Advances in modern medicine and medical technologies have increased life expectancy and also altering natural death norms. Although many modern treatments and technologies do not cure chronic diseases, medical interventions like artificial nutrition and respiratory support can help people live longer lives by providing secondary care. End-of-life care is an increasingly important topic in modern medicine. This process begins with the diagnosis of a fatal disease and includes the dignity death that the patient desires and the post-death mourning period.
From an ethical perspective, the patient, rather than the family, proxy, or physician, makes the best decisions about limiting treatment or treatments that do not cure but do extend life for a time. However, if the patient has lost the ability to make decisions, the family, the proxy nurse, or the physician must make a decision about the care to be provided to the patient.
This guide discusses ethical principles to consider when providing end-of-life care. Moreover, Dissertations are an essential component of all nursing education programs. This project includes extensive research on this topic, and students are expected to contribute to existing knowledge with new insights that are useful to the progress of the field. When writing dissertations, accuracy and conformance to standards are paramount. As a student, you must be familiar with the proper guidelines for writing, formatting, data analysis, and other project-related tasks. But if you are unsure about this, the dissertation help online service can help you with a strong grasp of dissertation writing criteria.
Universal Ethical Principles
The universally accepted ethical principles are autonomy, beneficence, nonmaleficence, and justice. These "4 principles" are common in both Eastern and Western cultures, but their application and weight may differ. This article highlights the universally accepted features of these basic principles.
Autonomy is defined as a patient's right to self-determination. Everyone has the right to choose the type of care they receive and to have their decisions respected. Respect for patient autonomy is a basic principle of medical ethics. This principle emphasises doctors' protection of their patients' right to self-determination, even when they are no longer able to make decisions. This protection can be achieved by using advance directives (ADs) correctly.
Healthcare professionals, particularly physicians, should provide all relevant information about their patients' conditions as needed. They have to provide detailed information to patients and, if necessary, to their decision-makers about advanced medical treatments that can be used during end-of-life care.
Decision-making during end-of-life care
In the end-of-life care of a patient, the decision to implement practices to prolong the life of the patient or to comfort the patient may be hard for the physician, patient, family members, or health care proxy. The following topics address some situations where decision-making about end-of-life care is difficult:
- Cardiopulmonary resuscitation (CPR);
- Mechanical ventilation (MV), extracorporeal membrane oxygenation (ECMO), and mechanical circulatory support (MCS);
- Artificial nutrition and hydration (ANH);
- Terminal sedation;
- Withholding and withdrawing treatment;
- Euthanasia and physician-assisted suicide (PAS).
Withholding or withdrawing interventions or treatment is one of the most tough decisions in end-of-life care that causes ethical quandaries. If a patient and physician agree that continuing an intervention is not beneficial, the appropriate course of action is to withhold or withdraw the intervention. However, the physician must be able to handle this discussion sensitively. Physicians must have communication skills that are both patient-centered and family-oriented. Respect for the autonomy of a patient seeking to continue or initiate treatment should be questioned when it would result in enormous harm, the unnecessary or unequal distribution of resources, or action requiring the physician to act illegally.
In most countries, the legal opinion is that patients cannot seek treatment that is not in their best interests, and healthcare professionals should not strive to save lives at any cost. However, if there is any doubt, the decision must be in favour of saving lives. All healthcare professionals should be able to define an ethical approach to making decisions about withholding and withdrawing treatment that considers the law, government guidance, evidentiary base, and available resources.
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Conclusion
This is a complex topic for nursing students, Hope this guide will be beneficial to your dissertation. The goal of end-of-life care is to reduce or eliminate suffering as much as possible while respecting the wishes of dying patients. However, physicians face numerous ethical challenges when providing end-of-life care. Because the decisions to be made may affect patients' family members and society as well as the patients themselves, it is critical to protect the rights, dignity, and vigour of all individuals involved in the clinical ethical decision-making process. Many of the ethical quandaries associated with end-of-life care could be avoided if healthcare providers, patients, and families communicated openly and shared decisions.
