The current debate on whether to adopt or reject a law that aims at legalizing physician-assisted death has been met both with positivity and negativity in equal measures. While it is important to respect the decisions of patients in palliative care units, nurses are under an obligation to making sure that the decisions they make concerning this grave matter are supposed to be in line with the reasoning perspective and following the set-out laws and regulations, rather than from emotive and polarized positions. There is the need to take into account different perspectives of the issue at hand with the intentions of finding answers for addressing individual concerns in connection with death and dying (Kai Tiaki Nursing New Zealand, 2013). An important point to note concerning assisted dying is that, while laws which are pro-euthanasia may be passed to the benefit of some patients under palliative care and who are in excruciating pain, there are possibilities of care physicians misusing the powers that they have by contradicting these legislations. As such, it is worth noting that the current debate on whether assisted suicide should be legalized or not poses a lot of ethical dilemmas in which one side of the story postulates that the views of the patient have to be respected while on the other hand, the possibilities of these legislations being abused by the health care practitioners are imminent.
According to the current legislation, nurses also have a role to play in providing care to terminally ill patients by fostering comfort, to alleviate suffering to the patient, and also advocate for fast relief in terms of pain (Storch, 2015). Such moves are directed at assisting patients to die peacefully. From this scenario, it is evident that terminally ill patients who may want to be assisted to die need to be in their correct mindset so as to give the consent for the procedure. This realization is aimed at reducing any possibilities of physicians abusing the mandate that they have been given. In addition to this issue, it is ethically and morally unacceptable to carry out physician-assisted suicide in children and young adults as it infringes on their rights to life (Kelly, 2014). Therefore, the ethical dilemma that is evident in this instance is that of whether nurses should participate in physician-assisted suicide or not.
Section I: Ethical theory chosen
The ethical theory that should be applied in this situation is utilitarianism theory. The basis of this theory is taking into consideration the outcomes that are deemed the best for all participants in a particular ethical dilemma. The primary focus of this theory is based on the consequences of the actions that an individual involves in (Monteverde, 2014). The actions done by persons are deemed right if they increase the levels of happiness in all the participants in a dilemma and also diminish misery. On the contrary, actions are deemed wrong if they do not increase the levels of happiness in a particular situation.
Section II: Application of the ethical theory to the dilemma
Applying this theory to the above dilemma, it is important that all participants in a physician-assisted dilemma be equipped with all the required facts and information concerning the issue at hand. Since it is the nurse who is in the dilemma of whether s/he should assist patients in committing suicide, it is important that they take the responsibility of involving the patient; their families and the organization with a view of having them understand all the facts at hand. To the patient, the nurse is obliged to provide all the facts concerning euthanasia and the available options that can be considered. It is the role of the nurse to make sure that they provide the required care in terms of comfort and also pain relieving medications to the patient. Secondly, since the law does not support the practice in particular states, the nurse should give the patient the option of relocating to another state where the practice is allowed to satisfy the needs of the patient. The fact that the patient is in deep pains means that their decisions need to be respected. To the family, the nurse is tasked with providing support in terms of addressing the emotional distress that they go through during these times. Additionally, the nurse is supposed to play the role of bringing up to speed the cost factors involved in providing the palliative care to the terminally ill patient and the fact that such a patient has got very minimal survival chances (Monteverde, 2014). From this realization, it becomes easy for the patient’s family to make decisions concerning their loved one. To the organization that the nurse is supposed to inform the management of the expenses involved in providing palliative care to this patient in addition to the legal consequences that are bound to follow in the event that the patient acquires other infections while still under their care. A situation like this can be a possible precursor for the organization being sued and as such, there is the reason for the organization to act in a manner that will be of benefit to it, the patient and the family. Therefore, in this regard, the nurse is tasked with providing leadership to all the individuals involved in this dilemma with the objective of assisting them to make decisions on what is the best course of action to take. This realization is in line with having all the participants in the dilemma achieve happiness and satisfaction concerning the dilemma at hand.
Section III: Evaluation of the dilemma
I resolved the dilemma by educating all the parties involved on the best course of actions that they can employ for them to achieve happiness at the end. To evaluate this resolve, there is the need to involve all the participants in the dilemma and laying bare all the facts for an effective solution to be arrived at.
Step 1
This step involves identifying all the facts that need to be considered in the dilemma. What is being solved is whether or not nurses should be involved in assisted suicide to patients who are under palliative care at the end of life unit (McTeigue & Lee, 2015). The participants involved in this theory include; the nurse, the patient, their family and the organization.
Step 2
The exact ethical issue that is under discussion in this dilemma is whether it is morally acceptable to carry out euthanasia. The role that the nurse plays in this situation is also important and should be taken into consideration before any actions are done.
Step 3
Currently, the law is clear that physician-assisted suicide is illegal. However, there are some states for instance Quebec where the practice is legal. From an ethical point of view, this practice is morally unacceptable since religion posits that no human being has got the moral authority to participate in taking the life of another person.
Step 4
In this situation, there are only two courses of action that can be taken. First, the nurse can either decide to assist in carrying out euthanasia or decline to be involved. Secondly, there is the need for all parties to come to a consensus concerning the dilemma.
Step 5
The advantage of accepting to be involved in the practice include reduced costs in providing care to the terminally ill patient and reduced possibilities of hospital acquired infections. The disadvantages include; the family not accepting to this practice and the possibilities of acting contrary to the provision of the law. The advantages of declining of euthanasia are that the nurse will uphold their moral standing in addition to preventing the possibilities of going against the law (McTeigue & Lee, 2015). The disadvantages are; not respecting the decisions of the patient and potential of the patient contracting hospital acquired infections increasing. The advantage of coming to a consensus is that all the stands of the participants are respected since all the facts are provided by the nurse. The disadvantage is that it will take a longer time to make a decision.
Step 6
The consequences of adopting these options are that the parties involved in the process can be in a better position to make their decisions since they have been presented with the required facts. The people to be affected by these options are the patient, their relatives and the hospital providing care to the patient.
Step 7
The best decision to act upon is by all parties involved coming to a consensus on what the best course of action needs to be undertaken. By the nurse providing leadership to all the parties involved in terms of giving them the facts and leaving them with the option of making the final decision, it plays an important role in developing the best outcomes for the patient (McTeigue & Lee, 2015). This model; is helpful in making the nurse uphold their ethical stand while not going against the wish of the patients and their families.
Section IV: Conclusion
Conclusively, it is evident that the healthcare providers always find themselves in dilemmas in their efforts of providing the required care to patients at the end of life division. While it is important to respect the views of patients in these units, there is also the need for nursing professionals take into consideration the rule of the law and their personal moral standings as far as euthanasia is concerned. With these two factors in mind, nurses will be in a better position to deliver care to their full knowledge
References
Kai Tiaki Nursing New Zealand. (2013). Tell us what you think.
Kelly, D. (2014). Euthanasia for children and young people?. International journal of palliative nursing, 20(5), 211-211.
McTeigue, J., & Lee, C. (2015). Legal and Ethical Issues for Health Professions, 3e 3rd Edition.
Monteverde, S. (2014). Undergraduate healthcare ethics education, moral resilience, and the role of ethical theories. Nursing ethics, 21(4), 385-401.
Storch, J. (2015). Ethics in Practice: At End of Life — Part 3.
