Introduction
Ethical values are essential and fundamental for all healthcare givers. Ethics are important in healthcare because workers are able to recognize ethical dilemmas and make good decisions and judgments with respect to their values and consistent with the laws that govern them. Professional ethics constitute the set of rules that govern professional conduct and provide a practical basis upon which to base certain actions, motives, and intentions. In other words, professional ethics govern the manner in which professional behave or conduct themselves and is also useful in determining the ultimate consequence of one's conduct. Professional ethics are at the foundation of nursing practice. To practice nursing with integrity and competence, nurses, similar to other healthcare professionals, must adhere to the ethical regulations developed by the American Nurses Association (ANA).
Statement of Purpose
One of the foremost ethical issues in healthcare includes the problem of death and dying. Active suicide (Physician-assisted death) and passive euthanasia are and have been an issue of controversy for decades. In some countries, it still remains illegal and unethical, making this an interesting area for research. The research paper will explore nurses' role in assisted death and the ethical and legal dilemma surrounding assisted death in nursing. This paper aims to explore the ethical topic and the potential incumbent ethical dilemma linked with it; the stakeholders who are impacted by assisted suicide; the legal concerns associated with euthanasia; the professional and personal values related to assisted suicide as well as reflect on the personal attitudes and perceptions relating to euthanasia.
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The Ethical Dilemma in Euthanasia
Physician aided death/euthanasia and palliative sedation are multidimensional healthcare practices that lead to the termination of a patients' life. Euthanasia can be active, passive, voluntary, and involuntary, or physician-assisted. Active euthanasia involves introducing the patient to something that induces death. Passive euthanasia, on the other hand, comprises of acts such as withholding treatment. Voluntary euthanasia is when the dying patients give the doctor's consent to terminate their life, while involuntary euthanasia is done on behalf of the patient (who may be incapacitated) by a legally authorized third party. Physician-assisted euthanasia is where the physician prescribes life-ending medication to the patient or authorized third party who administers the medication to induce death.
Nurses and other healthcare providers' first responsibility is to the patient, that is, provide the best quality healthcare services that will help the patient recover their health in full, and to do no harm to the patient. Healthcare providers are guided by four fundamental principles; Maleficence, beneficence, autonomy, and justice. Euthanasia can be viewed as being in direct contravention of these four ethical principles, and when nurses are faced with such a decision, and it is against the nurses' beliefs and values. For instance, what would a nurse who strongly believes in saving lives do when a patient expresses their desire to die to them? Will, he/she try providing the patient with the correct information, or will he/she try to coerce the patient out of their decision because of their personal ideas on life?
Stakeholders Impacted by Euthanasia
The decision for Euthanasia must be a collaborative effort involving all stakeholders. These stakeholders include; physicians, nurses, psychiatrists, patients, the family, relatives, and the hospital administration. The patient is directly impacted as he/she is the one the decision is made for. The physicians are impacted because they have to deviate from their primary role of saving and healing to taking life (directly or indirectly). The family, friends, and relatives of the patient are also affected because they are the ones to bear the psychological burden of grief, sorrow, and loss of their loved one once he/she is dead. The hospital administration is affected directly if the procedure is not done up to code, as there are legal ramifications to complying with or denying a patient's request to be euthanized. Finally, psychiatrists and mental healthcare professionals must be involved to ensure that the patient's decision for euthanasia is not made under duress, and also, they are essentially the ones to help the family deal with the loss of their loved one.
Legal Concerns Associated with Euthanasia
In legal philosophy, euthanasia fits perfectly into the "slippery slope" argument. This argument premises that one exception to the law is followed by subsequent exceptions up to a point whereby what was previously unacceptable is now a norm. Initially, euthanasia could not be done without the consent of the patient and was otherwise murder. Advanced directives, living wills, and proxy decisions make euthanasia complicated; this is because these documents are prepared in the past and are unrelated to the current situation. This means that there is no way to know whether the present euthanasia act is the patient's will or not by the time it is carried out. Making illegal active euthanasia, particularly in the United States, denies the patient their right to self-determination, which is a basic human right protected by the constitution. Additionally, involuntary euthanasia denies the patient the right to life.
Primary Position Reflection
Arguments for Euthanasia
For decades, researchers, particularly in the medical field, have held disparate positions on euthanasia's controversial issue. However, it is important to hold with those who support Euthanasia. For instance, intensive care experience and the numerous conversations with patients in palliative care (those who are chronically and terminally ill or injured). In this regard, death is perhaps more merciful than a life of agony (Strinic, 2015).
By allowing Euthanasia, patients suffering from incurable, degenerative, debilitating, and disabling conditions are allowed the right to die in dignity. In addition to this, Euthanasia helps reduce the burden to caregivers, with respect to financial, emotional, physical, mental, social, and time. It is not uncommon to find family members petitioning for Euthanasia for patients to ease the patients' suffering as well as theirs. The United States law allows the right to refuse medical treatment, be it life-sustaining or life-prolonging. Passive euthanasia is consistent with this law, and it is, therefore, good to allow for mercy killing. Euthanasia honors patients' right to die with dignity. Finally, Euthanasia allows for organ transplants to patients who may live longer than the dying patient. The ethical principle of doing the greatest good for the most number of people is upheld here. Organs from a person with a debilitating mental illness may save tens of people in critical condition (Kim et al., 2016).
Alternate Position
Arguments against Euthanasia
Critiques for euthanasia argue that euthanasia is a form of murder. With the advancement in medical science and technology, there exists a variety of life-prolonging and life-sustaining options in palliative care, which make euthanasia unnecessary. According to Banovic et al. (2017), patients who opt for euthanasia after being told that nothing can be done anymore will change their mind after the doctors tell them that a lot can be done with palliative care. Others argue that euthanasia is a twisted way of eliminating the invalid. For example, in Holland, the mercy killing of deformed fetuses is allowed.
New Knowledge and Conclusion
Researching on this topic was very useful in disseminating the knowledge that physician-assisted suicide, despite having straight forward benefits, is contested more than supported. This position is held by both faith and non-faith organizations, which are opposed to Euthanasia (Ezekiel et al., 2016; Sulmasy et al., 2016). To conclude, this paper discussed the ethical and legal issues surrounding mercy killing. While only a handful of countries globally have legalized euthanasia, health professionals in the other countries should make an effort to sway the governments to decriminalize euthanasia for the patients' good.
References
Emanuel, E. J., Onwuteaka-Philipsen, B. D., Urwin, J. W., & Cohen, J. (2016). Attitudes and practices of euthanasia and physician-assisted suicide in the United States, Canada, and Europe. Jama , 316 (1), 79-90.
Sulmasy, D. P., Travaline, J. M., Mitchell, L. A., & Ely, E. W. (2016). Non-faith-based arguments against physician-assisted suicide and euthanasia. The Linacre Quarterly , 83 (3), 246-257.
Banović, B., Turanjanin, V., & Miloradović, A. (2017). An ethical review of euthanasia and physician-assisted suicide. Iranian journal of public health , 46 (2), 173.
Kim, S. Y., De Vries, R. G., & Peteet, J. R. (2016). Euthanasia and assisted suicide of patients with psychiatric disorders in the Netherlands 2011 to 2014. JAMA psychiatry , 73 (4), 362-368.
Strinic, V. (2015). Arguments in Support and Against Euthanasia. Journal of Advances in Medicine and Medical Research , 1-12.
