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Ethics in Nursing Practice

Death, whether voluntary or involuntary, while in the care of health professionals is a contentious concern in medical practice and subject nurses and other professionals to moral conflicts and dilemmas. There are three ways this can be pursued: terminal sedation, rational suicide, or physician-assisted suicide, all of which are used in various situations and for varied reasons.

Terminal sedation has been decried as a disguised form of euthanasia, largely debated, especially with the need to quicken demise. Palliative sedation uses medications to put the patient in a condition of ease and obliviousness of their circumstances without deliberately hurrying death. It is primarily used to alleviate refractory manifestations that do not respond to prior treatments in individuals with limited chance or cure and who are nearing death (Menezes & Figueiredo, 2019). This procedure is mainly used in patients with severe brain injury or those declared brain dead, mainly after cessation of brain stem functions (Chapter 14). Patients often get dehydrated or starved when sedated, which shortens the death process. It is argued whether the discontinuation of nutrition and hydration is necessary, with some believing that the permanence of both contains suffering.

Conversely, rational suicide is associated with the desire of the patient to bring to stop the physical and emotional pain. The individual is usually mentally competent to decide on an action to sensibly keep one’s fundamental interests which can be considered admirable. The rationality of the suicidal process indicates that there is the absence of coercion of any form and that the motives and alternative forms have been comprehensively explored to reach their decision. The approach to rational suicide involves carefully assessing the patient’s attitudes toward death and the meaning of life, as well as developing appropriate support systems to face the emerging needs of the patient (Gramaglia et al., 2019). Ethically, it is associated with patient autonomy and the right to self-determination, but the act has been considered an oxymoron and directly related to conventional suicide.

Physician-assisted suicide happens when the physician enables a patient’s demise by delivering the essential needs and details to help them perform the act (Chapter 14). For instance, the doctor may provide sleeping pills with information on the lethal dose. Autonomy has also been argued in t favor of this procedure. If patients can determine their health circumstances by being accustomed to making care decisions, they should likewise be allowed to decide the situations under which they prefer dying (Dugdale et al., 2019).

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