End of life care is something that is difficult to think about, but necessary for individuals who have terminal illnesses, chronic conditions, or have other wishes set in place, such as do not resuscitate or not wanting to be on life support. Individuals also have to decide if and who they want to make decisions that pertain to the patient’s end of life care, such as family members or close friends . There are several ethical dilemmas that arise, including patients who want to be euthanized and individuals who choose to to be in hospice care. Ethical dilemmas crop up even more if a family member or spouse knows a family’s members wishes, but there is no documentation in place.
I chose end of life care-ethical dilemmas as a topic because it is an issue that affects many people today. As our society becomes more and more medically advanced, discovering more drugs that can treat illnesses and prolong lives, as well as finding cures for diseases, people are living longer . This means that more end of life issues are apparent in contemporary society. There are people who not only have terminal illnesses, but have chronic diseases that cause much pain and discomfort. I have also known some relatives that have had to deal with end of life care issues, these relatives making difficult decisions about a loved one’s end of life care. More end of life care also costs more money.
Three types of care are associated with one’s end of life, such as hospice, palliative, or curative care. Curative care is concerned with trying to cure a disease or lengthen one’s life, medical treatments part of this type of care. Palliative treatment helps one manage pain from diseases, and offers emotional and spiritual support for the individual and people close to the individual. It is focused on making somebody comfortable, drugs usually used to help relieve pain. Hospice care, a type of palliative care is a type of care that occurs when somebody is terminally ill, the person not expected to live more than six months .
There are many ethical principles in the medical profession that one must think about in end of life care, including autonomy, beneficence, justice, and non-maleficence. Autonomy refers to the degree of control that the patient has over one’s life and health care. If an individual is in constant pain, this person may want to end their life with the assistance of a physician. The concept of beneficence deals with doing what is best for the physician’s patient . Would it be good for the patient if the physician helped the person commit suicide? Is it fair for the patient to have to endure chronic pain if it is that distressing for the patient?
Justice and non-maleficence are other concepts associated with end of life care.
Justice refers to doing what is fair for the patient and non-maleficence refers to not harming the patient. For example, is it fair to give a patient with low chances for survival curative care, which is can be costly and expensive, versus less expensive palliative care? It is an ethical dilemma that is not so easy to resolve. Another issue is a patient who has no written record of not wanting to be on life support, but the patient’s spouse knows that the patient does not want to be on life support. There is an ethical dilemma on hand here. Does the spouse tell the hospital to put the patient on life support or uphold the spouse’s wishes and not allow life support? If patients have not designated anybody to have medical power of attorney, which means that somebody is in charge of making medical decisions, then who choose make those hard end of life care choices, such as going on life support or going into hospice care.
With people living longer, there are many ethical dilemmas in end of life care. Issues related to euthanasia, hospice care, and other issues need to be contemplated and handled in an ethical manner by patients’ families, physicians, and other parties involved with sensitivity.
- Callahan, D., & Lawler, P. A. (2012, July 24). Ethics and health care: rethinking end-of-life care. Retrieved from The Heritage Foundation: http://www.heritage.org/
- Care at the end of life- topic overview . (2014). Retrieved from WebMD LLC website: http://www.webmd.com/
- End of life care. (n.d.). Retrieved from WordPress.com: http://bfsendoflifecare.wordpress.com/