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Ethical Issue
One of the most important ethical issues in nursing is how to approach end-of-life care. Nurses have a duty to provide compassionate care in ways that respects the individual’s autonomy and dignity. As patients live longer due to advancements in medical care, nurses are increasingly being faced with care options that extend life, versus options that do not extend life but which promote quality of life through a greater acceptance of death. A related issue is physician-assisted suicide. When physician-assisted suicide is legal, nurses may have this option presented to them by patients, creating ethical dilemmas. This paper will examine multiple sides of the end-of-life issue, showing that while there is no easy or “right” solution, individual cases should highlight the means by which nurses can always ascribe to their professional duties and the ethical standards of the profession.
Point of View: Quality of Life Over Quantity
Legal Issues
With the exception of physician-assisted suicide laws and liability torts, there are no clear legal guidelines for end-of-life care in general (Pope, 2018). The principles of non-maleficence determine individual cases. However, physicians and other healthcare staff in the United States have been generally opting for life extension in all circumstances, even when doing so conflicts with patient wishes (Pope, 2018). High-profile cases like the Terry Schiavo...
Healthcare workers have recently been acting more out of fear of litigation than out of duty to care, duty to respect patient autonomy, and duty to respect patient dignity (Pope, 2018). From the perspective of providing compassionate and holistic care, nurses need to honor a patient’s wishes even if those wishes are to terminate life and to help patients embrace mortality with a sense of peace and acceptance.
Scope of Practice
Within the general scope of practice, end of life care issues arise in all healthcare settings but primarily in hospice and palliative care environments, including nursing homes. A survey of nine nursing home residents and their relatives showed that residents generally defer to relatives and staff and few have formal advanced care planning directives (Bollig, Gjengedal & Rosland, 2015). Healthcare administrators should start mandating advanced care planning directives to avoid legal and ethical conundrums. Moreover, offering patients the ability to plan helps them to psychologically contend with mortality, which can also improve relationships with family members. Extending life indefinitely and for no reason is not necessarily beneficence, just as physician-assisted suicide and passive euthanasia are not maleficence. As Hogsnes, Danielson, Norbergh,…
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