Clinical Ethical Dilemma
The clinical ethical dilemma addressed in the paper entails the end-of-life issues. The moral dilemma involves a situation where a terminally ill patient requests to end their life by seeking to withdraw or withheld treatment. In a situation where a critically ill patient does not improve and continue to experience immense pain due to a worsening medical condition; the issue of end-of-life arises creating a major ethical dilemma among the clinical practitioners engaging in the provision of care to the patient. The effect creates a significant dilemma considering that assisting a patient to die by either withholding treatment or through active euthanasia may not be deemed to be morally right.
Medical Facts
Considering that the end-of-life issue comprises of complex moral, ethical, and legal dilemmas, there are medical facts that are relevant to the issue. The first medical fact that is relevant to the issue is the fact that most of the chronic conditions result from immersing pain that may not have a possible cure (Jeffrey, 2018). In this case, the end of life may be a relevant procedure that may help in dealing with the situation. The second medical fact entails the fact that physician-assisted deaths are a way to provide a solution to a long term illness and may help in preventing further complications. In that case, based on the medical perspective, the issue of end-of-life issues is relevant in a bid to ensure that the patient does not incur more pain.
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Diagnosis and Prognosis
Despite the advancements developed to treat chronic conditions such as cancer, patents tend to die despite the efforts to overcome the condition. In that case, the medical practitioners need to engage in the prognosis and diagnosis of the issue to ascertain the need for the implementation of end-of-life measures such as patient assisted suicides. However, although the medical prognosis and determination of the condition may justify the issue, the ethical dilemma associated with the condition influence the real applicability in a real situation.
Non-Medical Facts
The issue of end-of-life is influenced by a wide range of non-medical facts that contribute to the need for implementation of the problems. The non-medical circumstances that affect the question relate to the factors associated with the patient or with the immediate family of the patient. The first nonmedical fact may involve the patient's will and individual desire based on personal reasons or based on the level of pain experienced. In this case, the patient may engage in the process to end life by refusing to take the prescribed medication. The second factor may relate to the family, considering aspects such as economic constraints that may lead to the thoughts to end life in a bid to prevent san increase in cost associated with the provision of care to the patient. The factors have a significant role in influencing the issue, thus contributing to the clinical ethical dilemma.
External Influences
The clinical dilemma is a significant issue that is relevant to various external stakeholders considering that human life is regarded as a precious aspect. The first foreign influence entails the organizational policies that have primary consideration regarding the life of the patients. According to Karnik, S., & Kanekar (2016), the majority of healthcare organizations capitalize on the provision of healthcare services to patients to improve their health. In that case, the policies of an organization may not engage in the support for end-of-life process considering that it will reflect a failure on the part of protecting the patient against any harm (Hutchison & Sparrow, 2017). The other external influences relevant to the issue entail the federal and the state laws. The federal and state laws maintain that every human has a right to life, thus prohibiting the issue of assisted suicide among the patients. Lastly, the code of ethics is an external influence that defines how medical practitioners should engage in their day to day interactions with the patients.
Assumptions
There are significant assumptions associated with the end of life issue, which influence the decision making processes concerning the matter. The first primary assumption that is related to the theme of the end of life is on the fact that death is a better solution to the sufferings and may help in creating ease to the bodily pains (Chan, Webster, & Bowers, 2016). In this case, the assumptions influence the patients to engage in processes such as suicide in a bid to create relief for their sufferings. The second assumption is on the fact that assisted suicide is painless; thus, a patient may not experience pain while dying. Lastly, healthcare professionals assume that the patients have a right to make decisions regarding their own lives. In most cases, the assumptions guide the healthcare professionals in matters concerning the issue.
Decision Makers
Dealing with the issue of end-of-life requires proper decision making in a bid to ensure that all the relevant considerations are made to avoid a situation that involves legal action (Van der Heide et al. 2003). In that case, it is essential for all the parties involved to consent on the need for the procedures of ending life. In this case, it is necessary to ensure that a patient requesting to be assisted at the end of life issue must be of consenting age to ensure that they have the ability to understand the repulsions associated with the issue. In the case of a terminally ill patient, the family members of the patient are entitled to engage in the decision making processes in a bid to engage I making relevant consideration regarding whether to approve the measures or not.
Underlying Ethical Principles
Considering that the issue of end-of-life results in a significant ethical condition, there are other underlying ethical principles associated with the issue. The main underlying moral principle entails the issue of nonmaleficence, which is an aspect that capitalizes on the infliction of the least harm possible to the suffering patients in a bid to provide a solution that benefits the patients (Rosenfeld, Wenger, & Kagawa ‐ Singer, 2000). In that case, the ethical dilemma raises the question of whether an assisted patient may be really of help to the patient. Another underlying principle is on the issue of justice, considering the questions on whether the medical practitioners are justified to assist patients in suicide.
Alternatives
Considering that the issue of end-of-life results in a significant dilemma regarding the questions on whether it is justified to assist patients to lose their lives, it is therefore essential to consider the alternatives that may be relevant in overcoming the issue. Firstly, it is essential to consider the provision of alternative care to the patients in a bid to ensure that they get better or enhanced treatment (Orrevall, 2015). Secondly, it is important to capitalize on the provision of counselling to the patients and family in a bid to provide them with hope regarding the medical condition. Counselling therapy may have a major role in enhancing personal acceptance, which may help in eliminating the thoughts of assisted suicide.
References
Chan, R. J., Webster, J., & Bowers, A. (2016). End ‐ of ‐ life care pathways for improving outcomes in caring for the dying. Cochrane Database of Systematic Reviews , (2).
Hutchison, K., & Sparrow, R. (2017). Ethics and the cardiac pacemaker: more than just end-of-life issues. Ep Europace , 20 (5), 739-746.
Jeffrey, D. (2018). Patient-centred Ethics and Communication at the End of Life . CRC Press.
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.
Orrevall, Y. (2015). Nutritional support at the end of life. Nutrition , 31 (4), 615-616.
Rosenfeld, K. E., Wenger, N. S., & Kagawa ‐ Singer, M. (2000). End ‐ of ‐ life decision making. Journal of General Internal Medicine , 15 (9), 620-625.
Van der Heide, A., Deliens, L., Faisst, K., Nilstun, T., Norup, M., Paci, E., ... & Van der Maas, P. J. (2003). End-of-life decision-making in six European countries: a descriptive study. The Lancet , 362 (9381), 345-350.
