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Essay Subject: Examines medical, legal & ethical issues in theory & practice. Suicide & euthanasia, role of Dr. Jack Kevorkian, living wills, health care providers.... More...

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Paper Abstract: Examines medical, legal & ethical issues in theory & practice. Suicide & euthanasia, role of Dr. Jack Kevorkian, living wills, health care providers. Paper Introduction: RIGHT TO DIE Introduction This research examines the concept of the right of a person to die. The right to die concept is complex, and often encompasses issues of suicide, assisted suicide, do-not-resuscitate (DNR) orders, livings wills involving terminal health care, and family decisions related to the cessation of terminal health care (Annas, 1994, pp. 1542-1545; Elpern, Yellen, & Burton, 1993, pp. 161-167; Kowalski, 1993, pp. 70-76; Lee, Swinburne, Fedullo, & Wahl, 1994, pp. 1358-1361; Levetown, Pollack, Cuerdon, Ruttman, & Glover, 1994, pp. 1271-1275; Rubin, Strull, Fialkow, Weiss, & Lo, 1994, pp. 209-212; Sansone & Phillips, 1995, pp. 397-401; Zimbelman, 1994, pp. 22-37). With respect to DNRs and family decisions related to the cessation of terminal health care, the Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. 7 -76; Lee,Swinburne, Fedullo, & Wahl, 1994, pp. Nevertheless, health care providers, physicians and hospitalsspecifically, more often than not have thwarted patient wishes on thepretexts that living wills fail to provide clear and convincing evidence ofa patient's desires (Rubin, Strull, Fialkow, Weiss, & Lo, 1994, pp. New England Journal of Medicine,33 (21), 1542-1545. The concept of utilitarianism is appliedin one of two ways: (1) acting to provide the greatest good for thegreatest number of people; or (2) acting to achieve a stated goal, i.e.,"the end justifies the means." Utilitarianism could be cited by those whocontend that withholding care from terminally ill patients is a cost-effective measure. 7 -76). Journal of the American Medical Association,271(3), 2 9-212. A similar initiative wasdefeated, also narrowly, in California in 1992. American Journal of Critical Care, 2(2), 161-167. Thus, the very idea of a right todie or the right to refuse care is difficult for many health care providersto accept, much less become an advocate for a patient in suchcircumstances. 161-167). B., & Burton, L. With respect to DNRs and family decisionsrelated to the cessation of terminal health care, the concept of the rightto die may be applied to infants and children, as well as to adults of allages-not simply old people (Annas, 1994, pp. References Annas, G. T., Ruttman, U. Juries in Michigan, however, continue to acquit Dr. Kevorkianfor such acts. (1994, January-February). Advance directives forelderly people: Worthwhile cause or wasted effort? Hospital administrators and legal counsel, by contrast, outof fear of an exposure to legal liability typically attempt to limit therights of patients and their families. Opponents of the Oregon law found a sympatheticjudge on the Ninth circuit to invalidate the initiative. Ethics and Economics Ethical principles create a framework wherein conflict may beanticipated in relation to decisions required of health care professionalsin right to die situations. Such conflicts may arise through theconsideration of a potential action within the context of a single ethicalprinciple, and through the consideration of a potential action withincontext of the complete ethical principle framework. This latter contention has served as the basis forreligiously-oriented public prosecutors in Michigan who have laid chargesagainst Dr. Kevorkian for the assistance he has provided to personsdeciding to end their own lives. This approach to therelationship between euthanasia and an individual's right to die suffers,however, from a lack of intellectual honesty. Sansone, P., & Phillips, M. Inaddition to these reasons, suicide in the elderly may be higher than forother age groups because of a widening social acceptance of the concept ofthe rational suicide for those individuals in the advanced stages ofterminal illnesses, with serious and incurable physical illnesses, andthose experiencing debilitating pain, with no recourse for relief whichwould leave then as alert and viable human beings (Kowalski, 1993, pp. Some of these American experts, however, are nowbeginning to distinguish between death with dignity for the terminally illindividual and suicide and other individuals desiring to end their lives. J. Rubin, S. Kowalski, S. W. Health care professionals in the contemporary period are beingconfronted with an array of issues that contain moral dimensions. (1993, February). Conversely, themajority of American experts continue to hold that suicide among theelderly and terminally ill should be prevented regardless of thecircumstances involved. While the nominal responsibilityfor such decisions is that of physicians, other health care professionalsand members of hospital establishments contribute to such decisions. 