Nurses are occasionally required to make difficult judgments regarding the patient at hand. In most circumstances, they violate their moral ethics in order to save or kill a life. This essay discusses moral difficulties in the nursing profession. This article was written by a group of five nursing students who had just finished a portion on the course outline on legal issues, professional ethics, and morals in nursing. As a result, the main point of view will be on decision-making abilities using the principal-based model of non-malfeasance. Euthanasia, physician-assisted suicide is a sensitive issue for both the doctor and the affected family and it calls for keen reflection before coming up with a decision. At some point, a patient can request for assistance in shortening their life, the big question is, what is the moral obligation for the doctor-in-charge, how should the doctor respond to such a patient without offending them. This requires due diligence and cautiousness, hence, the application of decision-making skills is paramount in this situation. This essay focuses on the principal based model to approach euthanasia, an act which involves painlessly taking the life of a patient who suffers from a painful and an incurable disease or is in a coma that may not be reversed. When nurses are faced with a patient in a life-threatening and irreversible situation, they ought to make the right decision that is in line with the ethical morals requirements in the profession. The principle-based model which we considered applicable on non-malfeasance is as per the ethical classification representing the nurse`s endeavor to avoid harm to the patient. The assignment address how the position and evidence of the five group members reinforced my position, that it is right to shorten a patient’s life upon request.
Literature
The group members based their decision on euthanasia whether it is ethical or not, established on the principal based theory on non-malfeasance which grants a nurse the moral responsibility to avoid damage to the patient. Non-malfeasance practices ethical principal and values that guide the decisions that nurse have to make. Also, it relies on tested virtues which respect, fairness, courage, and honesty to guide a nurse`s action.
Maryann based her argument on her Christian faith. Which share the same virtues as non-malfeasance. According to her, the sanctity of life is paramount. She based her argument on the bible verses. She supported this opinion with referencing on the World Federation of Rights to Die Society which states that there is no moral difference between euthanasia and provider assisted suicide. To her, the argument that euthanasia is a relief to the patients in pain and are bound to die does not hold water. She further states that pain and suffering do not justify murder a claim that both euthanasia and provider assistance is based on. Based on Maryanne's knowledge on the recommendations from the Institution of medicine in regards to improving care at the end of life, she asserts that health professionals must commit themselves to improving care for the dying patients and to apply their knowledge effectively to prevent and relieve pain and other symptoms (Dobbins, 2016). Consequently, she maintains the stand that euthanasia and provider assisted suicide is ethically wrong.
Given that I hold the same faith as Maryann, I reviewed my interpretation of life and observed it as a gift from God.I believe that through euthanasia, the patient is relieved of pain which according to my understanding is more human than watching them helplessly in pain. The idea of "sanctity of life" did not cross my mind. I also interpreted that, the fact that the patient`s interest should be a doctors priority means that when the patient is in pain and their ultimate end is death, then a doctor has the right to go as per the patient's needs. Founded on the principal based model, activating death for whatever reason is not ethical, instead, nurses should make attempts to the end to restore the patient`s life.
According to Lakisha, man has no moral obligation to decide when a person`s life should end. An act of euthanasia, which has a similar definition as assisted suicide. They both involve intentionally, knowingly and directly acting to cause death to another person. Though other scholars have a contrary opinion on the ethical moral of euthanasia, Lakisha supports the state laws that rules out the moral obligation of euthanasia.
Lakisha`s point of view reinforced my new position on euthanasia since it emphasized on the fact that man has no moral obligation to take another person's life. If a patient will ultimately die, they should die a natural death.
Paul supports Lakisha`s view arguing that euthanasia empowers doctors to kill patients, an act against the Hippocratic Oath. Which mandates doctors to make decisions which lead to the well-being of the patients. Paul adds that, if euthanasia is considered ethical, then a doctor may selfishly induce death on a patient which leads to mistrust. However, after Guilene presents an argument in support of assistant- suicide on critical circumstances whereby beyond all medical assistance, the patient`s life cannot be saved, Paul supports that at this stage in life, it is appropriate for a doctor to perform euthanasia.
Paul dispute the argument of medical bills and harvesting organs to assist other patients. He holds on Christian faith that believes in the sanctity of life, according to him, no reason warrants the taking of another`s life. He also cites that the government should focus on saving life and discourage any act that denies a person life for any reason. This is possible if the state promotes research geared towards finding better ways of improving life rather than destroying life. He adds that this will motivate the doctors to save a life.
Paul disputes this idea based on the principal of non-malfeasance which states that the nurse has the moral obligation to avoid harm to the patient since the nurse`s primary obligation is to the patient.
Guilene feels that it is ethically wrong for doctors to perform involuntary euthanasia. He brings out the two conditions that a patient`s death may be initiated; euthanasia is performed under two conditions; voluntarily or involuntarily, although either way it is medical, ethically, and morally inappropriate. Guilene argues that the mentality the other group members have based on the fact that euthanasia is only initiated by the doctor hence the doctors are held responsible for the act is wrong. Guilene puts forward the comparison between palliative care and voluntary euthanasia he states that both are focused on reducing human suffering, and value the patient’s ability to control care at the end of life, and finally, “both palliative care and the VE/AS legalization movements recognize that death is not always the worst thing that can happen (Varelius, 2013)
My initial stand was a contrary opinion, though I share the same opinion on the sanctity of life, I felt that despite the fact that euthanasia and assisted suicide is a debatable issue, at some point upon a patient`s request, they should be granted their wish. I support my argument based on research by stating that most patients suffering from terminal illness opted for euthanasia or assisted suicide. Hence, in my opinion, the patients wish should be respected because only they know what is appropriate in their situation. She further gives evidence on why euthanasia can be considered as a moral obligation.
