End of Life Care Sample Paper
Ethical issues take centre stage in instances where choices need to be made, the solution may not be clear, and the available options may not be most suitable (Gaines, 2020). Such a dilemma causes a decrease in the quality of care a patient receives, problems with the clinical relationship between a patient and a practicing nurse, and moral distress. As a practicing nurse, I have found myself in ethical situations when providing end of life care. While working at the UT Health East Texas in 2019, I was once faced with an ethical situation where a patient requested to be withdrawn from a life sustaining treatment. Being fully aware that the patient’s decision-making capacity was compromised, I found myself between a rock and a hard place. Ultimately, I did not pull the patient out of the life sustaining treatment. I believe I got the most out of the situation, because my patient’s liberty of interest to refuse treatment which is constitutionally protected was violated.
The ethical consideration in this stage usually includes breakdown of communication where nurses find it difficult to understand the demands of the patient. Normally, it is advised that nurses should ask the patient their preferences earlier for documentation. Furthermore, poor symptom management is another factor where medication side effects outweigh the benefits and shared decision-making when more than one person is involved in decision-making (Gaines, 2020).
The legal concern in the scenario arises since patients have a constitutionally protected liberty of interest in refusing unwanted medical treatment, deducing earlier decisions. Patients may withdraw a life sustaining treatment, and this happens when a seriously ill patient may feel captive of the machine required to support the life; thus, they will require the machine to be removed (American Medical Association, 2018).
Even though patients are constitutionally protected from refusing unwanted medical treatment, I felt the patient is not in the right capacity to pull out of the life-sustaining treatment. Besides, the treatment was necessary to keep my patient alive. The person who benefits from the situation was the patient, and the people hurt by it are the families and the doctors or nurses. The major influential factor is that the nurses can engage with the patients and educate them on their situation through counselling (Flückiger et al., 2020). In such situations, one of the core concern issue is the decision-making course. It becomes an ethical issue since it involves more than one person, both the practicing nurse and the patient are involved in making the decision, and both sides having contradicting approaches to the matter.
References
- American Medical Association. (2018, November 14). Withholding or withdrawing life-sustaining treatment. https://www.ama-assn.org/delivering-care/ethics/withholding-or-withdrawing-life-sustaining-treatment#:~:text=%20When%20facing%20decisions%20about%20withholding%20or%20withdrawing,record%20and%20ensure%20that%20the%20reco
- Flückiger, C., Del Re, A. C., Wlodasch, D., Horvath, A. O., Solomonov, N., & Wampold, B. E. (2020). Assessing the alliance–outcome association adjusted for patient characteristics and treatment processes: A meta-analytic summary of direct comparisons. Journal of Counseling Psychology, 67(6), 706–711. https://doi.org/10.1037/cou0000424
- Gaines, K. (2020). What is the nursing code of ethics? Nurse.org. https://nurse.org/education/nursing-code-of-ethics/#:~:text=%204%20Principles%20of%20Ethics%20for%20Nurses%20,in%20all%20medical%20and%20nursing%20decisions…%20More%20
