End of Life policies in USA and other countries - Thesis Example

Advance directives/Personal wills, life support, communication, and decision making are core to any EOL policies and care. Methods The literature review was carried out by Meta Analysis, using available publications, reviews, the WHO policies and guidelines for end-of-life care. The publications were mostly concerning the US, and developed countries where there are more defined and evidence based studies carried out in this area. Conclusions Any model of the best EOL care practice or policies is generally lacking .

It might be argued that the lack of a fixed and coherent model is due to the relevance of issues in EOL, such as specific cultural settings, patient-centered needs, and family ethics and ethos. The clinical ethical dilemmas (e.g. withholding or withdrawing life-sustaining treatment) has become quite difficult. However, it is desirable to have EOL policies adapt the model or policies to the specific needs and values of each patient, more than applying a fixed, although maybe comprehensive, model.

Key Words: End of Life (EOL) Policies; Palliative Care; Health Care Introduction A large number of the people who die each year, of terminal disease and, old age, though the most vulnerable amongst all of us, do not have access to End-of Life (EOL) care or policies that could ease their suffering during final days of life particularly in developing countries. The clinical ethical dilemmas (e.g. withholding or withdrawing life-sustaining treatment) are becoming more intriguing yet , ethics consultation remain primitive and poor.

Palliative care an essential aspect of End-of life (EOL) policies, nevertheless, is not uniformly practiced across the world. Although the support of family and friends is incomparable, EOL care or policy an important public obligation is more than often lacking in majority of countries. According to the WHO(2011), “Palliative care as an approach that improves the quality of life of patients and their families facing problems associated with life-threatening illness through prevention and relief from suffering by means of early identification and impeccable assessment and treatment of pain and other problems, and physical, psychosocial, and spiritual care”.

Background Literature Review Dying persons encounter unique emotional and physical challenges that are associated with dying process, support of love ones is considered irreplaceable, however, EOL care is an important public obligation ( Wilson and Ross Kerr 1998). The importance of addressing the needs of dying persons has been felt for decades (Kubler-Ross, 1973). Clinical ethical dilemmas have become quite difficult due to advances in life-sustaining interventions, an aging society, cultural diversity, and other commercial issues.

According to Jonsen et al (2002) clinical ethical dilemmas should be reviewed by considering: (1) medical indications, (2) patient preferences, (3) quality of life, and (4) contextual features. Approach and beliefs involved with death and dying vary among different cultures, religions and countries (Volts et al. 1998). Due to the different needs of cultural groups it is necessary to address those needs in providing end-of-life (EOL) care (McGrath 2001), (Doorenbos and Nies 2003) in all kinds of health care settings including home based, as a growing proportion of dying persons desire home-based EOL care (Burge et al. 2003). Burgeoning aging population has necessitated more