Introduction
Individuals and family members often have particular needs and wish related to death and dying. The advance directive instructs health care providers and family members about an individual's medical care decision if they are unable to make such decisions when needed. Although few persons take any step toward causing their death, some dying people may consider suicide. Under some conditions and areas, laws permit doctors or health care practitioners to aid in dying if specific needs are met, and particular procedures are adhered to. On the other hand, fear of the law deters health care practitioners from acting in their patients' best interest and assisting family members face problems level headedly. Even though doctors and physicians have processes laid down to help the act in their patients' welfare, those processes aren't enough in themselves without some tantamount changes in the law. The purpose of this scholarly paper is to describe the ethical problem of death and dying, highlighting any potential ethical dilemma associated with it.
Ethical Dilemma Relating to Death and Dying
Human beings are mortals; thus, death is an unavoidable occurrence. The advancement of technology in medicine is changing the norms of natural death; at the same time, these technologies can prolong the lives of individuals. Therefore, medical technologies are reshaping and facilitating natural death situations through sustaining human lives ( Quill et al., 2016) . Despite advanced medical treatment technology, physicians have no promises for their patients; they can care for them with meaningful existence or assistive technology, such as ventilators and feeding tubes. Therefore, medical advancement has empowered patients and family members with the significant responsibility of choosing their treatment preferences while dying. Physicians are faced with ethical dilemmas in their daily work; circumstances under which no right answer is clear. This is particularly common during end-of-life care, where doctors and patients might experience grief and loss. An ethical dilemma might arise from communication breakdown; patient autonomy is compromised, ineffective symptom control shared decision making, and non-beneficial care ( Quill et al., 2016) . A physician can navigate this ethical dilemma by providing the best possible care at some time, allowing patients and family members an opportunity to experience end-of-life care with dignity.
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Stakeholders Impacted by Death and Dying
There are three significant euthanasia stakeholders: the patients, the physicians, and the government. Most patients suffering from harrowing diseases agree that ending their life is paramount to living in agony. However, most people believe that legalizing euthanasia affect ill patients mentally. Physicians are individuals with the mandate to euthanize willing patients. However, physicians go against their oath of saving lives to perform euthanasia ( Shaw & Elger, 2016) . Individuals who fight against euthanasia believe that the power given to the physicians will be abused by allowing euthanasia, resulting in physicians hiding their malpractice. They view euthanasia as a homicide. Another major stakeholder affected by the legalization of euthanasia is the government. To ensure that assisted suicide does not impact society, negatively active government participation is necessary ( Shaw & Elger, 2016) . Most governments do not allow assisted suicide. Physicians who have assisted patient suicide may be prosecuted. However, there are other countries and states where euthanasia is permitted.
Legal Concerns Associated with Death and Dying
Some of the legal concerns related to the ethics of death and dying are advance directives. Health care advance directive is a legal issue that advocates an individual's wishes about healthcare decisions in circumstances that the individual becomes incapable of making medical decisions. Advance directives are supposed to comply with the state law requirement and be in written form. The advance directive is categorized into two; HCPA and living wills. The attorney's health care power assigns an individual refers as a health care proxy or agent to make decisions for the patient in case of incapacity, either permanent or temporary, to make health care decisions ( Hosseinzadeh & Rafiei, 2019) . A living will be expressed in an advance, the individual's preferences or instruction about future medical treatments, specifically end-of-life care if the patient loses the capacity to make medical care decisions.
Professional and Personal Values Associated with Death and Dying
Position Regarding Death and Dying
Due to changes in the medical delivery system, there has been a steady change in the physicians and the patient's attitude toward greater acceptance of euthanasia as an alternative for dying patients and terminally ill. In developing countries, physicians come across the ethical of death and dying and a very increasing rate. Attitude toward the moral of death and dying is more sophisticated than merely voicing an opinion against in favor of it; this is due to numerous aspects such as religious beliefs, culture, and the person's knowledge about the topic ( Hosseinzadeh & Rafiei, 2019) . Several types of research have indicated that public opinion at the international level tends to favor the legalization of euthanasia more than medical opinion. The patients who suffer from chronic illnesses are directly affected and share their experience of suffering and the knowledge of the awaiting death; this prompts the reflecting more on euthanasia. For example, an article on the relationship between dementia and assisted suicide indicates an increasing number of patients requesting to get euthanized over time. In the Netherlands, in 2014, more than 81 patients with dementia were granted permission for euthanasia (De-Beaufort & De-Vathorst, 2016). Physicians administered lethal drugs on the patients' requests or assisted them by handing them the deadly drugs.
Alternative Position
Voluntary ceasing to eat and drink is an ethical alternative to euthanasia. The debate over the moral of death and dying has included little discussion on the other options approaches for voluntary death (terminal dehydration) other than physician-assisted suicide. With terminal dehydration, patients with an incurable illness and excruciating diseases seek death by ceasing to drink or eat or forgo artificial nutrition and hydration ( Jox et al., 2017) . The patient's option to voluntarily terminating to drink or eat is based on the ethical principle of autonomy and is supported by law. For instance, a patient may refuse to take food, which is permitted by the principle and autonomy, which may hasten their death. This form of death is an alternative to euthanasia.
New Knowledge Gained from Ethics of Death and Dying
The primary new knowledge related to the ethics of death and dying is that not all people deal with death in the same way. Often, most people dislike death but normally make different decisions when faced with life-threatening diseases. Some individuals prefer to die and escape the agony of a life of pain and misery, while others prefer to respect the sacred nature of life even if it means living in pain. All this comes to individual priorities and beliefs. Besides, physicians also have a hard time when dealing with patients who choose euthanasia. Although it may be legal in the state they are operating in; some physicians are uncomfortable about assisted suicide while others are not. The choice of a physician to aid euthanasia depends on their beliefs. While others believe that it is wrong, others are okay with it. Therefore, the choice of euthanasia comes down to the belief of an individual.
Conclusion
Physician-assisted suicide provides patients who wish to end their lives posse eternal debate on how ethical the act is. It is very controversial since it reverses the main objective and goal of doctor and patient, saving or preserving life. Under some conditions and areas, laws permit doctors or health care practitioners to aid in dying if specific needs are met, and certain procedures are adhered to. On the other hand, fear of the law deters health care practitioners from acting in their patients' best interest and assisting family members face problems levelheaded. Over the past few decades, more progress has been made in expending patients' and family members' right to control file and death decisions. The movement has sorted to increase the alternatives of physician-assisted suicide.
References
De Beaufort, I. D., & van de Vathorst, S. (2016). Dementia and assisted suicide and euthanasia. Journal of Neurology , 263 (7), 1463–1467. https://doi.org/10.1007/s00415-016-8095-2
Hosseinzadeh, K., & Rafiei, H. (2019). Nursing student attitudes toward euthanasia: A cross-sectional study. Nursing Ethics , 26 (2), 496-503.
Jox, R. J., Black, I., Borasio, G. D., & Anneser, J. (2017). Voluntary stopping of eating and drinking: is medical support ethically justified? BMC Medicine , 15 (1), 1-5.
Quill, T. E., Back, A. L., & Block, S. D. (2016). Responding to patients requesting physician-assisted death: physician involvement at the very end of life. JAMA , 315 (3), 245-246.
Shaw, D. M., & Elger, B. S. (2016). Assisted suicide for prisoners? Stakeholder and prisoner perspectives. Death Studies , 40 (8), 479-485.
