Post # 2: Katherine
As nurses, we are confronted with the complexity of end of life care which may include the desire to hasten death; According to Wilkinson (1997), independence is the core theme of personal autonomy, although the author acknowledges it exists in varying degrees. While personal autonomy implies self-determination and allows the freedom to have control over our choices free of coercion, there are instances where one’s ability to choose for oneself may be limited, as is the case for Margaret Bentley (Wilkinson, 1997).
Ethical issues raised in the podcast, “If You Have Dementia, Can you Hasten Death As You Wished?” included conflicting goals between the family and healthcare givers. Additionally, ambiguity in the patient’s advance directive, inadequate communication regarding the degree of suffering, an imbalance between patients’ choice (opening her mouth to accept food) and family choice, and disagreement over withholding treatments, i.e., feeding (Karnik and Kanekar, 2016).
A model case for end of life care would include the recognition of an advanced care plan in which wishes for treatment are clearly outlined, and an end-of-life care plan is developed with a medical provider before being required to put into action. A model case would also include a substitute decision-maker named in the event the patient cannot make decisions for themselves and knows what the patient would have wanted. Ideally, an open dialogue between the patient, a medical decision-maker, and the healthcare provider which would address possible ethical issues about end-of-life care to protect the interests of the patient (Karnick and Kanekar, 2016).
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