Care for Dying Patients - Essay Example

Euthanasia Name: College: Course: Lecturer: Date: Introduction Euthanasia is basically a way of ending one’s life painlessly with the sole motive of terminating one’s suffering. The ethics behind euthanasia has been a major issue in recent debates particularly in relation to the rapidly aging population. Many people argue that euthanasia is ethical on grounds that it may be the only option for a person wishing to escape intolerable suffering. Further, the physician responsibility to ease suffering may justify the action of offering support with euthanasia. These contentions rely heavily on the idea of individual freedom, identifying the fundamental right of mentally competent individuals to choose the path of their lives, as well as how it will end. According to Andrej (2007), euthanasia can be categorized as either passive or active. Passive euthanasia is typically characterized as withdrawing treatment with the premeditated intent of causing death. For instance, if an individual needs kidney dialysis to stay alive and the physician disengage the dialysis equipment, the person will most probably die reasonably soon. Active euthanasia involves taking particular steps to cause the death of the patient including injecting the person with poison. Although euthanasia is of much significance to the elderly populace, numerous barriers have denied them the choice to terminate their lives voluntarily. Such barriers have included the likelihood of such practices being extended to other vulnerable groups, occurrence of varying outcomes for aged people in situation which are clinically similar and lack of generally tolerated professional position. Rationale for Selecting the Topic Just like any other contentious issues such as abortion, same-sex marriages, the issue of the euthanasia has elicited many heated arguments and dominated public debates worldwide. The issue has become quite interesting particularly because many developed countries are experiencing problems with their increasingly ageing populations. The major issue that these countries face includes the fact that ageing population spends huge amounts of money from government coffers. Such costs include high medical expenses, Medicare and pension costs. The issue is made worse by the verity that developed nations tend to possess lower levels of fertility, which implies less people work which in turns leads to decreased tax revenues (Duffy et al. 2006). Although immigration is widely believed to have the capability of fixing age distribution, it remains uncertain whether it has considerable impact on age distribution. The only viable solution in dealing with the increased medical expenditure is permitting mercy killing for elderly people who have expressed their desire to terminate their lives. Widespread Controversy The debate on euthanasia has also been selected due to the immense controversy and confusion that continually surrounds it. Those who do not support euthanasia contend that it would be subject to abuse by individuals who are not old or terminally ill. According to Hilde (2009), the definitions provided for the phrase ‘terminal’ varies. For instance, some people define terminal illness as any ailment that affects life even for a short period of time. Others relate terminal illness to old age. Some laws characterize terminal illness as a condition that is likely to result to death within a very short time. Similar equivocalities make the issue of euthanasia a more confusing and complex topic. Significance of Euthanasia to elderly People Ethnological researches indicate that the care which societies are capable of providing for their old people relies largely on accessible resources (Duffy. S et al, 2006). Nevertheless, the principle of resources relies on contemporary expectations and requirements. Modern households still attempt to look after old people, but prolonged existence is making this a little more difficult. There is a finite capability of populace, however rich, to provide support to dependent members. Resources available or offered to take care of elderly people must essentially be subtracted from those accessible by others, still more significant dependent category, the children, with potential disastrous outcomes in under-funding of education and social support. The sociological principle of inclusive health stresses the significance of the manner in which household members relate to assist each other and attempt to guarantee their genetic endurance, even if this pertains foregoing their personal interests and once in a while, their lives. However, most aged people do not want to further their lives after they become too physically or mentally disabled to be of any service to their households, and would opt to see restricted financial resources being spent in caring for the younger generations (Messerli, 2007). Incurable Diseases Euthanasia is of utmost importance to aged people due to several reasons. First, majority of elderly people suffer from varying kinds of incurable illnesses till the conclusion of their lives. The disease gets more and more detrimental as it lasts. Majority of the aged patients lose basic mental and physical functions in the later stages of their ailments. They require to be taken care of by their families and relatives all the time. Enormous amounts of cash are spent on their medication. Nonetheless, in many instances, the expensive medication serves to make their lives no longer