The Edmonton Symptom Assessment System - Assignment Example

Reflective Assignment Nursing [Pick the His is Laurie Strike, age 84 years and hailed from Perth. Doctors diagnosed him with melanoma in 2010 and since then, he has been undergoing a series of surgeries and treatments. But now he has been too tired to live. Talking to ABC’s Local Radio, he said, “I have done everything possible to prolong my life in order to arrange my affairs and take care of my family, but now I wants to end my pain”. He described his way to live as very uncomfortable because colostomy bag and catheter in his penis made his life miserable. Laurie Strike expressed desire to “pass away” instead of committing suicide. He revealed that his family and close associates have been shocked initially but later they reconciled themselves with the situation. Laurie Strike actually desires euthanasia which means “the intentional killing by act or omission of a dependent human being for his or her alleged benefit” There are many form of euthanasia like: (i) Voluntary Euthanasia It means the deceased himself desired to be killed. (ii) Non-Voluntary It means the deceased expressed no consent or willingness to die. (iii) Euthanasia by Action When a person intentionally provides a lethal injection to a deceased, it is called euthanasia by action. (iv) Euthanasia by Omission Euthanasia by omission means an intentional act for not providing necessary medicines or diet to the deceased. Different Views on Euthanasia There are divergent points of view regarding the morality of euthanasia. Some scholars bitterly oppose it and on the other hand some consider it moral or legal. The American Medical Association opposes the concept of euthanasia and held the view that a physician assisted death is harmful not only for the ethics of medical profession but for the patient also. The association negates the idea of abandoning the incurable patients instead more love and affection should be shown to these patients to lessen their miseries. Like AMA, many medical practitioners in Australia have the view that medicines are meant to cure the diseases of patients and the concept of euthanasia is quite opposite to it. In euthanasia, medicines are used to snatch the life of a living being. Pope Benedict XVI declares it a grave sin. Besides, he also declares abortion as a kind of euthanasia, when a mother chose abortion to avoid abdominal pains. He stated, “The deliberate decision to deprive an innocent human being of his life is always morally evil and can never be licit”. He asked the family members of patients who were suffering with the incurable diseases to come forward and help the patients with love and care; in this way the family system would also be strengthened. The National Catholic Bioethics Center declares life as a beautiful gift of God and said, “God did not make death, nor does He rejoice in the destruction of the living” (Wisdom 1:13). They are saying that human life is precious and any effort to temper with it will be immoral and grave sin. Roman Church also has the same views on euthanasia and terms this concept as morally wrong. According to BBC, “The Roman Church does not accept that human beings have the right to die. Human beings have the freedom to do whatever they want; however, they do not have a choice of ending their own lives. Since it is morally wrong to commit suicide it is morally wrong to help someone commit suicide”. On the other hand, pro-euthanasia voices have also strong arguments. They have the view that decision regarding one’s life of death is a personal matter of every one and anyone else including state should not interfere in the personal matters of its citizens. It is a matter of sovereignty for an individual to decide about his death. (Alexander 2010) Moreover, some philosophers of Australia introduce distinction between the biological and spiritual life. They held the view that spiritual life survives even after the culmination of the biological life. Hence, they consider mercy-killing as moral and quite ethical. Some of the thinkers believe that it is better to die instead of a languished life in which you die on daily basis. They describe euthanasia as a defeat to unbearable pain. History of Euthanasia in Australia Euthanasia is illegal in Australia but remained legal in the Northern Territory for a particular period during which a carpenter named Bob Dent opted for voluntary euthanasia in September 1996. There are many organizations in Australia, which are supporting euthanasia. Amongst them major are: “Dying with Dignity” of Queensland; New South Wales”, “South Australian Voluntary Euthanasia Society”, “the Western Australian Voluntary Euthanasia Society”, “the Northern Territory Voluntary Euthanasia Society”, “Exit International”, “Christian Supporting Choice for Voluntary Euthanasia” and “Doctors for Voluntary Euthanasia Choice”. On the other hand an organization named, “HOPE” and “the Australian Catholic Church” is fiercely opposing the practice of euthanasia in Australia (Arlington, 2008) The case of Laurie Strike and divergent views regarding euthanasia In the above paragraphs, I have discussed various views regarding euthanasia that are prevailing particularly in Australia and generally in other parts of the world. In my personal opinion the case of Laurie Strike is quite appropriate for euthanasia as he has witnessed 84 springs of his life, suffering from incurable cancer and most importantly bearing a constant pain. It is only death that can relieve him all kinds of sufferings. Another important argument in this particular case is the strong desire of Laurie Strike to get relief from the pain; besides his kith and kin are also ready to see off him. The Role of Palliative Care In Australia, it is estimated that more than 130, 000 perish in each year. The major reasons behinds these deaths are serious illness, old age and chronic disease. The healthcare services provided to patients who have progressing disease leading to death is called palliative care. Basically, it is supportive care that intends to revive the quality of life and to console the patients. It can be provided in public and private hospitals, rest houses, old homes and in person’s home. Palliative care: a. Avow life and considers dying as a natural phenomenon; b. Neither speeds up nor deters death; c. Provides respite from pain and other stressful warning signs; d. Combines the bodily, emotional, societal and spiritual aspects of care; e. Provides a support system that enables patients to remain active till their death; and f. Offers help to bereaved families to cope with the situation (Department of Health, 2014) Recipients of Palliative Care