Euthanasia
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5 slides with speaker notes and references
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Euthanasia
Euthanasia is defined as the intentional administration of drugs that are lethal with the intention of terminating person’s life in a painless manner; to relieve patient from continued suffering from an chronic and incurable condition which that is unbearable. There are three types of euthanasia; a) voluntary euthanasia- which refers to euthanasia conducted upon patient requests; b) Non- voluntary euthanasia- which refers to euthanasia performed but not from patient wish/ request and c) Physician assisted suicide- where the physician willing and knowingly terminates patient life at the patient request (Dierckx de Casterlé, Denier, De Bal & Gastmans, 2010).
Impact on nursing practice, social values, morals, and norms
The advancement in technology and medical knowledge has led to changes in the causes as well as death timing in the modern world. The advancement in technology have made life expectancy to increase; but the longer they live, the more people are subjected to degenerative diseases which are chronic and have gradual health deterioration to old age, who are admitted in the palliative care where they get end of life are. In the diverse healthcare facilities, the physicians and the nurses are part of the interdisciplinary team but the role of the nurses differs from the other healthcare providers. This is because the nurses are closer to their patients, and are often confronted with the mourning and distress from the family members and relatives (Sharp, 2012).
Human euthanasia is legal in few countries including Luxembourg, Belgium, Colombia, Netherlands, Germany, Switzerland and Japan. In the USA, the euthanasia is legal is few states including New Mexico, California, Vermont, Oregon, and Montana (Sharp, 2012).
For example, in nursing profession, there is the issue of trust, i.e. the patient should trust the nurse that he or she will not be killed by the nurse. In this context, euthanasia concepts develop the dimension of suspicion that conflicts with the nurse roles as healer and comforter. On the other hand, the patient expects the nurses to be their advocates, thus, institutions that co-opt euthanasia in their policy could cause the rise of the concept of distrust due to the interrupted confidence in relationship between the service user and the service provider (Quaghebeur, Dierckx de Casterle & Gastmans, 2009).
The integrity of nurses should never be used mainly to meet the patient goals i.e. patient wishes to die. Although utilitarian theory supports this practice, it is against the nurse moral and professional dignity for the nurses. Although involvement of the nurses in executing euthanasia adversely affect the society faith as well as trust in nursing practice; it is in line with the nurses professional responsibility of protecting human dignity, caring and promoting as well as protecting patient interest. Thus it can be said it is compatible with nursing practice (Salladay, 2015).
Ethical theory and principle
The four medical ethical principles impact significantly about the nursing debate about euthanasia. These principles include non-maleficence, autonomy, justice and beneficence. For instance, the nurses are obliged to respect for the patient autonomy. This justifies the issue of euthanasia, as the nursing professional ethics indicates that patient’s autonomy must be respected. The patient request on their private life must be respected by the physician, government and the nurses. Therefore, the nurses must never feel guilty when undertaking these tasks as it is respecting autonomous (Salladay, 2015).
The critics that arise in this context include the fact that these practices have little respect to empathy and autonomy of the patient family and relatives. It is argued that a patient autonomy is not vital if it erases all the importance of the community social paradigm. Life is a valued paradigm in the society. Secondly, it is strange that euthanasia supporters advocate for patient autonomy even when the patient does not enjoy his/her autonomy. Therefore, euthanasia is an indication that the healthcare providers are unable to deal with death, which causes the questioning the quality of autonomy if the patient flees from anxiety or their uncertainty by choosing death. This is a mere defeatist perspective, where there lacks room for positivity or hope in ending the person suffering (Sharp, 2012).
Rejection of euthanasia is mainly supported by the nursing ethics principle of non-maleficence. If this principle is applied, euthanasia is a drastic interventions applied in the end of life care, which makes it difficult to deal in with death correctly. This principle supports the sanctity of life making it difficult to acknowledge euthanasia as ethical practice. Therefore, this principle calls for respect for life. This is also supported by the ethical principle of beneficence delineates the importance of promulgating the legitimate interests of all other people involved. On the other hand, the ethical principle supports in practicing the overall good of the patient, which requires in stating what is medically appropriate for the patient (Quaghebeur, Dierckx de Casterle & Gastmans, 2009).
Additionally, in protecting patient’s request, then, euthanasia is viewed as justice as it illustrates the expression of delivering good care for the patient. Although the consequentialism theory criticizes euthanasia, the ethical principle of justice here implies that the patient needs are addressed to according to their needs or according to their possibilities. Additionally, this principle is likely to be affected by the danger of being self-righteous or self-gratification attributes associated with the new movement- which euthanasia is a part of (Salladay, 2015).
Conclusion
The increased lack of consensus between the nurses on this ethical issue points the importance to analyse the world view and ideologies as well as the nurse’s attitudes and beliefs about euthanasia. Attention should be focused on the role of euthanasia in essence of care by evaluating the evidence based studies. This is especially important because of the specificity nature of the nursing expertise in care, especially in end of life care.
References
Dierckx de Casterlé, B., Denier, Y., De Bal, N., & Gastmans, C. (2010). Nursing care for patients requesting euthanasia in general hospitals in Flanders, Belgium. Journal Of Advanced Nursing, 66(11), 2410-2420. http://dx.doi.org/10.1111/j.1365-2648.2010.05401.x
Quaghebeur, T., Dierckx de Casterle, B., & Gastmans, C. (2009). Nursing and Euthanasia: a Review of Argument-Based Ethics Literature. Nursing Ethics, 16(4), 466-486. http://dx.doi.org/10.1177/0969733009104610
Salladay, S. (2015). Ethical Problems. Nursing, 45(2), 14. http://dx.doi.org/10.1097/01.nurse.0000459548.37627.9a
Sharp, R. (2012). The dangers of euthanasia and dementia: how kantian thinking might be used to support non-voluntary euthanasia in cases of extreme dementia. Bioethics, 26(5), 231-235. http://dx.doi.org/10.1111/j.1467-8519.2011.01951.x
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