than one year. In the course of treatment, the pain is not endurable and cannot be decreased to a suitable level. In other words, the patients are forced to endure relentless agony. As a fact, most of the elderly people who are mentally competent in the last stages of illness wish they could be allowed euthanasia to halt their psychological and physical pain and remove the financial burden that most families endure (Miller, 2005). Second, life is more about eminence than length. Great individuals including artists, soldiers and scientists died when young but are remembered permanently. But for those individuals leading a low-quality such as the mentally or physically disordered ones and morbidly elderly, if the problems become unbearable or incurable for as very long time, life becomes pointless if they wished to die. To the elderly, living longer actually implies more sufferings. Thus, euthanasia is a significant issue for them as they should be permitted to terminate their lives in order to gain the ultimate peace of life. Barriers in the Health Care System Health Risks There are many barriers that prevent elderly patients from accessing palliative care. According to Andrej “such care is limited by legal stipulations, economic resources, societal values, and ethical principles” (2007). One of the barriers that prevent old people wishing to terminate their lives from doing so is the likelihood of such practices being extended to other vulnerable groups (Krakauer and Crenner, 2006). Euthanasia supported by a physician helps to spare elderly people the suffering and pain that may form a part of the patient’s dying route and permits a dignified easy death. One of the most believable parties for providing such support is the doctor. It is the doctor who has access to medicine, who possesses specialized skills of correct dosage and deterrence of side effects including vomiting and nausea. Equally imperative, the doctor can form a good source of poignant support for the family and patient. Perceived in this viewpoint, the entitlement to euthanasia is realistically interpreted as the patient’s right to assistance from the doctor. Although it is comprehensible, though awful, that patients in incredible pressure including old people anguishing from debilitating and terminal illness may decide to conclude their lives, allowing physicians to get involved in euthanasia would finally result into more injury than good. Euthanasia is primarily unsuited to physician’s responsibility as healer, difficult to control, and may front grave societal risks. The participation of physicians in euthanasia heightens the importance of its moral prohibition. The medical professional participation in euthanasia assumes exclusive accountability for the action of terminating patient’s life. Additionally, there is likelihood of euthanasia being extended to vulnerable populations and incompetent patients Lack of Protective Procedures Another barrier revolves around the fact that allowing euthanasia to elderly people is likely to guide the community and the entire health care system down a slippery and dangerous road with legitimate killing ultimately being allowed for elderly, depressed and disabled people including those who are mentally incompetent to demand to die. Protective procedures may fail to safeguard the patients. Dutch familiarity with euthanasia is evidence of the slippery slope reality and the varying meaningless of protective guidelines (Hilde, 2009). In addition, money matters of contemporary drugs would encourage euthanasia as a kind of medical care expenditure containment, taking note that medicine used in euthanasia cost less that forty dollars, while appropriate medical care for an ailing patients may cost huge amounts of money (Messerli, 2007). Approximately forty million citizens are not covered by insurance companies, and that health care is provided in a prejudiced manner against minorities, elderly people and racial order and it may be that the last people to receive medical treatment will be the first to receive euthanasia. Lack of Skills and Knowledge Most health care providers lack skills and knowledge of the dying process and the expertise to control the patho-physiological changes and symptoms that go together with the later phases of dying (Tarzian, Neal and O’Neil, 2005). The magnitude of this issue is best demonstrated by work tasks that targets malfunction to control pain in dying patients. Numerous studies have indicated that nursing and medical educations have totally failed to offer medical professionals with sufficient foundations for managing pain in elderly patients(Tarzian, Neal and O’Neil, 2005). As a result most professionals in the health care system cannot appropriately assess pain as well as other complications in elderly patients and many have restricted skills for managing pain. In addition, health care providers tend to underrate patient distress and pain. Apart from underestimating the level of pain experienced by elderly patients, physicians also deny such patients the chance to die by providing false hope to them. Most physicians, assuming that their fundamental mission is saving the patient from deadly disease, pursue this believe beyond sensible anticipation for cure and thereby eliminating palliative care (Tarzian, Neal and O’Neil, 2005). In such instances, physicians and family members occasionally collude in proffering optimism for rescue even in cases where none exist while the individual, resigned