Pallia -ethical and legal considerations
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The document discusses ethical and legal considerations in palliative care, outlining key ethical principles like respect, autonomy, justice, beneficence, and non-maleficence that should guide decision making, as well as legal implications around issues like the right to die, advanced directives, do not resuscitate orders, terminal weaning, death certificates, organ donation, and autopsies. Ethical theories around deontology, utilitarianism, and virtue-based ethics are also presented as approaches to adopting an ethical perspective in palliative care situations.
Pallia -ethical and legal considerations
- 1. S. Tagapan- Feb1, 2012 right and virtuous action as opposed to what guides actions in terms of rules and obligations ETHICAL AND LEGAL CONSIDERATIONS IN PALLIATIVE CARE Ethical principles- provides a sound foundation for our own personal beliefs, morality and actions when applied to modern-day living Ethics- is a branch of philosophy that considers and A. Respect- respect for persons requires that each examines the moral life individual be treated as unique and entitled to - Systematic examination which seeks to provide treatment that is respectful of their human dignity sound justification for moral decisions and B. Autonomy- is multidimensional and in its broadest actions of people sense incorporates the following: having a minimum - Deciding what is right or wrong, is not quite as of relevant information; self-determined choice; simple in palliative care freedom to act on the basis of one’s choices; and - Although it is nurses who spend the greatest self-governance amount of time with a patient, all team C. Justice- involves the determination of what members involved in caring for the patient someone or some group is owed, merits, deserves, should contribute to the decision making or otherwise is entitled to process D. Beneficence, Non-maleficence- doing good and not causing harm Ethical dilemmas- difficult problem for which there E. Application- reflect, analyse, and discuss in each is no totally satisfactory solution, or which involves situation- apply the ethical principles of respect for a choice between equally unsatisfactory individual, autonomy, justice, beneficence and non- alternatives maleficence to the analysis Ethical theories- adopting an ethical approach is Legal implications: not always about having a set of rules to obey but is rather about transforming oneself to someone for A. Right to die- an individual has a right to refuse whom the duty of care for the individual is inherent. medical treatment and the refusal of such treatment will cause death. B. Advanced directive- a formal written advanced statement by a pt refusing treatment in specific A. Deontological ethics- doing what is right stated situations that may occur in future illness regardless of the consequences 1. Living will - No lies; e.g. Not to tell pt his condition if the 2. Durable power of attorney- document that health care team has decided not to tell him permits individuals to designate another person B. Utlitarian ethics- theory considers the value of to make decisions for them should they lose merit of an outcome of an action rather than decision making capacity the action itself, evaluates the ends produced C. Do not resuscitate- for clients who are in terminal by an action to determine its goodness or state, irreversible illness or expected death rightness - Generally written when the client or proxy has - It strives to maximize benefit and minimize expressed the wish for no resuscitation in the misery for the greatest possible number event of CP arrest - E.g: support for pediatrics or geriatrics? D. Terminal weaning- gradual withdrawal of - Utilitarianism/consequentialism mechanical ventilation from a client with terminal C. