Legal Rights Regulations of Health Workers and Patients - Assignment Example

Critically Evaluate How the Law Protects (A) Patients from Euthanasia and Assisted Suicide (B) How the Law Protects Doctors and Nurses from Prosecution on the Practice Critically evaluate how the law protects patients from euthanasia and assisted suicide. Quite often in the clinical practice, the nurses come across ethical dilemmas. Ethical dilemmas are clinical scenarios when the care giver, the physician or even specifically a nurse ends up in a conflict between two ethical principles, and the correct decision making suffers as a result of that. Therefore, these are practical situations where, the caregiver is supposed to do something and at the same time is not expected to do something (Johnstone, M., 2005, 227). If this occurs, the physician or the nurse will have to make some choice between the two conflicting options, both of which are equally unsatisfactory. This dissatisfaction originates from the ambiguity of the questionable decision even though the problem is resolved. In suicide, persons, for whatever reasons, decide voluntarily to end their own life; in voluntary euthanasia, another assists in carrying out the person's wish (Johnstone, M., 2005, 236). Common to both is that the decision is made by the person who wishes to be and who ends up dead. When patients are hopelessly ill, the choice is between living longer at the price of suffering or living shorter at the price of death. It seems reasonable, in the last instance, to allow patients to make such a choice for themselves. Patients who have terminal cancer or another terminal condition not rarely ask their physician for the means of suicide. Patient requests to their physician for help in committing suicide are unfortunately often met by physicians and other healthcare providers with a refusal or by an appeal to the law (Johnstone, M., 2005, 241). Allowing patients to have access to an acceptable means of suicide empowers them. Empowering patients in this way helps them to hold on a bit longer than they often otherwise would. Allowing patients as much control over their own destiny as possible is not only ethically proper, it also allow more cooperation in care process. Physician-assisted suicide is an example of active euthanasia that involves deliberate actions resulting in death of the individual. This assistance can also be passive where the caregiver deliberately omits actions in care that may prolong life (Johnstone, M., 2005, 243). In physician-assisted suicide, the physician actively provides the client with the means to end life. Patients with terminal illnesses that are accompanied by considerable pain and suffering often do not wish their disease to be treated aggressively. All want the pain and suffering to be minimized, but many, at least at some stage, do not want their lives prolonged. This has put a considerable burden on physicians, whose culture, tradition, and instincts are devoted to the prolonging of life, not to the shortening of it (Johnstone, M., 2005, 251). Inadequate palliative care at extreme age group is one of the significant reasons patients seek to die. The client's right to refuse treatment is based on the principle of autonomy, and the client can do this only after the treatment methods and their consequences have been explained. Sometimes, however, a patient who does fully understand the consequences of not being treated ranks the harms of treatment as worse than the harms of not being treated and so does not want to be treated. Ethically, if the consequences of such an action is death, a physician may overrule a competent informed patient's rational refusal of treatment, including life-preserving treatment, always involves depriving the patient of freedom, and usually involves causing him pain. Moreover, ethically, the medical profession is entitled to do no harm to the client, and sometimes in reality, the pain of the treatment is more than that of the disease, and many treatments are known to cause more harm than the disease itself. In such situations, the physicians choose between the more harmful and the less harmful (Johnstone, M., 2005, 263). Legally bound and directed, the physicians in such situations, would situations allow the patient's right to choose the pattern and form of death, by means of choosing the less harmful from the more harmful, and when the patient ranks death as less harmful than treatment, the patient chooses death. Legally speaking, artificial nutrition and hydration through the use of nasogastric tubes, intravenous lines, and surgically implanted tubes, artificial ventilation or other supportive measures are not different from other forms of treatments. In certain circumstances, it can be both lawful and ethical to withhold or withdraw these treatments, and patients have legal rights to refuse these and request discontinuation of these, but these can cause death where health care professionals execute these resulting in intentional death of the patients. Law protects these patients, therefore, undergoing euthanasia, and suicide assisted by care professionals. How the Law Protects Doctors and Nurses from Prosecution on the Practice Ethics and law overlap in significant ways. As far as nursing ethics are concerned, the areas of law and ethics vary from each other. The plight of patients suffering intractable and intolerable pain who request euthanasia as a form of treatment even though prohibited by law is worth considering. For euthanasia, any nurse or doctor who administers a lethal injection to a patient with the main aim to cause his death, may be for his benefit, would be probably charged with murder. The fact that such an act was in conformity with the patient's autonomous wishes would not stand the ground of law. This may be according to the ethical principles of benevolence, nonmaleficence, or volition, but legally, it will be wrong and unlawful. This legal wrongness, however, is not the same as moral wrongness (Johnstone, M., 2005, 265). When it construes an ethical dilemma, some argue that it may be illegal, but assisting suicide according to the client's will is in conformity to client's autonomy, and doing otherwise, although follows the other ethical principles, it violates client's autonomy. The choices therefore are to oppose or support physician assisted suicide, by either active, deliberate actions of omission or commission, or just remaining inactive at a life-threatening situation ((Johnstone, M., 2005, 262). With a few exceptions, in all common law jurisdictions, active voluntary euthanasia is a serious criminal offence. Passive euthanasia, legally in certain circumstances is lawful as opposed to active, with no exceptions, which is always unlawful. Aiding and abetting suicide is criminal, but due to discrepancies between law and practice, even though there is quite frequent incidence of active euthanasia, no doctor or nurse has ever been prosecuted or has been convicted. In order to establish criminal liability, it must be shown that there was some act committed by the doctor or the nurse which was intended to cause death and which caused the patient to die at the same time, in that intended manner. The law fails to take no account of the motive of the doctor or the nurse and the relation between them and the patients. The intention requirement to prove criminal liabilities of murder is a significant aspect. The aforethought malice that is often closely associated with criminal murders, is glaringly absent in euthanasia, which is done out of benevolent motives with great compassion for the deceased. Even then, the law does not recognize this as a protective instrument against liabilities in such cases. The common law, however, provides almost literal protection to the doctors and nurses when it is an act of omission leading to passive euthanasia (Larson and Tobin, 2000, 1573-1578). There are many reasons for this. The basis of this distinction is that the common law is built on the premise to prevent positive harm. The law does not see the act of omission that leads to passive euthanasia as an act of positive harm. More over, practically, there are practically difficulties in attributing blame of omission. The difficulty in such cases is that there would be too many candidates with potential liability and the need to prosecute all, if prosecution is permissible. It has also been argued that omissions do not cause evil as obviously as an act. The defendants can take the plea that they had not done anything. Thus, because of the special nature of acts of omission to prevent harm, the common law has rarely imposed criminal liability to passive euthanasia (Kyba, 2002, 141-155). It is clear from the previous discussions that physicians and nurses by assisting patients to die in the terminal conditions, actually are performing ethical acts in a compassionate manner, and even though legally they can be prosecuted in the case of active euthanasia, it is clear that acts of omission in delivering passive euthanasia to the suffering patients where existing management can do little to revive life and shorten suffering, can not incriminate the doctors and nurses for such acts, unless otherwise indicated. Reference Johnstone, M., 2005. ( 4Ed) Bioethics: A Nursing Perspective. Elsevier Australia Kyba FC., (2002). Legal and ethical issues in end of life care. Crit Care Nurs Clin North Am; 14:141-155. Larson DG, Tobin DR. (2000). End of life conversations. JAMA; 284:1573-1578 Read More