to the inexorableness of death, lacks encouragement that his functional capability and comfort will obtain sufficient medical care during his final days. Health care providers fear that providing palliative health care for the elderly patients will distort the protective process of denial and consequently distress the family and patient. Lack of Professional Position In western communities, the main agent in decisions to terminate life is the health care (Wesley, 2009). Public views of the technical expertise of its affiliates and the increased wish for those in susceptible situations to provide them with unflustered ethical values accord them a high level of well-liked permission to take uncomfortable, problematic decisions. However, individual affiliates of the medical profession although repeatedly faced with the duty of taking precautions which may either prolong or shorten life, have had minute if any prescribed instruction in how to take into account the legal or ethical questions inherently involved in the process of decision making. Thus, their acts mirror individual assumptions and beliefs, those of fellow medical professions and their views on the law and of the desires of the next-of-kin as well as those of the dying individual, rather than generally tolerated professional position. This may result in varying outcomes for aged people in situation which are clinically similar. Involuntary murders The probability that euthanasia could be broadened to other groups of people even in the era of highly sophisticated medical ethics deters policymakers from allowing it even in cases where elderly people have expressed their wish to die. Laws prohibiting euthanasia have been put in place to circumvent maltreatment and to safeguard people from crooked physicians. They are not aimed at making anyone to suffer. There is prevalent surreptitious with euthanasia carried out in clinical care and appropriate medical treatment as well as hospice care offer the morally tolerable replies to the challenges that are occasionally linked to the dying process (Sachs, Shega and Cox-Hayley, 2004). Euthanasia is widely perceived as a deeply compassionate and a rational way to reduce health care expenditure but such a trend would be likely to lead the country towards a slippery slope where the groups of those who should be put to rest with impunity are likely to be broadened even in the era of highly sophisticated medical ethics. Netherlands is appropriate evidence of what euthanasia can do if it is where allowed for persons who consent to it. According to Wesley (2009) a report on euthanasia in Netherlands indicates that many patients have died from unintentional euthanasia. Their doctors were consumed with sympathy that they chose not to bother the patients by requesting their view on the issue. Legal Systems Euthanasia is a form of killing which cannot be integrated in legal systems. The assumption that the continuing life of an individual lacks worth amounts to depriving value to that individual, since the certainty of an individual is not something separate from his ongoing life. What underlines euthanasia is judgment concerning overall value of specific human lives. Policy makers argues that it would amount to violation of any system of laws which alleges to safeguard and enforce an equitable social order to legitimize murders which bases its validation on the assumption that specific lives do not have worth (Krakauer and Crenner, 2006). This is because fair dealing in community itself needs a non-discriminatory and non-arbitrary way of recognizing the justice subjects is to belief that every human being, purely in virtue of being humans, has a right to be treated fairly and is basically the subject of specific human rights. In other terms, the fundamental human esteem and value which are distinguished in honoring human entitlements should be perceived as affixed to humanity. Basic worth and dignity wouldn’t, nonetheless, constitute a title to fair treatment if individuals were perceived as able to lose them. A euthanasiast killing, even in cases where it is intentional, involves deprivation of the continuing value of people chosen to be contenders for euthanasia. From a legal point standpoint, it is for which principle in the dignity and worth of each individual is foundational. Strategies to Overwhelm Barriers Additional Courses for Medical Professionals One of the major barriers is lack of good knowledge base which compromises eminence of health care in different ways for elderly patients. For instance, patients vary considerably in morphine needs for pharmacokinetic rationales. Two patients with similar pain sources may need notably varying doses to attain the same level of pain relief. The health care professional who does not understand this may hold back sufficient dosage from the sick with the larger dose need on the ground that titrating to reduce pain will perpetuate tolerance and higher risk of depression. According to Sachs, Shega and Cox-Hayley (2004), these barriers can be overwhelmed in the domains of clinical practice and education by requiring health care professionals to learn additional courses concerning the management and control of the dying process while tailoring medical school courses to meet the needs of the aging populace. Integration into Law Euthanasia should be an extension of person’s right permitting him to choose death and worth of life. Under common law, capable patients are competent to object