A dying patient challenged me during my internship in the 1st year of nursing in the gastro-enterology north-east ward of Erasme Hospital. I had seen this person for six days (from 12 to 18 April 2008), and during these few days, her son made a euthanasia request for his mother to the medical team. I will initially describe the situation in detail. Then I will make an analysis of the same. This analysis will include identification of the ethical problem, where I will link this with ethical principles, identify appropriate mental elements and values which come into play, and evaluate the ethical problem. Then we will look at the alternatives.
[...] Analysis Identifying the ethical issue, the relevant mental elements and values in play According to the situation presented above, we note that this is a situation of ethics, and specifically the decision of euthanasia in a person who cannot speak properly, and whose request was made by a third party. These are two aspects that can be argued: the justification of euthanasia and the procedure for decision making. Faced with this situation, the care taker may experience several reactions and feel a conflict between the duties: helping the patient to relieve her pain, or the principle of beneficence and the respect of the patient's own will, which is the principle of autonomy. [...]
[...] The cessation of treatment. To stop the treatment the patient is taking, since they are not effective on the patient's pathology and cannot cure the patient. Only treatments to relieve pain would be maintained. The administration of sedatives or analgesics. The patient would sleep and it would relieve suffering, but these also entail the risk of shortening life. Palliative care with the establishment of comfort care. The objective here is to relieve physical pain, while taking into account mental pain and social support and spiritual aspect of the patient. [...]
[...] They recognized that the patient had repeatedly spoken of her death, but also noted the absence of the word euthanasia or implicit request of the latter in her remarks. They also listened to the son on this person's suffering, noticed the distress over the vision of his mother in this state and the request for euthanasia that thus arose. Doctors: Just as nurses, physicians have heard about the patient and of her son. They decided to set up a committee for consideration, and asked one of their colleagues, a 'specialist,' to go see the patient about whether or not she wanted to be euthanized. [...]
[...] According to a certain point of view, the act of euthanasia is to kill a person so they can be released from their illness and physical and psychological suffering that accompany it. This is for their good. But this principle can also show the importance of "taking care," which becomes an important purpose in life. Thus, it shows us that despite the absence of cure, the caregiver can anyway, until the end, provide welfare to the patient. It gives us a direction to follow and guides us as to what we can do for the patient. [...]
[...] Indeed, according to the Consultative Committee on Bioethics, euthanasia requests made by terminally ill patients can be classified into three categories, the 1st is the demand expressed by the family and not by the patient himself, inferring that this situation is not unique. After identifying the ethical and moral elements, values come into play and in the context of this particular situation, we will, using books and ethical nursing literature, examine the standards for this problem. Evaluation of the ethical problem According to the Act of May on euthanasia, the latter is defined as "an act performed by another person who intentionally ends the life of a person to request it." The same law stipulates that the decriminalization of euthanasia implies that the patient is important, capable and aware, he makes his request voluntarily, carefully and repeatedly, and it is not due to outside pressure. [...]
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