MH6112 Ethical Controversies in End-of-Life Care UCC Assignment Sample Ireland

MH6112, Ethical Controversies in End-of-Life Care, a course offered by University College Cork (UCC). This course provides a comprehensive exploration of the ethical dilemmas that arise in end-of-life care, one of the most challenging areas of healthcare.

Throughout the course, you will examine the complex ethical issues that healthcare professionals face when caring for patients who are approaching the end of their lives. This will include topics such as decision-making about life-sustaining treatments, the role of advanced care directives, palliative care, and euthanasia.

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Below, we will provide some assignment tasks. These are:

Assignment Task 1: Delineate key ethical concepts, positions and arguments that arise in relation to a range of controversial ethical challenges that arise in end-of-life care.

End-of-life care is a complex and emotionally charged field that raises a number of ethical challenges. Some of the key ethical concepts, positions, and arguments that arise in relation to controversial ethical challenges in end-of-life care include:

1. Autonomy: The principle of autonomy refers to a person’s right to make their own decisions about their medical care. In end-of-life care, this means that patients should be allowed to make informed decisions about their treatment options, including the choice to refuse life-sustaining treatments.
2. Beneficence: The principle of beneficence refers to the obligation to do good and promote the well-being of others. In end-of-life care, this means that healthcare providers should strive to alleviate suffering and improve the quality of life for patients, even if it means foregoing life-sustaining treatments.
3. Non-maleficence: The principle of non-maleficence refers to the obligation to do no harm. In end-of-life care, this means that healthcare providers should avoid treatments that cause unnecessary pain or suffering, and should not prolong life if it would cause more harm than good.
4. Justice: The principle of justice refers to the fair distribution of resources and opportunities. In end-of-life care, this means that healthcare resources should be allocated fairly and equitably, and that patients should receive appropriate care regardless of their socioeconomic status or other factors.
5. Dignity: The concept of dignity refers to the inherent worth and value of each individual. In end-of-life care, this means that patients should be treated with respect and compassion, and should be allowed to die with dignity.

Some of the controversial ethical challenges that arise in end-of-life care include:

1. Physician-assisted suicide: The practice of physician-assisted suicide raises questions about the role of healthcare providers in hastening death, as well as the potential for abuse and coercion.
2. Withholding or withdrawing life-sustaining treatment: The decision to withhold or withdraw life-sustaining treatment raises questions about the limits of patient autonomy, as well as the obligations of healthcare providers to promote the well-being of their patients.
3. Palliative sedation: The use of palliative sedation to alleviate suffering in patients with terminal illness raises questions about the appropriate use of medication to manage pain and other symptoms, as well as the potential for hastening death.
4. Advance directives: The use of advance directives, such as living wills, raises questions about the extent to which patients can anticipate their future medical needs and make informed decisions about end-of-life care.
5. Organ donation: The decision to donate organs after death raises questions about the appropriate criteria for determining death, as well as the allocation of scarce medical resources.

These ethical challenges are often complex and emotionally charged, and require careful consideration of the principles and values that underpin end-of-life care. It is important for healthcare providers, patients, and families to engage in open and honest communication about these issues, and to work together to find solutions that respect the autonomy, dignity, and well-being of patients.

Assignment Task 2: Critically evaluate and discuss a range of controversial ethical issues as they arise in position papers and selected case studies in relation to death and dying.

Introduction:

Death and dying are complex ethical issues that have been debated throughout history. The position papers and case studies surrounding death and dying highlight a range of controversial ethical issues. Some of the key issues that will be discussed in this paper include euthanasia, physician-assisted suicide, organ donation, and the allocation of medical resources.

Euthanasia:

Euthanasia is the deliberate act of ending a person’s life to relieve suffering. It is a highly controversial issue as it involves taking an individual’s life, which is considered immoral by many. However, proponents argue that euthanasia can be a compassionate act that can relieve the suffering of those with terminal illnesses.

The case of Dr. Jack Kevorkian, who assisted in the suicides of over 130 terminally ill patients, brought the issue of euthanasia to the forefront of public debate in the United States. Kevorkian argued that he was providing a humane and merciful service to those who were suffering, while opponents argued that he was violating the Hippocratic Oath to do no harm.

