Death With Dignity Scenario and Reflection

Death With Dignity Scenario and Reflection Death With Dignity Scenario and Reflection In the scenario assignments, you are asked to reflect on responses to the presented scenario. This should not just be writing down your first reaction or what you already know. Reflection involves critical thinking, which means rethinking your existing knowledge and previously held opinions in light of what we have learned about theories of ethics, logic, and reasoning. You will need to question your existing knowledge and beliefs. To complete each scenario assignment: Complete the entire scenario. Death With Dignity Scenario and Reflection Compose your reflection in a Word document and be sure to address, at a minimum, the following questions: Why do you feel the way you do about the issue presented? Of the four responses offered in the scenario, which do you feel is the most ethical and why? Support your conclusions with evidence and specific examples from the textbook, as well as other sources as needed. Your reflection must be 1-2 pages in length and follow APA formatting and citation guidelines as appropriate. Scenario is locked down, but attached you can find 3 other students work on it, just go over them and write a new one similar to them. dig.docx dig2.docx dig3.docx ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Running head: DEATH WITH DIGNITY SCENARIO AND REFLECTION Death With Dignity Scenario and Reflection Caroline Cruz NURS 434 West Coast University 1 DEATH WITH DIGNITY SCENARIO AND REFLECTION 2 The response that I believe is the most ethical is that Dr. Mahal’s assessment of the law is reasonable. The death with Dignity Act is carefully constructed, and protects both doctor and patient. In order for PAS to be legal, the patient must be sane and properly informed about potential alternatives. This is an ethical template that other states considering such a law might be encourage to adopt. The reason that I believe that this is the most ethical is because these patients have already been diagnosed with terminally ill prognosis where they only have six or fewer months to live (Pence, 2017). With the law Death with Dignity Act there are certain requirements that they must meet in order for them to be approved to die with dignity. According to Division 9 the requirements that they must meet are that they must be older than 18 years of age, an attending physician must have primary responsibility of care and treatment of the patient, the authority from Oregon Health Authority, the patient must be capable to communicate and make decisions on their own, have a consulting physician confirm the diagnosis and prognosis of the patients illness, and lastly go to counseling to determine if the patient is capable and not suffering from psychiatric or psychological disorders (Division, n.d.). If patients are given the option to relieve their suffering and pain that they have endured from a severely terminally ill prognosis knowing they only have a certain amount of time left, we are giving them the opportunity to relieve all the pain that they went through. As health care professionals it is our duty to care for patients and ensure that they are comfortable and pain free when they do have a diagnosis/ prognosis that completely affects them on their everyday life. They endure so much pain and suffering that they are not enjoying the remaining time that they have. If they are given the opportunity of a death with dignity they are being able to die in peace from pain. DEATH WITH DIGNITY SCENARIO AND REFLECTION 3 References DIVISION 9 – REPORTING REQUIREMENTS OF THE OREGON DEATH WITH DIGNITY ACT. (n.d.). Retrieved June 18, 2019, from https://www.oregon.gov/oha/ph/ProviderPartnerResources/EvaluationResearch/ DeathwithDignityAct/Documents/rules.pdf Pence, G. (2017). Medical ethics: Accounts of ground-breaking cases (8th ed.). New NY: McGraw-Hill Education York, Running head: DEATH WITH DIGNITY SCENARIO AND REFLECTION Death with Dignity Scenario and Reflection Mahnoor Abbasi West Coast University 1 DEATH WITH DIGNITY SCENARIO AND REFLECTION 2 Death with Dignity Scenario and Reflection It is important to understand that everyone has their right to an opinion, being it ethical vs. unethical. Most unethical cases though, are termed as illegitimate reasons, so they are frowned upon by, or as a society. Out of the four responses that were given in the Death with Dignity scenario and reflection, the most ethical according to me would be that of Dr. Mahal’s assessment of the law, which is reasonable. The Death with Dignity Act is carefully constructed, and protects both doctor and patient. For PAS to be legal, the patient must be sane and properly informed about potential alternatives. This is an ethical template that other states considering such a law might be encouraged to adapt. I believe Dr. Mahal’s views were ethical to me. First, let’s understand the Death with Dignity law. This law allows a qualified terminally-ill adult to voluntarily request and receive a prescription medication to speed up the death process (Death with Dignity, 2017). Death With Dignity Scenario and Reflection This law as Dr. Mahal said protects both the doctor, as well as the patient. It is vital to understand that it is the patient’s legal right, judging by their health condition, to choose if they want to make the decision of passing PAS (Death with Dignity, 2017). Patient is of sound mind while making this decision, and has an informed consent to sign, and understand what he or she will be going through under the Death with Dignity law. Although I find Dr. Mahal’s views ethical, it is with no doubt that PAS continues to be debated as either ethical or non-ethical. The ethics of Physician associated suicide is often argued on the grounds for a dying person who is choosing to escape unbearable suffering at the end of life. This furthermore causes the physician to be involved in alleviating the suffering and pain, DEATH WITH DIGNITY SCENARIO AND REFLECTION and provide aid in the dying process. PAS also comes under unethical views, as some condone the practice of PAS as a slippery slope that could lead to euthanasia (Starks, 2013). 