Intense Pain due to Terminal Illness - Assignment Example

Scenario 5: A patient who is terminally ill and in a lot of pain begs you to end her What is your immediate action? What must you do following this? Which sections of the Australian National Competency Standards for the Registered Nurse apply here and why? What are the possible legal/ethical implications? Name Institution Professor Course Date Introduction Assisted suicide/Euthanasia refers to the painless extermination of a patient suffering from terminal illnesses or a painful or incurable disease. It is the practice of permitting the death of hopelessly injured or terminally ill individuals in a painless manner for the purpose of mercy. Euthanasia is one of the most controversial issues facing today’s society. It has been regarded as a logical accessory to treatment of patients with terminal illnesses (Friedman, 2012). Assisted suicide is largely acceptable on the foundation that it eases anguish while allowing a patient to die in dignity. However, there is increasing fear on the issue, which seems to question the quintessence of medicine and the role of health care providers. Since the rights of the terminally ill Act were overturned, Australia has become one of the strictest anti-assisted suicide nations in the world. However, the nursing profession acknowledges the autonomy, privacy, informed consent and individual rights of patients. The above case scenario relates to ethical issues that take place at the micro-level of nursing. Case Scenario and Australian National Competency Standards According to Berman and associates (2014), the rise in technological advances and the increasing number of older persons have extended the ethical dilemmas experience by health care professions and individuals. Offering people information and professional help besides the highest quality care is of utmost significance today. Some of the most disturbing and frequent ethical issues for nurses entail issues that surface around dying and death. These issues include termination of life-sustaining treatment and euthanasia. A lot of moral issues surrounding the end of life can be resolved if people complete advance directives or a living will and feel convinced that health care providers will act on them (Hiruy & Mwanri, 2014). In Australia, Queensland, Victoria, South Australia, Australian Capital Territory, Northern Territory and Western Australia offer legislation for advanced directives even though the statutes differ in operation and scope. Advance directives direct caregivers as to a person’s wishes regarding treatment, offering a constant voice for people when they lose the ability to communicate or make decisions. However, in the scenario, the patient is of sound mind and has the ability to make an informed decision. The person is terminally ill and in a lot of pain. The agony the patient is going through makes her to beg the nurse to help her end her life. Johnstone (2011) asserts that the euthanasia question has proved to be a major professional issue for Australian nurses. For example in 1995, acknowledging the seriousness of assisted suicide for nurses, the Royal College of Nursing, took the exceptional step of putting for comment a discussion paper, “ Euthanasia: An issue for nurse” (Johnstone, 2011). The responses from the nurses operating in different clinical areas indicated an overpowering call for guidance and information on how best to deal with controversy, perplexity and uncertainty that has become characteristic of the right to die movement. The more confronting was the surfacing of an intricate question of whether the nursing profession should support the legalization of active voluntary euthanasia. Linked to this was equally confronting question whether nursing organizations representatives should adopt a formal position statement either rejecting or supporting the role of nurses in mercy killing (Johnstone, 2011). Notwithstanding the illegal status of assisted suicide in Australia, there exist a moral opinions on mercy killing that remind nurses of their professional responsibility to be credibly informed about clinical, cultural, legal and ethical implications of assisted suicide. Nurses in Australia are guided by the Australian National Competency Standards for the Registered Nurses. These standards are the core competency standards through which a registered a nurse’s performance is assessed to get and retain a licence to practice as a registered nurse (Grealish, 2013). The core competency standards provide registered nurses with a blueprint for assessing their competencies as part of the yearly renewal of license process (Rebeiro, Jack & Wilson, 2013). More importantly, the core competency standards are used to evaluate nurses entailed in professional conduct matters. There are several sections of the the Australian National Competency Standards for the nurse faced with the dilemma to help or not to help the patient to voluntarily end her life. Immediate Action According Tee et al. (2013), decision making in health care involves balancing the benefits and risks among numerous options. The nursing profession acknowledge the universal human rights of persons and the moral responsibility to protect the inherent dignity and equal value of everybody. This entails acknowledging, respecting and the protecting the wide range of civil, economic, social, political and cultural rights that are applicable to all people. The nursing profession in Australia appreciate and accepts the crucial link amid human and heath rights and the sturdy contribution of human rights in promoting health upshots. Accordingly, the nursing profession acknowledges that accepting standards and principles of human rights in health care region entails acknowledging, promoting, safeguarding and respecting all persons to the highest achievable standard of health as a basic human right. Contraventions or lack of attention to human rights can hold crucial health implications. Based on the case scenario, the most appropriate immediate action a nurse should take is to talk to the patient to offer moral care before consulting with other health care team. According to Hebert, Moore and Rooney (2011), nurses are crucial in supporting and advocating for patients’ care. Yoost and Crawford ( 2015) assert that the role of nursing include promotion of health, prevention of illness and the care of ill, dying , and disabled people. In this respect, nurses play major roles in taking care of persons at the end of life. Their roles entail managing and assessing pain and other signs and symptoms, tackling psycho-spiritual needs, helping patients and their families in articulating beliefs, goals and values that impact the choices made at the end of life. Nurses also discuss treatment decisions, and help patients and their families to communicate their wishes and needs for care. Nurses play a major role in lowering the effect of illness and enhancing health. Section 1.2 of the Australian National Competency Standards for the Registered Nurse requires that nurses fulfil the duty of care (NMBA, 