Healthcare professionals who favor the euthanasia and assisted suicide reason out using the following justifications. They believe assisted suicide and Euthanasia “allows the individuals to value ‘Quality of life over Sanctity of life.' They also believe that it respects the sufferer’s autonomy and helps end suffering” (Devakirubai, & Gnanadurai, 2014, p.59). However, it is important to assess the patient's cognitive ability and decision-making capacity. Consequently, she advises that the nurses have the moral obligation to counsel terminally sick patients on euthanasia but they cannot make decisions on their behalf.
Researchers have been divided on the issue with some believing that it is morally right to end the life of terminally ill patients upon request while others believe that it is against the tenets of Hippocratic Oath and an impediment to the general objectives of science. A research conducted by Ozcelik et al. (2015) indicates that although the law that allows patients to make decisions regarding their lives is selectively applied, it should be embraced since it allows patients to die with dignity. The authors argue that the quality of human life should be protected up to the point of death. Allowing patients to suffer while being certain about the eventuality of their condition is morally wrong.
However, such stances care vehemently opposed by Cohen-Almagor (2015), who believes that taking a patient’s life upon request is a slippery ground since it would be a gateway to other controversial medical decisions that may not be genuinely conceived. The author gives a situation of terminally ill patients who cannot make a rightful decision regarding their desired fate. The relatives and close family members may opt for euthanasia claiming that it is the most appropriate option for the patients. In such a condition, it would be difficult for doctors to make a decision on the issue. Moreover, the authors believe that some patients may be wrongly influenced and taken away by influential members of the family. Therefore, they decided to have their loves terminated would not be out of personal will but wrongful conviction. The authors concur with the views of Guilene who believes that euthanasia is morally inappropriate whether done voluntarily or involuntarily.
The primary objective of science, that is, to make people’s lives better is detrimentally affected by euthanasia. According to Harris (2015), allowing nurses to conduct euthanasia on willing patients affects this objective. The numerous efforts that health researchers put in trying to come up with solutions to terminal ill menses are watered down. It also affects the role of medical professionals in protecting and promoting the well-being of the patients. The author notes that when doctors convince the patients that there is no solution to their problems other than death, they fail to protect lives. Although this can be a controversial statement by the author, it is noteworthy that patients go to the hospital in the belief that they will get a solution for all their problems. Giving the patients an option to take away their lives is damages the trust and confidence that the patients and the close relatives may have on the health profession. Maryanne (one of the group members) shares in this school of thought and agrees that the terminally ill patients should not be seen as a challenge but rather a determination for the health professionals and researchers to continue running tests and trails with the intention of preventing patients from such intransigent circumstances.
Conclusively, the views of the group members and the available research on the issue have changed my view on the issue of patient assisted suicide. Initially, I held on to the idea that it was morally right for nurses and other health professionals to participate in euthanasia. However, I have learned that there are various limitations that should be embedded in the practice if it should be enacted. It has dawned on me that there is a possibility for some health professionals who may exploit the opportunity to wrongly administer euthanasia on particular patients.
In addition, there is a looming danger of the patients being negatively influenced by relatives who may view them as a burden to have their lives terminated. The decision to end one’s life should be autonomously conceived and it sold not be a preliminary option. The rationale for this is that research has indicated that the practice can discourage researchers who run numerous tests to ensure that invent procedures to save people’s lives, particularly for conditions that are terminal. Therefore, although my initial stand has not been entirely changed, it can only be applicable if the precautions are adhered to by nurses and the policymakers.
References
Cohen-Almagor, R. (2015). An argument for physician-assisted suicide and against euthanasia. Ethics, Medicine and Public Health, 1(4), 431-441.
Degenhardt, L., Larney, S., Chan, G., Dobbins, T., Weier, M., Roxburgh, A., & McKetin, R. (2016). Estimating the number of regular and dependent methamphetamine users in Australia, 2002–2014. The Medical Journal of Australia, 204(4), 153.
Devakirubai, E., & Gnanadurai, A. (2014). Euthanasia-An Overview with Indian and Nursing Perspective. Asian Journal of Nursing Education and Research, 4(1), 56.
Harris, J. (2015). The philosophical case against the philosophical case against euthanasia. Euthanasia Examined: Ethical, clinical and legal perspectives, 36-45.
Ozcelik, H., Tekir, O., Samancioglu, S., Fadiloglu, C., & Ozkara, E. (2014). Nursing students' approaches toward euthanasia. OMEGA-Journal of Death and Dying, 69(1), 93-103.
Varelius, J. (2013). Ending life, morality, and meaning. Ethical theory and moral practice, 16(3), 559-574.