3 DEATH WITH DIGNITY SCENARIO AND REFLECTION References Death with Dignity. (2017). How to Access and Use Death with Dignity Laws. Retrieved from: https://www.deathwithdignity.org/learn/access/ Starks, Helene. (2013). Physician Aid-in-dying. Retrieved from: https://depts.washington.edu/bioethx/topics/pad.html 4 Running head: DEATH WITH DIGNITY SCENARIO AND REFLECTION Oregon’s Death with Dignity Act: Against life Vivian Toma West Coast University 1 DEATH WITH DIGNITY SCENARIO AND REFLECTION 2 Oregon’s Death with Dignity Act: Against life Oregon became the first state to legalize physician-assisted suicide (PAS) when it enacted the Death with Dignity Act (DWDA) on October 27, 1997. This act allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose (Oregon’s Death with Dignity Act, n.d.). Currently, five additional states and Washington, D.C. have death with dignity statues: California (End of Life Option Act; 2016), Colorado (End of life Options Act; 2016), District of Columbia (D.C. Death with Dignity Act; 2016/2017), Hawai’i (Our Care, Our Choice Act; 2018/2019), Vermont (Patient Choice and Control at the End of Life Act; 2013), and Washington (Washington Death with Dignity Act; 2008) [Death with Dignity Acts, n.d.]. According to Oregon’s DWDA annual report from 2018, 249 people received prescriptions for lethal doses compared to 219 people during 2017 (Oregon Death with Dignity Act 2018 Data Summary, 2019). Though this report shows DWDA’s increasing popularity, I believe that physician-assisted suicide (PAS) is not a solution. Of the choices at the end of the scenario, PAS is a bad idea from the start. Regardless of one’s personal beliefs, state-sponsored suicide is not good precedence for anyone. It sends a message that life is not sacred, and if that door is opened, several undesirable outcomes may follow. Philosophically, this ethical view of a strong regard for life was embraced by Immanuel Kant, a non-consequentialist. He believed that ending another person’s life untimely is unacceptable because it cannot be rationally universalized (categorical imperative), and it also violates the innate value and dignity of human life (Pence, 2017). At the beginning of the scenario, Dr. Mahal stated that he believed that the ethics of “informed” PAS are “sound”, and Oregon’s DWDA conforms to ethical standards and practices. This was an important distinction according to Dr. Meadows because Oregon DWDA statute DEATH WITH DIGNITY SCENARIO AND REFLECTION 3 clearly states that a person has to be “capable”, which means that in the opinion of a court or in the advice of the patient’s attending physician or consulting physician, psychiatrist/psychologist, a patient has the ability to make and communicate healthcare decisions to healthcare providers (Oregon’s Death with Dignity Act, n.d.). In Oregon, however, it has been found that fewer psychiatric consultations are being done to evaluate prospective PAS patients for depression, which raise the possibility that reversible mental disorders may be playing a factor in PAS requests (Erdek, 2015). This issue further proves that PAS is a bad policy because it endangers the weak and vulnerable in the society. Death With Dignity Scenario and Reflection The safeguards that profess to lessen the risk have shown to be insufficient and have often been mitigated or eliminated over time; thus those who deserve society’s help are instead offered a quick death. When asked, Dr. Mahal verbalized that pain management’s techniques fail in 5% of cases of terminally-ill patients, though pain is not the only issue of those who are terminally ill. According to Erdek (2015), the practice of palliative sedation is an alternative to relieving pain and anxiety that these patients suffer from. Palliative sedation is the deliberate lowering of a patient’s level of consciousness via continuous or temporary/intermittent sedation until the moment of death (Broaeckert, 2011). Its objective is to relieve refractory symptoms; hence, suffering and is not to lengthen or cut short the patient’s life; the level of consciousness is the means to that end, whereas in PAS, a person is using himself as a mere means, rather than respecting himself as an end (Pence, 2017). Dr. Mahal also argued that PAS relieves terminallyill patients of the loss of dignity they may feel during their last moments. In response to his statement, PAS further encourages attitudes such as loss of dignity and becoming a burden on others (Doerflinger, 2017). Doerflinger (2017) added that the solution is to care for people in DEATH WITH DIGNITY SCENARIO AND REFLECTION 4 ways that assure them that they