Advancement of medical sciences has affected decision making in end-of-life care, and medical practitioners have to make tough ethical decisions such whether to withhold and withdraw treatment of terminally ill patients. The government is responsible for establishing laws and regulations that affect the decision-making process when it comes to human life. Parties involved in making end-of-life care decisions should carefully consider the consequences of their actions considering that they are entitled to protect all individual members of society. Ethics and theories such as utilitarian, virtue, and ethical egoism provide ethical explanations and guide for patients, family members, and healthcare providers in making tough ethical decisions regarding the end of human life issues.
Utilitarian Ethics
Utilitarianism provides that an individual should act in a way that results to more good than evil; hence it is essential to consider everyone affected by a decision. Therefore, individuals should consider all possible consequences of an action from their broad implications. One shortcoming of utilitarianism is that it does not provide for special consideration of other aspects. For instance, it does not give extra weight to personal relationships when evaluating the consequences of an action (Skelton, 2017). Physicians should judge a situation and provide an appropriate prediction of the results of various available forms of treatments and outcomes, and this will enable patients and their family members to make appropriate decisions. They should act towards beneficence for the patient; hence medical practitioners should offer information regarding treatment, more so in case of fruitless treatment to avoid any undue harm to the patients (Skelton, 2017). In situations where physicians determine what treatments will be unsuccessful, they should consider the allocation of unlimited resources to avoid cases of inequity. Therefore, healthcare providers should consider the elements of equitable and distributive systems when providing expensive treatment in end-of-life care because of limited medical and technological resources: hence can choose to withdraw or withhold the futile treatment.
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Virtue Ethics
Virtue ethics, which is person based, consider the moral character of an individual undertaking an action. It is not action based because it does not consider ethical duties and rules, or outcomes of a specific action and this applies in end-of-life care during decision making. Patient’s family should make appropriate treatment decisions or end-of-life care for the patients in case they are not in a position to make them. During all times, they are expected to put aside their interests and analyze a situation from a broader perspective then make decisions in the patient’s interest (Skelton, 2017). Therefore, family members and physicians should act and make decisions aimed at achieving the greatest good for the patient.
Divine Command Theory
The divine command theory, also called theological voluntarism provides that a morally right action should be similar to what God commanded. One of the commandments is that individuals should not murder and with the emergence of euthanasia, several controversies have emerged. Medical practitioners, however, consider it as a humanitarian act to aid terminally ill patients to end their mystery. “Decision-making for end-of-life care has earned paramount importance as it can prolong human life with the support of medical technologies or can let the natural death process continue by foregoing the treatment option” (Karnik & Kanekar, 2016). Religious values of healthcare providers determine the ethical decisions they make when it comes to treatment of terminally ill patients. Therefore, medical practitioners and patients face a challenge of making ethical decisions during end-of-life care.
Ethical Egoism Theory
Ethical egoism theory provides that moral agents should do what it takes to protect their self-interest and this means that they do what is right according to them. Under certain circumstances, individuals should consider the consequences and make their decisions without consideration of others’ interests. It is the task of healthcare providers to ensure patient safety through offering treatment to them and ensuring they get well and during end-of-life care, they can make decisions for their self-interest (Karnik & Kanekar, 2016). However, they should work against the egoistic theory for the wellness of the patient. Therefore, healthcare workers should consider the interests of patients and their family members before making any final decisions in end-of-life care whether to withdraw and withhold futile treatment.
African Ethics
One of the main challenges in end-of-life care issues is communicating with patients and family because various cultures handle bad or death news differently. in most situations, medical practitioners face an ethical dilemma whether to withhold or give information about the outcomes of a patient’s terminal illness. “Enhancing nurse communication skills during EOL requires opportunities to gain experience coupled with clinical strategies, such as standardized curricula, simulation, competency-based orientation programs, mentorship, and peer support” (Montgomery, Sawin & Hendricks-Ferguson, 2017). In this case, medical practitioners or physicians should consider their decisions from the perspectives of their target groups, evaluate the consequences on individuals, and develop a communication plan to address the issue at hand. Therefore, end of human life issues become challenging when it comes to dealing with various groups of individuals and healthcare providers should be aware of and consider a patient’s cultural background when it comes to decision-making in end-of-life care.
Postmodernism Ethics
The primary aim of the law is to regulate an individual’s life. Each country consists of its unique legal framework of rules that provide individuals with the freedom to choose between life and death. Several developing countries have adopted the concept of euthanasia to aid terminally ill patients to make decisions regarding their death. The medical practice considers this as fair in assisting them to get through the pain, but religious views differ because they believe in the preservation of life no matter the situation (Croitor, 2014). Some people may feel that administering euthanasia is illegal and the physicians doing so are guilty of murder. As a result, several speculations surround this concept, but with current civilizations and change of perspectives, most consider it to be a better way of ending the suffering. Therefore, most medical practitioners and states have adopted the act of euthanasia in the event of quality of life to provide terminally ill patients with a right die a dignified death as they choose between a painful and painless death.
Conclusion
In conclusion, end of human life is a complicated matter in the healthcare system as patients, family members, and physicians face difficulty in making appropriate decisions because of variations in ethics. Medical practitioners should judge a situation and offer appropriate treatment predictions to enable patients and family members to make appropriate decisions during the provision of end-of-life care. It is challenging to make appropriate decisions regarding the end of human life issues because of the dilemma that may exist in acting towards beneficence of the patient not to cause due harm or on behalf of broader society. Therefore, it is challenging for medical practitioners to make better end-of-care decisions because of ethical dilemmas.
References
Croitor, E. (2014). Ethics of Responsibility? Some Postmodern Views. Procedia-Social and
Behavioral Sciences , 149 , 253-260.
Karnik, S., & Kanekar, A. (2016, June). Ethical issues surrounding end-of-life care: a narrative
review. In Healthcare (Vol. 4, No. 2, p. 24). Multidisciplinary Digital Publishing Institute.
Montgomery, K. E., Sawin, K. J., & Hendricks-Ferguson, V. (2017). Communication during
palliative care and end of life: Perceptions of experienced pediatric oncology nurses. Cancer nursing , 40 (2), E47-E57.
Skelton, L. (2017). Ethical Theories and Perspectives on End-of-Life Decisions. Dialogue &
Nexus , 4 (1), 13.