Palliative care is being provided to everybody in Australia who is dying. Normally the patients of cancer multiple sclerosis, HIV/AIDS, end-stage dementia, motor neuron disease and muscular dystrophy are the major recipients of palliative care. Providers of Palliative Care Palliative care service providers include: a. Specialist providers: personnel related to medical profession and attained the training in the field of palliative care or have sufficient experience in this field; b. Supportive services: persons who assist patients in the chores of daily life and try to lessen the pain through emotional and spiritual support (Seymour et al, 2004) The National Palliative Care Program Australian government has launched the National Palliative Care Program for such persons and composite health and other facilities are being provided under this program. The government also launched Pharmaceutical Benefit Scheme (PBS) to provide medicines related to palliative care in affordable rates. Difference between hospice and palliative care Hospice care differs from the palliative care in a way that recipients of hospice care have reached near to death and their medicines have also been stopped. In contrast, palliative care can be provided to any patient, who becomes the victim of incurable disease. The treatment of the disease goes side by side with palliative care (Bruera et al, 1991). Symptoms’ Assessment Edmonton Symptoms Assessment Scale (ESAS) is the method which is used to assess the symptoms of patients who are admitted to provide palliative care. The method uses eight Visual Analogue Scales (VAS) including: level of pain, anxiety, activity, depression, drowsiness, nausea, sensation of well being and appetite. There are three methods to complete this assessment: a. By the patient alone; b. By the patient with the help of nurse; and c. By the nurse with the help of relatives of the patients. Symptom Management Medicines during palliative care are used differently as compared to the standard use of medicines. In this connection, there are many examples like nausea is treated through the use of antipsychotic medicines, pain is relieved through the use of anticonvulsants and morphine is used for the treatment of dyspnea. The case of Laurie Strike and the Role of Palliative Care The pain and sufferings of Laurie Strike can be lessened through the application of proper palliative care methods. Many doctors reported that patients who long for euthanasia have changed their mind after receiving the palliative care. In this case also, Laurie Strike can change his mind after receiving palliative care facilities. Reflection: As a nurse, I can use various techniques and methods to redress the sufferings of Laurie Strike. I think depression and anxiety are the major factors that contributed in the miseries of the patient concerned and both relate to mental faculties instead of physical one. In this connection, engaging the mind of Laurie Strike towards something else would be proved fruitful. Helping him to recall the pleasant memories of the past can yield positive results. Spiritual energy of the patient can also be invoked to relinquish his pain. Moreover, as a nurse of Laurie Strike, I give him full attention beyond his expectation which force him to think about myself instead of focusing the ailment. Another technique that can be used is his interaction with children with particular emphasis on his grand children. Children are innocent and full of life. They have the potential to amuse a person even at the hanging stand. In my opinion, Mr. Laurie Strike will definitely be relaxed to some extent after interaction with these little angels. Religion is the need of human being especially in times of distress. It comes to rescue them; when every hope of the life is vanished. Stories and the wisest quotations of Jesus Christ can be proved a source of courage and healing for the patient. Besides, proper and timely medicines are the primary ethics of my profession, which can lessen his physical pains along with turning his state of mind from pessimism to optimism. Proper and suitable medicines can play a magic with the patient and resultantly he can forget his present conditions for some times and this period can be enhanced through the consecutive doses of medicines. Good movie, interesting novel, pretty faces, natural beauty, black clouds, sunshine, beautiful birds and glaring stars have the capacity to attract anyone towards them. I shall try to use one of them or all of them, simultaneously, after observing the behavior of the patient. Relatives, siblings and offspring of the patient can provide necessary information about his complexes, accomplishments and inclinations. This information can be used to tackle the phenomenon of depression and anxiety. As a primary strategy, I shall explore the sources of strength and comfort for the patient. In this connection, a number of questions can be asked like: How have you overcome your difficulties in the past? Where did you find strength? What are your comfort zones? The patient can be helped by providing various choices of probable answer to him. The achieved information can also be used to relinquish his pains and sufferings. Another activity that can be proved helpful is to invoke Mr. Laurie Strike for creative expression. Creative expression has many forms like story- telling, poetry, painting and photography etc. I can use one or all of them keeping in view his inclinations and temperament. In nutshell, it is my firm belief that every effort which is embarked upon with sincerity and devotion yield positive results. Work Cited Alexander, C. (2010, September 13). Pro-euthanasia TV ad ban a violation of free speech. Retrieved May 21, 2014, from http://www.theage.com.au/national/proeuthanasia-tv-ad-ban-a-violation-of-free-speech-20100912-1570f.html Arlington, K. (2008, June 20). Graeme Wylies partner Shirley Justins guilty of manslaughter. Retrieved May 21, 2014, from http://www.dailytelegraph.com.au/news/national/graeme-wylies-partner-shirley-justins-guilty-of-manslaughter/story-e6freuzr-1111116683847 Bruera, E., Kuehn, N., Miller, M. J., Selmser, P., & Macmillan, K. (1991). The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. Journal of palliative care. 7 (2): 6–9. Department of Health (2014, January 13). Palliative Care. Retrieved May 21, 2014, from http://www.health.gov.au/internet/main/publishing.nsf/Content/Palliative+Care-1 Seymour, J. E., Clark, D., & Winslow, M. (2004). Morphine use in cancer pain: from ‘last resort’to ‘gold standard’. Poster presentation at the Third Research Forum of the European Association of Palliative Care. Palliative Medicine, 18(4), 378. Read More