The futile treatment can be useful on other patients with

practically higher chances of recovering. Ignoring this fact, in the end, would result to use of

unnecessary resources and ultimately a waste of pleasurable resource such as the doctor’s time.

Most importantly, the decision must be mutual, between the patient and doctor. It would be

unethical for the doctors to withhold treatment without letting the patient see sense in it.

In opposition to this argument, the role of physicians is to protect life, by ensuring that patient

access the available treatment option. Acting contrary to this fact would amount to unethical

action. Besides, it would beat the logic of having assistive technologies and fail to use them to

enhance life. Failure to use them would emotionally hurt the family seeking the healthcare

services for their loved ones. Besides, the community may altogether fail to comprehend the

need for withdrawing treatment despite the effort to awaken them. According to beneficence and

non-maleficence principles, nurses should undertake activities that do not harm others but

instead supports the well-being of other people. Withdrawing technologies to pave the way for

the natural process of dying would not uphold any of these principles. Instead, it would harm

them emotionally. It is more important not to harm as it is to know how the treatment can cause

unseen harm in the patient.

To conclude, the doctor may be justified to withdraw intervention to prolong life and hence pave

the way for a natural death. However, they should rely on the autonomy of the patient in either to

withhold their consent for life saving interventions or to continue with the treatment.

References

Karnik, S., &Kanekar, A. (2017, May 05). Ethical Issues Surrounding End-of-Life Care: A

Narrative Review. Retrieved January 30, 2019, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934577/

Field, M. J. (1997). Approaching Death: Improving Care at the End of Life. New York, NY :

Oxford University Press

Karnik, S., & Kanekar, A. (2016, June). Ethical issues surrounding end-of-life care: a narrative

review. In Healthcare(Vol. 4, No. 2, p. 24). Multidisciplinary Digital Publishing Institute.

Lee, R., & Morgan, D. (2013). Death Rites: Law and Ethics at the End of Life. Florence: Taylor

and Francis.

Macauley, R. C. (2018). Ethics in palliative care: A complete guide. New York, NY : Oxford

University Press

Smith, S. W. (2012). End-of-life decisions in medical care: Principles and policies for regulating

the dying process. Cambridge: Cambridge University Press.

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Ethical Issues Surrounding End-of-Life Nurses are each day surrounded by situations that lack the right answers. This is especially true to the end-of-life (EOL) care. Under this situation, both the patient and the caregiver experience an instance of emotional grief. In EOL care, the ethical dilemma also arises from the circumstances surrounding the autonomy of the patient and shared decision-making. The biggest challenge arises from making a decision on whether to continue life limit or even withdraw the life-sustaining treatments. The principal contention is whether to use medical technologies to support life or let the natural death take place by withdrawing the treatment options. The first side of the argument is that technology should be used to prolong life. The recent innovations in the healthcare sector currently reshape the decision to be undertaken in EOL care. These technologi ...
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