Analysis of Ethical Dilemma
Analysis of Ethical Dilemma
The healthcare system encounters a variety of ethical dilemmas, which sometimes have an impact on the social, legal, and professional world. An ethical dilemma is a situation that doesn’t have a right or wrong solution, but is rather determined by the outcome or the rationale behind the actions taken. While some ethical dilemmas resolve quietly, others arouse much conflict among the stakeholders. Voluntary/assisted euthanasia is one of the controversial issues in healthcare that affects various aspects of the profession. This paper will discuss the ethical dilemma of euthanasia and assisted suicide with reference to Terri Schiavo’s story. The analysis will contribute to better understanding the ethical implications of the case, obligations of nursing profession to ethical dilemmas, stakeholders, and laws regarding the issue of euthanasia and assisted suicide.
NHS (2014) describes euthanasia as an action that leads to the deliberate ending of the life of a human being with the aim of relieving suffering and pain. There are various ways of carrying out euthanasia, including withdrawing or withholding treatment and administration of overdose medications that cause death. Euthanasia can either be voluntary, involuntary, or non-voluntary, depending with the involvement of the patient in the act. While some patients request for means to end their lives, others are incapable of requesting or carrying out the action, leaving the burden to either their families or the medical practitioners. Whichever the case, euthanasia is a complicated and ethical issue. Euthanasia is also referred to as assisted suicide.
In most countries, euthanasia is considered illegal, and even in countries where it is legal, certain criteria must be met before the act is performed. One of the criteria to euthanasia is that the patient must have made a voluntary request within a sufficient mental capacity to have the act performed (NHS, 2014). Unfortunately, most of the patients who find themselves under these situations neither possess the sufficient mental capacity, nor do they have advanced directives regarding their end of life care. As a result, such cases become ethical and legal issues.
Description of the Topic and Related Ethical Implications
Terri Schiavo was a young vibrant woman until she suffered from a heart attack, which deprived her brain of oxygen for 10 minutes, culminating to a persistent vegetative state (Lynne, 2005). Unlike being in a comma where the reflexes and consciousness are essentially gone, being in a vegetative state means that a person can actually feel and the reflexes function. There have been cases of recovery from vegetative states, although the affected persons remain disabled. However, medical science describes a vegetative state that has lasted for more than five years as irredeemable. Terri’s vegetative state lasted for 15 years. During this time, Terri’s husband, with the help of Terri’s parents, took Terri to a myriad of therapies, including experimental ones, with the hope that she would recover. Unfortunately, she never recovered or improved.
According to Terri’s husband, she had expressed a wish to never be left in a state that required medications and medical equipments to sustain her life. Under Florida’s laws, that expression was enough to allow assisted suicide when Terri went under the vegetative state. Eventually, the courts decided to pass a law that saw Terri’s feeding tube removed. Some articles describe this act as the dehydration and starvation of Terri to death. The most outstanding issue that comes to mind when reviewing Terri’s case is the value of human life, and which life is considered more valuable. Terri was in a vegetative state, but family claimed that she could respond to touch and presence of family members.
Placing the value of life in the hands of spouses, hospital boards and legislators is in itself an arguable decision, as quality of life is defined differently by different people. Some doctors argued that Terri’s health could improve with treatment, while others argued that she would remain in a vegetative state for the rest of her life. The quality of Terri’s life was described by medical practitioners as low, while her family, especially her mother and father, saw her as a human being who deserved to receive end-of-life care instead of prematurely ending her life. Ethical implications of this case are that the decision made had the potential to change the way people view life.
Guardian Staff (2014) posits that since this case, a lot has changed for the worst as thousands of people are ‘killed’ every year as a result of the Terri Schiavo’s case ruling. Michael, Terri’s husband, had the exclusive right to make decisions regarding the issue of assisted suicide on behalf of Terri. The ethical implication of this is that a spouse may make decisions that do not align with the wishes of the patient for own selfish reasons. For example, Terri’s family argued that Michael made the decision to have the feeding tubes removed as he stood to gain from Terri’s medical trust. The ethical implications in regards to Terri’s case equally affected all the stakeholders.
Obligations to Profession and Work as a Nurse
Decision-making in the event of ethical dilemmas in the healthcare setting is guided by a variety of available guidelines, including the code of conduct for nurses, ethical principles, and the law. The code of conduct for nurses posits that the primary commitment of a nurse is to a patient (ANA, 2015). The code also acknowledges nurses as promoters and advocates of the health and wellbeing of the patients. However, the decisions regarding ethical dilemmas are further affected by the moral and social values to which nurses subscribe.
Ethical theories also affect the actions that nurses take during ethical dilemmas. For example, one caregiver may hold that all life is important, and should be protected and preserved at all costs. On the other hand, others may hold that relief from suffering is equivalent to preserving the inherent dignity of an individual. Faced with a similar situation, the two caregivers would make different decisions, one to preserve life, and the other to end it. The obligation of a nurse is to protect the patient from any harm, to do good, and to avoid any harm to the patient (ANA, 2015).
Laws Regarding this Topic
Terri’s case was surrounded by a myriad of laws, some of which existed before the case, and others that were instituted during the case. A law passed by President George Bush made a spouse the legal surrogate decision-maker on behalf of an incapacitated patient. This law affected Terri’s case in that it made her husband the main decision-maker regarding her health. Purvis (2004) accuses the Republicans of capitalizing on Terri’s case to gain political mileage, particularly “Terri’s Law” legislation. This legislation accorded the governor the power to overrule court order, and reinstate his own ruling, a decision that greatly affected Terri’s case. The major stakeholders in this case included the hospital management, Terri, and Terri’s family.
References
American Nurses Association, ANA. (2015). Code of ethics for nurses with interpretive
statements. Retrieved from http://www.nursesbooks.org/Table-of Contents/Ethics/TOC-Code-of-Ethics-for-Nurses.aspx
Guardian Staff. (2014). Euthanasia and assisted suicide laws around the world. Retrieved
Lynne, D. (2005). The whole Terri Schiavo story. World Net Daily. Retrieved from WND
Database
NHS. (2014). Euthanasia and assisted suicide. Retrieved from
http://www.nhs.uk/conditions/euthanasiaandassistedsuicide/pages/introduction.aspx
Purvis, D. (2004). Hypocrisy and grandstanding in the name of a woman’s life. Raw Story.
Retrieved from Raw Story Database.