1358-1361; Rubin, Strull, Fialkow, Weiss, & Lo,1994, pp. 1542-1545; Levetown, Pollack,Cuerdon, Ruttman, & Glover, 1994, pp. RIGHT TO DIE Introduction This research examines the concept of the right of a person to die.The right to die concept is complex, and often encompasses issues ofsuicide, assisted suicide, do-not-resuscitate (DNR) orders, livings willsinvolving terminal health care, and family decisions related to thecessation of terminal health care (Annas, 1994, pp. (1995, May). Because suicide isprohibited by law, however, many states also specifically prohibitproviding assistance to help someone commit suicide, and even in thosestates where specific legal prohibitions are not in place, other statutesare used by prosecutors to lay charges against persons assisting others tocommit suicide (Kowalski, 1993, pp. Further complicating the issue of the right of an individual to makedecisions concerning her or his own death is the confusion introduced intothe debate through attempts to equate an individual's right to die witheuthanasia. In November 1994, a similar initiative will beplaced before Oregon voters. In examining the concept of the right to die, the issue is addressedin all of its complexity. Considered only in this very general context, the act of aperson opting to commit suicide in some painless way to escape anintolerable health condition could be viewed as a form of euthanasia. The initiative was successful. Certainly,not all people agree with this position. The relentless advanceof medical technology assures that the pressures on health care providerswill continue as the means to maintain biologic life far surpass the healthcare professional's ability to protect the quality of a patient's life.The decisions of health care professionals to permit death are amalgams ofmedical, ethical, and legal judgments. M., Fialkow, M. Controversies and Legal Issues The enactment of the Patient Self-Determination Amendment requiresthat facilities funded through either the Medicaid or Medicare programsinform patients of their decision-making rights related to health care(Elpern, Yellen, & Burton, 1993, pp. There are many people,organizations, and religious groups in this country who strive to preventsuicide by the elderly, regardless of the circumstances involved. In this context, many elderly persons have indicated clearly thatthey no longer want to be burdens, and want to end their lives with dignityand grace while they are still aware and alert human beings. What these ostriches cannot seefrom their disadvantaged perspectives is that in the evolving contemporarysociety a refusal to accommodate patient rights in itself will exposehealth care institutions and providers to legal liability. The health care professional, therefore, is in asituation wherein he or she must be prepared to advocate patient autonomy,while simultaneously providing assurance to the patient that any caredesired by the patient will continue to be provided. (1994, 26 October). Euthanasia is most often defined as painless putting to deathpersons suffering from incurable diseases or other types of incurable andintolerable health conditions (Lee, Swinburne, Fedullo, & Wahl, 1994, pp.1358-1361). A preliminaryinvestigation of opinions and behaviors regarding advance directives formedical care. 7 -76). Living wills are not anew concept. 161-167; Kowalski, 1993, pp. The prosecutors have consistently failedin their efforts to send Jack Kevorkian to prison for these acts. Decisions based onethical principles are typically reached within the context of an ethicalframework. Nursing & Health Care, 14(2), 7 -76. 1358-1361; Levetown, Pollack,Cuerdon, Ruttman, & Glover, 1994, pp. Utilitarianism is a system of normative ethics in which "good" isdefined as happiness or pleasure. 2 9-212; Sansone & Phillips, 1995, pp. J., & Lo. Michigan was one of the state without a specific law coveringproviding assistance to a person in committing suicide. The Oregon ruling is now under review. F., Weiss, S. At the same time, patients often worrythat advanced directives such as living wills may foster abandonment byhealth care providers. 1542-1545; Elpern,Yellen, & Burton, 1993, pp. Journal of the American MedicalAssociation, 272(16), 1271-1275. Journal of the American Medical Association,271(17), 1358-1361. A. Living wills generally apply inthe context of terminal illness or irreversible coma. K. Assisted suicide: Where do nurses drawthe line? Euthanasia implies that some party other than the individual who is todie makes the decision concerning how and when that individual should die.The essence of the concept of the right to die, however, is that suchdecisions are made by the individual who is to die (Kowalski, 1993, pp. E., & Glover,J. 2 9-212). RomanCatholic Archbishop William Levada in Portland termed the initiative murderin the name of mercy. The practice has been legalfor years, and there are no reported instances of abuse of the law. Social Work, 4 (3), 397-4 1. Zimbelman, J. (1994,4 May). A living will is recognizedunder this legislation as a part of a patient's decision-making rights.While this legislation establishes the right of the patient to makedecisions related to personal health care, the legislation fails to providelegal immunity for the health care providers associated with adviceprovided to the patient with respect to such decisions. Individuals suffering from diseases that are at one incurable,painful, and led to a loss of personal dignity are frequently motivatorsfor an individual to decide on a course of suicide-assisted or unassisted.Society is being required by such individuals to collectively confront theissue of whether suicide can be a rational choice for such persons(Kowalski, 1993, pp. The major systems of ethics prevalent in contemporaryhealthcare environments are utilitarianism, deontology, and natural law(Zimbelman, 1994, pp. The intellectually bankrupt opponents of the right of an individualto make decisions concerning her or his own death, however, extend theirflawed argument even further by contending that, regardless of who makesthe decisions regarding an individual's death, if the individual asks andreceives assistance to commit suicide, then the assisting individual ispracticing euthanasia. 