Ethical and Unethical Dilemmas Hospice Workers Encounter when Patients Wish to Hasten Death

Hospice in the United States Hospice is a concept of caring borrowed from medieval times, where travelers, pilgrims and the sick, wounded or dying could find rest and comfort. The contemporary hospice offers a program of care to patients and families facing a life threatening illness encompassing medical, nursing, spiritual, and psychological care. It is more than a medical alternative, it is an attitude toward death and the process of dying. Terminal disease is managed so patients can live comfortably until they die. The hospice program in the United States has evolved in part as an attempt to compensate for the inadequacies of the present medical system, particularly in caring for patients with a terminal illness.

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.

Section One Article One Analysis This work posits that medical professionals, i.e. nurses, often find themselves with patients who are grappling with life regrets and unresolved relational conflicts. To this end, Ferrell, Green and Garcia (2013) posit that medical caregivers may find themselves providing care terminally ill or end of life patients. Developmental theorist argue that it is not uncommon for older adults to contemplate and struggle with issues of dispositional, interpersonal, and self-forgiveness. Lacking formal training in grief interventions, nurses and doctors may feel at a lost because they are not equipped to address a patients trepidations regarding forgiveness.

30 January 2014. Hudson, Peter L.Kristjanson, Linda J.Ashby, MichaelKelly, BrianSchofield, PenelopeHudson, RosalieAranda, SanchiaO'Connor, MargaretStreet, Annette. "Desire For Hastened Death In Patients With Advanced Disease And The Evidence Base Of Clinical Guidelines: A Systematic Review." Palliative Medicine 20.7 (2006): 693-701. Alt HealthWatch.

The elderly’s psychological problems do not give them the opportunity to participate and to adapt to the new situation linked with being in a nursing home. They begin to feel worried about the future, fear of collapse, and have a sense of the futility of life, as they feel loneliness, isolation and alienation. This leads to despair and depression, and they start to remember the past, especially periods of success. Nursing homes help them in many ways, one of them is psychological sessions. Nursing homes use the importance of those sessions in many ways, where the elderly can learn how to deal with the psychological attitudes that might be exposed to them in their lives, and how he or she could get rid of them.

The Importance of Effective Communication between Doctors and Nurses during End-of-Life Care in the Intensive Care Unit End-of-life care, as defined by the U.S. National Institute on Aging, is the term used to describe the support and medical care given during the time surrounding death. The Intensive Care Unit (ICU) is a specialty area that cares for critically-ill patients who are facing life-threatening problems. The goal of the ICU is to help patients and their families get through this difficult stage using advance medical interventions and continuous emotional support. But sometimes, patients may not recover and death can be imminent. ICU nurses are the first ones to notice when a patient’s condition is not improving despite all the interventions.

The phases of acceptance are; denial about having the illness, feeling guilty as if they had done something wrong, and then depression about having six months or less left to live. A person who finds strength in denial may never reach the point of acceptance and may react negatively towards anything said to them that threatens their defense mechanism. Other people find comfort in arranging their financial and legal affairs and planning their funerals. In many older patients, many of them have a bucket list (Short). A bucket list is a list consisting of items such as: people they want to meet, places they want to travel to, or activities they want to take part in before they die.

Theory of Caregiver Stress and its Practice in Nursing Primary caregivers are given an opportunity to take care of their loved ones; however, this job comes with a lot of stress and its consequences (Tsai, 2003). Primary caregivers take care of those with a chronic illness such as a family member or friend, are given a task that is so immense that it induces a lot of stress. In the previous decades, many research articles have developed studies which focused on stressors that were associated with the task of being the primary caregiver; yet, a theory surrounding this topic has not been developed until the early 2000s. Tsai (2003) developed the Theory of Caregiver Stress based on the Roy Adaptation Model to identify the caregiver’s response, perceptions, and adaptations to the stress and burden that primary caregiver’s experience. The Theory of Caregiver Stress explains the primary caregiver’s social role, how they reduce stress, and how they cope with stress.

(2007). A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU. The New England Journal of Medicine, 356(5), 469-478. Patton, D. (2004). An analysis of Roy’s Adaptation Model of nursing as used within acute psychiatric nursing.

Evidence-based practice and family presence: paving the path for bedside nurse scientists. JEN: Journal Of Emergency Nursing, 37(1), 9-16. . Oman, K., & Duran, C. (2010). Health Care Providers' Evaluations of Family Presence During Resuscitation. JEN: Journal Of Emergency Nursing, 36(6), 524-533. doi:10.1016/j.jen.2010.06.014 Twibell, R., Siela, D., Riwitis, C., Wheatley, J., Riegle, T., Bousman, D., & ... Neal, A.