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EUTHANASIA

Euthanasia

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Dilemma & Euthanasia

My dilemma starts out with a 64-year-old patient who has terminal cancer. She was diagnosed two years ago and the cancer is now at stage four. She has been experiencing sever fatigue and weakness so she is unable to do much with her family or friends. She has experienced rapid weight loss since diagnosed so she is very skinny. The frequent infections she receives from going out around lots of people so she does not get out very much anymore. Her pain level is constant and continues to go up each day even with her pain medications. She is a Christian woman and believes in God. She recently has heard of euthanasia and is contemplating on proceeding with this action. “Disapproval was associated with religiousness, collectivistic morality (loyalty and purity), and prosocial dispositions, in terms of emotional empathy and behavioral generosity, but not values (care and fairness),” (Deak, 2017). Unfortunately, her family is against this and says God does not believe in this and she will not be going to heaven if she does this. “These foundations include loyalty to the group, respect for authority, and purity, that is, valuing the preservation of the natural and sacred order of things and the world,” (Deak, 2017). Her family would also be upset with her for disrupting the natural order of the human life. Some of the healthcare providers do not approve of such barbaric acts so she would have to find a doctor willing to do the procedure.

Conflicts/Controversies

The conflict in that her religion does not believe in euthanasia or assisted suicide as they call it. In Christianity they believe that god is the creator of all, and everything will end on gods’ terms as her created it for. So, by interrupting this process by essentially ending your life you are going against Gods will. Ultimately, they believe you will go to hell and her family will not approve of this notion. Another conflict she would face is the search for a healthcare provider who would take her case. This may drain her of her money with consultations and test she may have to go through. Many health care providers may deem this as unethical and even if she does find a doctor she would have to go through weeks of counseling. “Patients have the moral and legal right to determine what will be done with and to their persons” (ANA, 2015). I feel as if doctors should respect the wishes of a patient and carry them out but that is not always the case. I believe the conflicts between loyalty to self and loyalty to the community. The nurse or health care provider has a duty to their own morals if they do or do not believe in this procedure. “This is particularly important in the case of nurses because they are in constant contact with patients and, therefore, are often confronted with the issue of euthanasia” (Naseh, 2020). So, if they need to perform a self-assessment to know if they are able to take care of this patient or assign a different nurse to the patient. They also have a duty to the patient’s wishes because we should respect the patient’s autonomy. The most moral thing for the patient to do is to go through counseling and make sure this is what she wants. Once deciding on going through with the assisted suicide she would need to converse with her family in therapy as well. The morality I would use is treating others they way you wanted to be treated. It takes a tole on you when you suffer every day and if you could end that suffering after you have lived a good life than I would respect that decision because if roles were reversed, I would want the same treatment.

Ethical Views

Aristotle’s Golden Mean rule can be described as choosing the middle answer between the 2 most extreme undesirables. On one hand the patient could go ahead with the procedure and dismiss her religion and let her family disown her. The other extreme is to continue to suffer day in and day out to please her family and religion. The common ground is to allow your family to understand where you are coming from and that you still believe in your religion, but suffering can really put a person down. I would believe family therapy would be able for them to understand your thought process and allow them to accept the reality of your choice. “Aristotle goes on to discuss such virtues as courage, self-control, generosity, and truthfulness” (Rachels, 2019). By the use of courage and truthfulness of telling your family should be seen as morally correct.

The utilitarian view is about optimizing the good and foregoing the suffering throughout life. “Though there are many varieties of the view discussed, utilitarianism is generally held to be the view that the morally right action is the action that produces the most good” (Driver, 2015). There for the utilitarian view would agree that euthanasia would end suffering therefore would agree with the procedure. “Hence, utilitarian’s see laws against euthanasia as restricting people’s freedom, for no good reason” (Rachels, 2019). Patients should have the right to choose their care and by not being able to choose this procedure it is restricting their freedom while prolonging their suffering.

“The “natural laws” of morality are just laws of reason; so, what’s right is what’s supported by the best arguments” (Rachels, 2018). Natural Law of Ethics View would be used in this scenario of what has the better outcome. The woman loves her family deeply and does not want to anger them or her God. On the other hand, she suffers from pain, not being able to go out and do what she loves, and not feeling like herself. The best argument would be made by the patient of why she would want to do the procedure. She is not only suffering physically but also mentally. The pain and poor diagnosis can make you depressed. The end of her suffering makes for a good argument to be supported by the Natural Law of Ethics.

The Right Ethical View

I believe the utilitarian ethical view works best for this scenario. As a nurse we aim to treat our patients with the best of care to make them as comfortable as possible. This would include alleviating their suffering by providing comfort measures. Therefore, by providing the option of euthanasia we give the option to alleviate their suffering. As it says in the book that by not allowing people to have this right, we are restricting their freedom for no good reason. This supports the moral code of honesty and compassion. We show compassion by understanding what our patient is going through and why they want to end their lives. No one really wants to end their life, but many can be ready to die after years of suffering. So, by showing compassion we can help our patient fulfill their wishes.

Aristotle’s Golden rule looks at extremes of the choices that the patient wants. It could be hard to meet in the middle of those. The patient’s family may never understand and still want her not to do the procedure. Sometimes we may just have to believe in ourselves and make decisions that is our own best interest. This may lead to one extreme or the other. The natural Law of ethics could be argued either way. Living your life to your last day and fighting to make the best of it would be the best argument of the patient. The best argument by the patient is that she would want to end her suffering. It would be hard to determine what argument is better in the patient’s case.

References

ANA, (2015). Code of Ethics. Retrieved: June 18, 2020. From: https://www.nursingworld.org/coe-view-only

Deak, C., & Saroglou, V. (2017). Terminating a Child's Life? Religious, Moral, Cognitive, and Emotional Factors Underlying Non-Acceptance of Child Euthanasia. Psychologica Belgica, 57(1), 59–76. https://doi.org/10.5334/pb.341

Driver, Julia, "The History of Utilitarianism", The Stanford Encyclopedia of Philosophy (Winter 2015 Edition), Edward N. Zalta (ed.), URL = <https://plato.stanford.edu/archives/win2014/entries/utilitarianism-history/>.

Naseh, L., Heidari, M. (October 28, 2016). The attitudes of nursing students to euthanasia. Retrieved: June 5, 2020. From: https://www.researchgate.net/profile/Ladan_Naseh/publication/309909385_The_attitudes_of_nursing_students_to_euthanasia/links/5826173b08ae950ace6a7bd0.pdf

Rachels, S., & Rachels, J. (2019). The elements of moral philosophy. New York, NY: McGraw-Hill Education.