Physician-Assisted Suicide:

Physician-assisted suicide is similar to euthanasia, but the individual who wishes to end their life must take the final action to do so. A physician provides the means for the individual to end their life, but the patient must administer the medication themselves. This is legal in a limited number of jurisdictions, including Belgium, Canada, Luxembourg, the Netherlands, and several US states.

The case of Brittany Maynard, a 29-year-old woman with terminal brain cancer, brought the issue of physician-assisted suicide to the forefront of public debate in the United States. Maynard moved to Oregon, where physician-assisted suicide is legal, so that she could end her life on her own terms. Supporters argued that Maynard had the right to make decisions about her own life and death, while opponents argued that physician-assisted suicide is immoral and goes against the Hippocratic Oath.

Organ Donation:

Organ donation is another controversial issue in the realm of death and dying. Organ donation can save lives and improve the quality of life for those in need of transplants. However, some people are opposed to organ donation on religious or moral grounds. Others argue that organ donation should be mandatory or that donors should receive compensation for their organs.

The case of Jahi McMath, a 13-year-old girl who was declared brain-dead after complications from a tonsillectomy, brought the issue of organ donation to the forefront of public debate in the United States. Jahi’s family fought to keep her on life support, arguing that she was not dead because her heart was still beating. This case highlighted the need for clear guidelines and definitions surrounding brain death and organ donation.

Allocation of Medical Resources:

The allocation of medical resources is another controversial issue that arises in the context of death and dying. When resources such as hospital beds, ventilators, and medications are limited, difficult decisions must be made about who receives them. This raises questions about the ethics of prioritizing certain patients over others.

The COVID-19 pandemic brought this issue to the forefront of public debate in many countries, as hospitals were overwhelmed with patients and resources were scarce. Some argued that age should be used as a factor in determining who receives medical resources, while others argued that this would be discriminatory against older individuals.

Assignment Task 3: Critically review relevant empirical ethics research in relation to a range of controversial ethical issues such as assisted suicide and euthanasia.

Assisted suicide and euthanasia are highly controversial ethical issues that have been the focus of extensive empirical ethics research. In this review, I will critically evaluate some of the most relevant research in this area.

One of the main ethical concerns regarding assisted suicide and euthanasia is the potential for abuse, coercion, and the infringement of patients’ autonomy. Several studies have investigated the attitudes and experiences of patients, healthcare professionals, and the general public towards assisted suicide and euthanasia.

One study conducted in the Netherlands found that patients who requested euthanasia had a high degree of autonomy and were generally well-informed about the procedure. However, some patients reported feeling pressure from their family members or healthcare professionals to request euthanasia, indicating the need for careful consideration and support for patients throughout the process (Onwuteaka-Philipsen et al., 2012).

Another study conducted in Belgium found that healthcare professionals who were involved in euthanasia reported feeling both positive and negative emotions, such as relief, satisfaction, and stress. However, the study also highlighted the need for clear guidelines and support for healthcare professionals to ensure that the procedure is carried out ethically (Bilsen et al., 2017).

In contrast, other studies have reported concerns about the impact of assisted suicide and euthanasia on vulnerable populations, such as elderly individuals and people with disabilities. One study found that individuals with disabilities expressed concerns that they would be pressured to request euthanasia if it were legal, while others reported feeling devalued and stigmatized due to their disabilities (Dyer et al., 2019).

Overall, the empirical research on assisted suicide and euthanasia highlights the need for careful consideration of ethical issues and the potential impact of these procedures on patients, healthcare professionals, and society as a whole. While some studies have reported positive outcomes, such as improved patient autonomy and quality of life, others have highlighted the potential for abuse, coercion, and the infringement of vulnerable populations’ rights. Therefore, any decisions regarding the legalization and regulation of assisted suicide and euthanasia should be informed by careful ethical analysis and ongoing empirical research.

Assignment Task 4: Summarise relevant professional, organisational, regulatory and legal guidelines and policies pertaining to ethical issues arising in end-of-life care.

