Ethical Dilemma
Ethical dilemmas arise on a daily basis for physicians, registered nurse, advanced practice nurses, pharmacists etc. in the medical field. Certain times ethical dilemmas are needed to improve the healthcare field and push the envelope. Dilemmas are part of everyday process and drives individuals to think of alternatives. However, in the medical field ethical dilemmas can place the professional in a tough situation between to possible outcomes. In an ethical dilemma, there can be two or more different solutions that are equally correct. Healthcare professionals encounter ethical dilemma when caring for patients, building a treatment plan with interdisciplinary professionals, or difference in opinion with family members. As an advanced practice nurse, it is essential to develop several courses of actions for ethical dilemmas. Healthcare professional have the responsibility to provide honest, correct information to patients and family members (Ayyub, 2015). Examining each course of action by harnessing ethical principles to guide decisions for best possible outcomes. This paper will discuss two potential resolutions while applying the ethical principles. The ethical dilemma that will be discussed is physician assisted suicide.
Topic and Definition
Assisted suicide has been an ethical dilemma since the beginning of medicine. Physician assisted suicide is when the physician provides the medications to the patient with the understanding that patient will use the medication to end his/her life (Emanuel, Onwuteaka-Philispen, & Urwin, 2016). Both parties are in agreement of the decision before prescribing the medication. Assisted suicide is only an option for patients who are terminally ill, mentally competent adults who have made a voluntary informed consent (Sanders, 2012). This process is not an option based on age, gender, lack of pain management, paralysis, neuropsychological conditions, or a chronic condition. The patient must have a terminal illness and is mentally stable to be qualified for physician suicide assistance. “The practice of physician assisted suicide is considered to be a criminal offense (Stokes, 217). However, currently six states authorize physician assisted suicide: California, Washington, Oregon, Vermont, Montana, and Colorado (Petrillo, 2017). Presently, only physicians are legally allowed to prescribe the lethal dose of medication to hasten death. Nonetheless, as nurse practitioners become increasingly involved in treatment of patients or are primary care providers for patients, nurse practitioners may qualify for assisted suicide (Stokes, 2017). Many Nurse practitioners already provide care to patients who consider end of life measures such as hastening death. The responsibility of the nurse practitioner will then be to direct the patient to a physician who is legal about to discuss these measures (Stokes, 2017). During this time, the nurse practitioner can remain involved in the care of the patient. When considering physician assisted suicide, personal opinions, values, morals, religious belief, and state laws are factored into making a sound, ethical decision. Healthcare professionals are faced with a difficult predicament relating to assisted suicide. Although multiple states have passed legal laws to assist in patient suicide, physicians may not agree with performing this type of treatment for the patient. The physician’s obligation as a provider of a patient is to make the best possible outcome. Not only does the provider consider the quality of life the patient currently has, but the progression of the condition in the future. Even though the healthcare provider may not agree with the decision of assisted suicide, but it may be the only viable option. Does the physician set aside the instilled values, morals, and religious belief to fulfill the patients request? On the other hand, states that do now allow physician assisted suicide may consider this option for their patients. Patients who have various progressive, chronic, noncurable conditions, may view ending life would be the most comfortable option. Patients with chronic conditions are frequently readmitted and discharged with no change in plan of care, except degree of progression. Human dignity is extremely important and ought to be respected during a time where patient is considering assisted suicide. The physicians are placed in a difficult situation seeing their patient in debilitating state. Physicians have a priority to make the patient feel the most comfortable. One the of the most important factors to consider when treating a patient is the quality of life. Patients who are considering assisted also have the same ethical dilemmas to think about as the physician. The patient imagines their death to be peaceful and painless as possible. Furthermore, physicians assisted suicide affects family members of the patient. The family may or may not agree with the patient’s decision. Before accepting assisted suicide the patient contemplates about the process that takes place. Does the physician continue to care for a patient who is suffering and ready to end their life? The patient and physician must agree on the plan along with timing, medication, and location. There are several questions to be asked in this particular ethical dilemma; however, only two will be investigated.
Framework and Model
A framework is used to simplify the process of making an ethical decision with a various course of actions. The framework assists by forming an organized layout to consider the possible resolutions. Ethical decision making involves defining the problem and collecting relevant facts (Hamlin, n.d.). Once relevant facts are collected, it is important to identify feasible options because this will help select best resolution (Hamlin, n.d.). Recognizing a process exists to facilitate in making a decision, will alleviate some tension. As ethical dilemmas are part of everyday in the healthcare field, utilizing process is essential to make the correct resolution in the best interest of the patient.
We will be applying the framework to physician assisted suicide by examining two different, yet equally correct resolutions. Part of the process is to openly acknowledge personal values, morals, and belief before initiating. It is important for the provider to understand the patient’s perspective. The first question in which a resolution will be examined is Does the physician have an obligation to accept a patient’s request for assisted suicide, even though it goes against their values, and morals? What will happen if the physician does not grant the patient’s wishes. The second question to analyze is a patient who has a chronic condition in which the patient is suffering, does the provider have any responsibility? The patient does not live in a state where assisted suicide is legalized. What can the physician do to make the patient most comfortable? Does the provider continue to watch the patient decline in quality of life?
Ethical Principles
Ethical principles are included in the process of selecting the best outcome for the patient. Ethical principles are used in a guidance to making the decision. It is tremendously important to apply the ethical principles to formulate a resolution. One way to use ethical principles is to utilize all of the applicable principles in the process. Autonomy, Justice, Beneficence, nonmaleficence, veracity, and fidelity are examples of ethical principles that impact an individual’s choice (Hamlin, n.d.). All of these will be used to evaluating in decision making. An organized matrix for these principles will assist in justifying two possible resolutions.