2010). This is attained through undertaking nursing interventions in harmony with acknowledged practice standards. The nurse is also required to recognise the role to prevent harm. Apparently, patients depend on their health professionals for guidance. Although the patient is under intense pain, the nurse should not take upon herself to end the life of the patient because of the legal implications involved. According to Daly, Speedy and Jackson (2009), the duty of care entails avoiding unpractical risk of harm to the patients and their families. If the nurse agrees immediately to assist the patient end her life, the nurse would be contravening the section 1.2 and 1.3 of the Australian National Competency Standards. Section 1.3 of the core competency standards requires nurses to acknowledge and react suitably to unprofessional and unsafe practice. The nurse is required to determine interventions, which can prevent contravention of law and compromise of care. Notably, mercy killing is prohibited under the Australian law. More so, section 1.3 of the core competency standards requires nurses to identify and explain optional strategies for intervention and their potential upshots. In this regard, talking to the patient and letting her know that there are other ways that can be used to help her ease her pains is the appropriate immediate action the nurse should take. More so, the nursing code of ethics does not promote assisted suicide but promote enhancement of health. Section 2 of the core competency standards requires nursing to practise within the ethical and professional blueprint (NMBA, 2010). Helping a patient to end her life is unprofessional and unethical. Patients have rights to health care and not rights to die. As such, the nurse should respect the right to health and perform evaluations sensitive to the needs of the patient. Mandatory Action After talking to the patient the about importance of life besides conducting evaluations that are sensitive to requirement of the patient, the nurse should then seek help to resolve the situation. Section 2.1 of the core competency standards requires nurses to seek help to resolve situation that involve moral conflict (NMBA, 2010). The nurse should consult pertinent members of the health care team. Section 6 of the Core Competency Standards requires nurses to plan nursing care in consultation with patients and the interdisciplinary health care team. This is achievable through determining the approved priorities for resolving health care requirements of patients. Consideration of the nursing code of ethics and conduct is also paramount. While in consultation with other health care providers, the nurse should assist and support the patient in making informed health care decisions. Section 9.4 of the Core Competency Standards requires the nurse to uphold and support the patient through communication with other members and via arranging consultation to support the patient to make an informed decision (NMBA, 2010). The nurse in collaboration with other health care professional should implement suitable strategies to enhance the patients comfort, integrity and self-esteem. In addition, the nurse should collaborate with other health care professionals to facilitate continuity of care instead of terminating care. However, the nurse should ensure that the patient is involved in making informed decision concerning her health care. Value statement 5 of the code of ethics of nurses in Australia emphasizes respect and value for informed decision-making (ANF, 2008). Nurses should value patients’ interests in making informed and free decisions. This entails patient holding the prospect to verify implication and meaning of information given to them when making choices. Nurses also acknowledge that making decisions is sometimes limited by situations that surpass an individual control and there may be situations where informed choice making cannot be completely realised. Nurses value moral and legal right of people to get involved whenever appropriate in decision-making regarding health and nursing care. Nurses help patients to determine their care on the foundation of informed-decision making. Possible Legal and Ethical Implications According to Killion and Dempski (2006), nurse involvement in assisted suicide contravenes the nursing code of conducts and ethics. The role of nurses in end-of-life decisions entails promoting comfort and pain relief. The legal prohibition of euthanasia and the refusal in the law to accept a patient’s consent to act as possible justification of homicide are due to intricacies in legal processes. Given that assisted suicide and Euthanasia are illegal in Australia, there are no legal implications for the nurse. This is because the nurse failed to provide the assistance needed to end the patient’s life. For many years, nurses declare an expletive to defend a standard of care and ethics developed for the advantage of patients (Johnstone, 2015). In this regard, conducting assisted suicide challenges the moral and ethical principles of the nursing profession. The essence of nursing is to promote human health and provide care and solutions to health issues that affect human beings (Fitzgerald & Melanie, 2015). If the nurse agreed to the patient request for assisted suicide, the nurse would have jeopardised the essence of nursing. It is essential to appreciate that nursing is an imperative health promotion endeavour, which does not advocate for mercy killing. People who help patients to end their pain through administration of injections and deadly drugs to individuals who have lost sanguinity in life take no notice of the healing process. Accepting the patient request would have put into question the human conscience and the role of nurses in promoting health. Nurses are not in the business of assisting people to die neither are they in the business of prompting premature deaths. More so, Australia law provides for rights to life and not right to death. Conclusion Assisted suicide may seem a good solution to the patient with intense pain due to her terminal illness. The patient believes that assisted suicide is the only way to lessen her suffering and the burden of care (Hiruy and Mwanri, 2014). Pain from unmanageable illnesses no matter how much efforts or money is put on them will never end. However, it is unethical for nurses to assist patients to end their lives. In addition, assisting patients to end their lives jeopardises the essence of nursing and medicine. However, making important decisions at a time when one suffers diminished life expectancy is a rather challenging task. Although consideration of the state of the patients is important, the nurse must adhere to the Core Competency Standards, nursing code of ethics and the Australian law to avoid ethical and legal implications. References Australian Nursing Federation.(2010). Code of ethics for nurses in Australia. 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Yoost, B., & Crawford, L.(2015). Fundamentals of nursing: active learning for collaborative practice. Australia: Elsevier. Read More