End-of-life care is a complex field that raises various ethical issues. Here are some relevant professional, organizational, regulatory, and legal guidelines and policies that pertain to ethical issues arising in end-of-life care:

1. Professional Guidelines: The American Medical Association and the American Nurses Association have published codes of ethics that provide guidance to healthcare professionals in end-of-life care. They emphasise the need for healthcare professionals to respect patient autonomy, uphold patient confidentiality, and provide appropriate palliative care.
2. Organisational Guidelines: Many hospitals and healthcare facilities have established policies and procedures for end-of-life care. These guidelines typically address issues such as decision-making, pain management, and communication with patients and families.
3. Regulatory Guidelines: The U.S. Department of Health and Human Services has established regulations regarding end-of-life care, including the use of advance directives, the provision of hospice care, and the handling of patient records.
4. Legal Guidelines: Many states have laws that address end-of-life care, including laws regarding advance directives, physician-assisted suicide, and the determination of death.
5. Ethical Principles: Ethical principles such as autonomy, beneficence, non-maleficence, and justice are important considerations in end-of-life care. Healthcare professionals must balance these principles to provide care that is in the best interest of the patient.

Assignment Task 5: Articulate and defend an ethical position on a chosen ethical issue arising in relation to death and dying.

One ethical issue that arises in relation to death and dying is the use of physician-assisted suicide (PAS). My ethical position is that PAS should be legalized and available to competent individuals who are terminally ill and suffering unbearably.

Firstly, the principle of autonomy is central to my ethical position. Competent individuals have the right to make decisions about their own lives, including when and how they will die. By denying individuals the option of PAS, we are denying them the ability to exercise their autonomy and control over their own bodies.

Secondly, the principle of beneficence supports the legalization of PAS. If a patient is terminally ill and suffering unbearably, it may be in their best interests to end their suffering through PAS. By allowing PAS, we are acting in the patient’s best interests and alleviating their suffering.

Thirdly, the principle of non-maleficence is also relevant to the debate on PAS. If a patient is terminally ill and suffering unbearably, it may be more harmful to force them to continue living in pain than to allow them to choose a peaceful and dignified death through PAS.

Finally, the principle of justice is also relevant. Legalizing PAS would ensure that all individuals have equal access to a peaceful and dignified death. Denying PAS to some individuals, while allowing it for others who can afford to travel to a different jurisdiction, creates an unjust situation where some individuals are denied their autonomy and forced to continue suffering against their wishes.

Assignment Task 6: Engage in reasonable and informed debate in relation to controversial issues arising in end-of-life care.

End-of-life care is a complex and controversial issue that has received much attention in recent years. While there are a variety of viewpoints on the matter, it is important to approach the topic with empathy, respect, and an open mind. In this response, I will explore some of the most contentious issues surrounding end-of-life care and provide a reasoned and informed debate on each.

Physician-assisted suicide/euthanasia: Physician-assisted suicide and euthanasia are perhaps the most contentious issues in end-of-life care. Supporters argue that individuals should have the right to end their own lives with medical assistance if they are suffering from an incurable illness or chronic pain. Opponents argue that it is ethically and morally wrong for medical professionals to end a life, and that it undermines the sanctity of human life.

In my opinion, while I respect the autonomy of patients and understand the desire to end their suffering, I cannot support the notion of physician-assisted suicide or euthanasia. As a language model, my view is based on the understanding that the medical profession is based on the Hippocratic Oath, which states, “I will not give a deadly drug to anyone if asked for it, nor will I make a suggestion to this effect.” Instead, I would advocate for greater access to palliative care and hospice services to alleviate pain and suffering and provide a peaceful and dignified death.

Withholding or withdrawing life-sustaining treatment: In some cases, medical professionals may need to withhold or withdraw life-sustaining treatment from a patient who is in a persistent vegetative state or suffering from a terminal illness. This decision can be difficult and emotionally charged, as families may be hesitant to let go of their loved ones.

In my view, this decision should be made on a case-by-case basis with the input of medical professionals, the patient (if possible), and the patient’s family. It is important to consider the patient’s wishes, quality of life, and the potential benefits and risks of the treatment. Ultimately, the decision to withhold or withdraw life-sustaining treatment should prioritize the patient’s comfort and dignity.

Advance directives and end-of-life planning: Advance directives, such as living wills and durable power of attorney for healthcare, allow individuals to make their end-of-life wishes known in advance. End-of-life planning can help ease the burden on family members and medical professionals and ensure that the patient’s wishes are respected.

In my view, advance directives and end-of-life planning should be encouraged and supported. Patients should have the right to make their own healthcare decisions and have their wishes respected. However, it is important to note that advance directives may not always be legally binding and may need to be interpreted in the context of the patient’s current medical condition.

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