22-37). 7 -76). In 1996, however,the full Ninth Circuit Court declared a Washington law concerning assistedsuicide unconstitutional. In the wake of the 199 Supreme Court decision allowing thediscontinuance of life support for Nancy Curzon, health care providers arebeing forced to reconsider their positions toward patient right and familyrights generally and to living wills particularly. Lee, D. Levetown, M., Pollack, M., Cuerdon, T. 1271-1275). B.(1994, 19 January). (1993). H., Yellen, S. Limitations and withdrawals of medicalintervention in pediatric critical care. J., & Wahl, G. M., Strull, W. Suicide is prohibited by law in all states in the United States. 397-4 1; Elpern, Yellen, & Burton, 1993, pp. Thisposition has been accepted by courts in the Netherlands. J. Thenurse, with a traditional role that is patient-centered, must counsel thepatient and the patient's family, and where required become an advocate forthe patient. Long before Jack Kevorkian became a public figure,however, the Hemlock Society was advocating a person's right to make achoice about her or his own death-the individual's right to die (Kowalski,1993, pp. Following thefailure of Michigan juries to convict Dr. Kevorkian for such acts, thestate legislature and the governor rushed through legislation making theprovision of assistance for the purpose of committing suicide a crime inthat state. 1271-1275; Rubin, Strull, Fialkow,Weiss, & Lo, 1994, pp. Theabsurdity of such laws lies in the inability of the state to punish theperson who is successful in committing suicide. P., Swinburne, A. 7 -76). An initiative legalizing assisted suicide was defeatednarrowly in the State of Washington in 1991. 397-4 1;Zimbelman, 1994, pp. Patients are seeking autonomy and self-determinationthrough the use of living wills. J., Fedullo, A. Withdrawing care. Medicaleducation and socialization focus on offering and providing treatment, asopposed to the facilitation of death. Controversy surrounds the concept of a patient's right to die and theexercise of that concept through the use of a living will. Good life, good death, and theright to die: Ethical considerations for decisions at the end of life.Journal of Professional Nursing, 1 (1), 22-37. Living Wills and DNRs A living will is a written and witnessed advanced directive thatcommunicate a patient's care preferences. Thus, the "do good and avoid evil" maxim ofnatural law ethics encompasses the ethical principles of beneficence andmaleficence. Deontology is a difficultethical system to employ because different people may adhere to differentsets of moral rules. 22-37). (1994, 26 May). Thisapproach to the issue is favored by Roman Catholics and FundamentalistChristians opposed to the concept of an individual's right to makedecisions concerning her or his own death. Asking the courts to set the standard ofemergency care-the case of Baby K. In the initiative campaignin Washington, Roman Catholics and Fundamentalist Christians acted withoutscruples in the purposeful misinterpretation of the specifics and intent ofthe initiative wording. Health care professionals, however, are increasingly beingasked and expected to assume such advocacy roles. Suicide and Euthanasia The issue of assisted suicide has been brought to the forefront ofpublic attention in the United States largely through the activities of Dr.Jack Kevorkian. Theseissues include considerations ranging from a patient's right to die toadhering to physicians' "do not resuscitate" orders (Lee, Swinburne,Fedullo, & Wahl, 1994, pp. Doctor-assisted suicide in legal in the Netherlands. 161-167). The ethical system of natural law holds that actionsare ethically correct when they are in accord with the end purpose of humannature and human goals. Elpern, E. Even within the system of natural law ethics, however,conflicts may arise in decision-making because a theist will conceive humannature and human goals in one way, while a non theist may conceive of thoseconcepts in a quite different way. Deontology is a system of ethics based on the tenets that (1) a set ofmoral rules exists which humans must follow, and (2) the principlesunderlying these moral rules are unchanging. Conclusion A growing number of sociological and medical experts outside of theUnited States are moving toward acceptance of the concept of the rationalsuicide for the elderly person, as long as such choices are free-willdecisions, the individual's physical or emotional pain may be described asunbearable, the wish to die can be identified as an enduring one, and theindividual at the time of the suicide decision is compos mentis. Among the many reasons why the suicide rate is so high for the elderlyare the isolation and loneliness that leads to despair, also boredom,depression, uselessness, loss of loved ones, economic hardships, generalfeeling of unhappiness with life, and persons who suffer from apsychological affliction, from loss of purpose and a sense ofmeaningfulness after retirement and separation from family and friends. 2 9-212). Increasing the completion of the durable power ofattorney for health care. Living wills providea means by which patients and families may describe their wishes and setforth legal guidelines for nurses and physicians (Sansone & Phillips, 1995,pp. Medical, legal, and ethical issues are coveredin the examination. 7 -76). If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.