medical care provided the choice is sensible and grounded on sufficient data for infirmed assent. In the instance of comatose or incompetent, the typical method of ascertaining care was for the doctors participating in the case to talk about treatment alternatives with the relatives of the patient. It was supposed that the person would wish beneficial care and wouldn’t wish to die of starvation and dehydration. Equally, it was presupposed that the relatives would wish the most suitable treatment for the patient. Life is frequently assumed to be a core good for individuals and essential for quest of other goods required in life (Miller, 2005). But when an elderly person chooses to forego further life sustaining medical intervention then the person either implicitly or explicitly, commonly chooses that the suitable life achievable for him with medication is of poor quality that it is poorer than no more life should be respected. In deed, euthanasia should be made an extension of person’s right permitting him to choose death and worth of life. Sustaining systems of life support against patient’s desire is assumed unethical by law and philosophy. If an individual has an undeniable right to terminate treatment, then such a person should also be given the authority to terminate his life and avoid intolerable suffering. Issue of Choice In order to overwhelm the difficulties experienced by older people in accessing services, euthanasia should be considered an issue of choice just like abortion. Euthanasia is the last civil entitlement and to deny terminally ill and elderly people who wish to halt their suffering through peaceful help in dying is to basically disregard their entitlement to personal freedom. Legitimizing or allowing euthanasia will be an essential insurance policy capable of ensuring that nobody dies in unremitting suffering and painful agony (Winston et al, 2005). Euthanasia is a bit different from pain management since both utilize strong medicine and death of the patient is occasionally and unintentionally hurried as a negative effect of the drugs utilized in palliation (Winston et al, 2005). Further, medical professionals commonly participate in euthanasia surreptitiously and encourage decriminalization as a means of protecting susceptible patients from cruelty inherent in the present unregulated practice. While acknowledging fears about probable abuses, putting in place and enforcing protective policies would help to safeguard the susceptible groups from unlawful death while at the same time allowing miserable individuals who are entitled for euthanasia to access a desired passive death. Conclusion With many developing countries experiencing demographic changes in their populace particularly with increased elderly people, the issue of euthanasia has taken center stage. The major issue that these countries face includes the fact that ageing population spends huge amounts of money from government coffers. Such costs include high medical expenses, Medicare and pension costs. Most elderly people suffer from varying kinds of incurable illnesses till the conclusion of their lives. Consequently, enormous amounts of cash are spent on their medication. Nonetheless, in many instances, the expensive medication serves to make their lives no longer than several months. Although most of the elderly people who are mentally competent in the last stages of illness wish they could be allowed euthanasia, numerous barriers such as likelihood of such practices being extended to other vulnerable groups, varying outcomes for aged people in situations which are clinically similar prevent elderly people from accessing such services. However some strategies can assist elderly people in overcoming these barriers such as extending of person’s right permitting him to choose death and worth of life and enforcing protective policies would help to protect the susceptible groups from illicit death while at the same time allowing miserable individuals who are entitled for assisted suicide to access a desired passive death. References Andrej, M. (2007). Care for dying patients – German legislation. Intensive Care Medicine, 33(10): 1823-1826 Duffy. S et al. (2006). Racial/Ethnic preferences, sex preferences, and perceived discrimination related to end-of-life care. Journal of the American Geriatrics Society, 54 (1): 150-157. Hilde, L. (2009). Autonomy, beneficence, and gezelligheid. Hastings Center Report, 39(5): 39- 45. Krakauer, E and Crenner, C. (2006). Barriers to optimum end-of-life care for minority patients. Journal of the American Geriatrics Society, 50(1): 182-90. Messerli, J. (2007). Should an incurably-ill patient be able to commit physician-assisted suicide? Retrieved May 16, 2009 from http://www.balancedpolitics.org/assisted_suicide.htm Miller, P. (2005). Life after death with dignity: the Oregon experience. Social Work, 45(3): 263-71. Sachs, G., Shega, J and Cox-Hayley, D. (2004). Barriers to excellent end-of-life care for patients with dementia. Journal of General Internal Medicine, 19(10): 1057-63 Tarzian, A., Neal, M and O’Neil J. (2005). Attitudes, experiences, and beliefs affecting end-of- life decision-making among homeless individuals, Journal of Palliative Medicine, 8 (1): 36-48. Winston, C et al (2005). Overcoming barriers to access and utilization of hospice and palliative care services in African-American communities, 50 (2): 151-63. Wesley, S. (2009). A Myth Is as Good as a Mile. National Review, 61(17): 36-38. Read More