end of life issues.pptx

Broken communication
Compromised patient autonomy
Poor symptom management
Euthanasia
DO NOT RESUSCITATE

1. The End Of Life

2. Common end-of-life ethical problems Broken communication Whether a patient can no longer speak for him or herself or family members have a hard time describing what their loved one wants, nurses may face the breakdown of communication during the decision-making process . End-of-life conversations are always difficult, but they need to happen. Asking patients early about their wishes and providing them with accurate information and resources ensures a clear line of communication. nurses should advocate for regular family meetings so everyone can understand the patient’s condition and the best steps to take as the disease progresses.

3. Compromised patient autonomy Nurse has respect patient autonomy while keeping in mind the best treatment route without compromising the patient’s decision. Nurses should encourage patients and their significant others to discuss end-of-life care and to use advance directives so patients’ wishes can be maintained if patients lose their ability to make decisions about their care.

4. Poor symptom management Symptom treatment is a major factor in nurses caring for patients at the end of their lives, as it brings up the question of whether the benefits of using medication outweigh potential risk and side effects .” The relief of symptoms must be balanced with the possible side effects of medications

5. Shared decision-making decision-making becomes an ethical issue when more than one party is involved. When significant others attempt to go against the patient’s wishes, nurses face the issue of trusting the intent of the significant others or respecting the patient’s wishes. “ An important role of the nurse is to help patients complete advance care plans to guide their end of life care by listening and offering necessary information ,”

6. I t is not death, but dying, which is terrible” “ Better to flee from death than feel its grip

7. Euthanasia refers to deliberately ending someone’s life, usually to relieve suffering . It’s a complex process and involves weighing many factors. Local laws, someone’s physical and mental health, and their personal beliefs and wishes all play a role.

8. Assisted suicide vs. euthanasia Assisted suicide is sometimes called physician-assisted suicide (PAS). PAS means a doctor knowingly helps someone end their life. This person is likely experiencing persistent and unending suffering. They may have also received a terminally ill diagnosis. Their doctor will determine the most effective, painless method. In many cases , doctors will provide people with a drug they can take to end their life. A lethal dose of opioids , for example, may be prescribed for this. In the end, it’s up to the person to decide whether they take the drug. With euthanasia, a doctor is allowed to end the person’s life by painless means. For example, an injection of a lethal drug may be used.

9. Active vs. passive When a doctor directly ending someone’s life. This is known as active euthanasia. Purposely giving someone a lethal dose of a sedative is considered active euthanasia. Passive euthanasia is sometimes described as withholding or limiting life-sustaining treatments so that a person passes more quickly. A doctor may also prescribe increasingly high doses of pain-killing medication. Overtime, the doses may become toxic.

10. Voluntary vs. nonvoluntary If someone makes a conscious decision to seek help with ending their life, it’s considered voluntary euthanasia. The person must give their full consent and demonstrate that they fully understand what will happen. Nonvoluntary euthanasia involves someone else making the decision to end someone’s life. A close family member usually makes the decision. This is generally done when someone is completely unconscious or permanently incapacitated. It usually involves passive euthanasia, such as withdrawing life support from someone who’s showing no signs of brain activity.

11. Aruna Shanbaug was a nurse working at the  King Edward Memorial Hospital ,  Parel , Mumbai. On 27 November 1973 she was strangled and sodomized by Sohanlal Walmiki , a sweeper. During the attack she was strangled with a chain, and the deprivation of oxygen left her in a vegetative state. On behalf of Aruna , her friend  Pinki Virani , a social activist, filed a petition in the Supreme Court arguing that the "continued existence of Aruna is in violation of her right to live in dignity". The Supreme Court made its decision on 7 March 2011 .  The court rejected the plea to discontinue Aruna's life support but issued a set of broad guidelines legalising passive euthanasia in India. The Supreme Court's decision to reject the discontinuation of Aruna's life support was based on the fact that the hospital staff who treat and take care of her did not support euthanizing her .   Aruna died from pneumonia on 18 May 2015, after being in a coma for a period of 42 years .

12. On 9 March 2018 the Supreme Court of India legalised passive  euthanasia  by means of the withdrawal of  life support  to patients in a  permanent vegetative state . The decision was made as part of the verdict in a case involving  Aruna Shanbaug , who had been in a Persistent Vegetative State (PVS) until her death in 2018

13. DO NOT RESUSCITATE Cardiopulmonary resuscitation (CPR) is an emergency procedure done to try to bring back to life someone who has stopped breathing or their heart. Do not try to resuscitate (DNAR) is a choice that the doctor can make in this situation if it is in the best interest of the patient. Often, the patient's relatives may face an ethical dilemma in making the decision regarding DNAR . Justifications for DNR orders: The patient refuses CPR. Competent : informed patients may not want CPR. Many patients wish to die peacefully rather than have physicians and nurses attempt to revive them. Such informed refusals should be respected.

14. Surrogates Refuses CPR Surrogates may decline for patients who lack decision making capacity. Surrogates decision should be based n patients preference. Basic Principles of DNR Patent autonomy Beneficience Distributive justice(similar pateint should receive similar care)