have dignity and it is a privilege, not a burden, to care for them as long as they live. Dr. Meadows made a good point that there is no requirement (regardless of time) that doctors explain the ethical position of those who oppose physician-assisted suicide and that reminding them of the sanctity of life might serve to jog their memory of what’s morally right and wrong. Smith (2011) reasoned that in legalizing assisted suicide, some patients would die instead of ultimately regaining their joy in living. He further added that the legalization of assisted suicide would cheat at least most people of the time, which is the universe’s most precious and irreplaceable commodity (Smith, 2011). On top of Smith’s response, I find it especially disturbing that Oregon’s DWDA allows a patient to participate if he/she is diagnosed with a terminal illness that will lead to death within six months and that the attending physician can determine whether this criterion has been met. How is it ever possible to predict death to happen within a certain timeframe? In Dr. Meadow’s response to an audience’s question, she stated that physicians are not required to provide prescriptions to patients if they are not willing to participate in PAS. Though participation is voluntary, some physicians who participated in PAS feel conflicted. According to Professor Stevens of Oregon Health and Science University, some physicians who participated in PAS at Oregon reported that it was a very stressful situation, and the state’s annual 1998 report observed that the “process of participating in PAS exacted a large emotional toll, as reflected by such comments as ‘It was an excruciating thing to do…it made me rethink life’s priorities,’ ‘This was really hard on me, especially being there when he took the pills,’ and ‘This had a tremendous emotional impact’” (Pies, 2018). I believe that the inner conflict and discomfort experienced by PAS-participating physicians is directly connected to the Hippocratic Oath, the most important DEATH WITH DIGNITY SCENARIO AND REFLECTION foundation of medical ethics, which clearly states, “first, to do no harm.” PAS is fundamentally incompatible with the physician’s role as a healer, and he/she assumes sole responsibility for the act of ending the patient’s life. As a nurse, instead of embracing PAS, I believe that society should respond to suffering with genuine compassion and care. Patients seeking PAS typically suffer from depression, anxiety, or other mental illnesses as well as merely from isolation or abandonment. Instead of helping them end their lives, the government should offer them appropriate medical care and human presence. For those in physical pain, pain management and other palliative medicine can better manage their symptoms. To patients for whom death is imminent, hospice care, palliative sedation, and fellowship can provide comfort in their last days. Anything less falls short of what human dignity requires. The real issue facing the society that needs to be addressed is making quality end-of-life care available to all. Death With Dignity Scenario and Reflection 5 DEATH WITH DIGNITY SCENARIO AND REFLECTION 6 REFERENCES Broeckaert, B. (2011). Palliative Sedation, Physician-Assisted Suicide, and Euthanasia: “Same, Same but Different”? The American Journal of Bioethics, 11(6), 62-64. doi:10.1080/15265161.2011.577518 Colwell, J. (2018, January 15). Hospitalists weigh ethical, practical impacts of aid-in-dying laws. Retrieved April 08, 2019, from https://acphospitalist.org/archives/2018/01/impacts-of-aidin-dying-laws.htm Death with Dignity Acts – States That Allow Assisted Death. (n.d.). Retrieved April 09, 2019, from https://www.deathwithdignity.org/learn/death-with-dignity-acts/ DEATH WITH DIGNITY SCENARIO AND REFLECTION 7 Doerflinger, R. (2017, January 30). Q&A with the Scholars: Physician-Assisted Suicide and Euthanasia. Retrieved April 09, 2019, from https://lozierinstitute.org/qa-with-the-scholarsphysician-assisted-suicide-and-euthanasia/ Erdek, M. (2015). Pain Medicine and Palliative Care as an Alternative to Euthanasia in End-ofLife Cancer Care. The Linacre Quarterly, 82(2), 128-134. doi:10.1179/2050854915y.0000000003 Oregon Revised Statute: Oregon’s Death with Dignity Act. (n.d.). Retrieved April 09, 2019, from https://www.oregon.gov/oha/ph/ProviderPartnerResources/EvaluationResearch/Deathwith DignityAct/Pages/ors.aspx Pence, G. E. (2017). Medical ethics: Accounts of ground-breaking cases. New York, NY: McGraw Hill Education. Physician Assisted Suicide – Christian Medical & Dental Associations. (2016, July 21). Retrieved April 08, 2019, from https://cmda.org/physician-assisted-suicide/ Pies, R. (2018, December 19). How does assisting with suicide affect physicians? Retrieved April 09, 2019, from http://theconversation.com/how-does-assisting-with-suicide-affectphysicians-87570 Public Health Division, Center for Health Statistics. (2019). Oregon Death with Dignity Act 2018 Data Summary (pp. 1-16, Rep. No. 21). Retrieved April 09, 2019, from https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONR ESEARCH/DEATHWITHDIGNITYACT/Documents/year21.pdf. DEATH WITH DIGNITY SCENARIO AND REFLECTION Smith, W. (2011, October 13). Wesley Smith: Assisted Suicide Is the Euthanasia of Hope. Retrieved April 09, 2019, from https://www.noozhawk.com/article/101311_wesley_smith_assisted_suicide/ 8 … Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10