Research that involves patients near the end of life has numerous ethical challenges particularly because of their designation as a special population. This has created an ethical dilemma for both investigators, providers and institutional review boards. It is for this reason that many have called for the non-participation of dying patients in research, while some have argued against it. However, there remains an uncertainty about the ethical limits of palliative care research. This paper focuses on three key ethical issues which have been identified as unique to this population and concludes by identifying areas in which further research will be beneficial in the context of palliative care research. A lot of key ethical issues surround the inclusion of …show more content…
However, a key issue in meeting this requirement is defining the research risk and benefits, and measuring them against an appropriate standard.2 Studies have shown that patient’s goals of care near the end of life changes. They become more focused on spending quality time with family members and symptomatic relief. This change in goals of care is most likely to result in a change of preference on what constitutes a risk or potential benefit in end of life research. This issue is unique to palliative care research and calls for future studies to investigate what patients at the end of life might perceive as a risk or benefit. Challenging as well is that, even when patient’s perception of risk and benefits are known, they are measured against the risk of everyday life. It has been suggested that investigators should consider the risk and benefits in relation to the risk and benefits that patients near the end of life typically experience in their daily
Gawande’s book is very pertinent to the present day and has by many accounts sparked a national discussion on end-of-life care and how we treat our elderly. With elderly people accounting for a greater proportion of the American populace and as people start living even longer than they do now, end-of-life care will become and remain a major issue faced by doctors, patients, their families, and the healthcare system. Additionally, with our greater focus on improving patient outcomes while getting the most value for our healthcare dollars, end-of-life care is a major area that healthcare systems and hospitals will focus on, as it accounts for a large portion of their budget. As a response to the need to take care of our aging population, hospice care and palliative medicine are some of the newer specialties in the medical field that have been increasing in popularity and more research needs to be focused in these areas to better understand how to improve patient outcomes.
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
There are questions about transplant allocation in regards to the four major ethical principles in medical ethics: beneficence, autonomy, nonmaleficence and justice. Beneficence is the “obligation of healthcare providers to help people” that are in need, autonomy is the “right of patients to make choices” in regards to their healthcare, nonmaleficence, is the “duty of the healthcare providers to do no harm”, and justice is the “concept of treating everyone in a fair manner” ("Medical Ethics & the Rationing of Health Care: Introduction", n.d., p. 1).
Planning included reaching out to other health organizations, objectives, and goals of health fair were established. The implementation includes getting volunteers, set up for the health fair. The evaluation of the process occurred throughout the implementation and changes were made as needed. The evaluation will be completed by gathering information from health booth to determine the number of participants. Review vendor and participant evaluations about the health fair including how they heard about the health fair, ratings of booths and suggestions for improvements. Record everything to determine changes. Reflection on past experiences and what worked and did not work.
There is great debate in this country and worldwide over whether or not terminally ill patients who are experiencing great suffering should have the right to choose death. A deep divide amongst the American public exists on the issue. It is extremely important to reach an ethical decision on whether or not terminally ill patients have this right to choose death, since many may be needlessly suffering, if an ethical solution exists.
This study showed that nursing ethical values in patients, clients car are similar in many cases due to a common core in humanistic and spiritual approach of nursing profession, which is taking care of a human values such as human dignity, kindness and sympathy, altruism, responsibility and commitment, justice and honesty, personal, professional competency were similar in most of the cultures.
promoting death: ethical issues surrounding psychological treatment of a terminally ill client. Ethics and Behavior 22(1), 44-59. Retreived from doi:
...nce that is necessary to provide primary care providers the tools necessary to provide care. Early hospice admission is statistically proven to be more effective in preventing pain at end of life. It is cost effective to do so and has been discussed within the confines of this project. A literature search using CINAHL proved that in different venues the fact that earlier admission does result in pain management was proven.
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
Ethics is a branch of philosophy that deals with the moral principles and values that govern our behavior as human beings. It is important in the human experience that we are able to grasp the idea of our own ethical code in order to become the most sensible human beings. But in that process, can ethics be taught to us? Or later in a person’s life, can he or she teach ethics the way they learned it? It is a unique and challenging concept because it is difficult to attempt to answer that question objectively because everybody has his or her own sense of morality. And at the same time, another person could have a completely different set of morals. Depending on the state of the person’s life and how they have morally developed vary from one human
Even though many dispute over the value and usefulness of treatment and care of terminally ill patients, the debate for the most useful care and pain reliever for these patients is the question that most patients, and their families, have to ask themselves daily. Wesley J. Smith suggests that Hospice care for patients with such a horrible illness is a beneficial program and that many patients need to utilize it. Smith also recommends that a valuable care option would be to “allow the terminally ill to enter hospice care without having to give up life-extending or curative treatments”. (Smith 3) With this statement, Smith demonstrates a way that these ill patients can be provided with treatment and also care for the patient’s quality of life.
When a person is dealing with a terminally illness they need to research the right to die, this also affects not only the patients, but also the doctors and loved ones.
Center for Bioethics: University of Minnesota. End of Life Care: An Ethical Overview. 2005. PDF.
The subject of death and dying can cause many controversies for health care providers. Not only can it cause legal issues for them, but it also brings about many ethical issues as well. Nearly every health care professional has experienced a situation dealing with death or dying. This tends to be a tough topic for many people, so health care professionals should take caution when handling these matters. Healthcare professionals not only deal with patient issues but also those of the family. Some of the controversies of death and dying many include; stages of death and dying, quality of life issues, use of medications and advanced directives.
Ethics asses the values, morals, and principles of nurses. Legal codes or laws are rules established by our government. It’s important that nurses have a clear and comprehensive understanding of ethical and legal codes within their career. The understanding of these codes is essential for nurses to safely practice and to protect their patients. Nurses must abide by these principles or face the consequences of legal action. These principles include autonomy, utilitarianism, confidentiality, and many others. Autonomy is the agreement to respect ones right to determine a course of action, while utilitarianism is what is best for most people as defined in American Nurses Association. In order to give you a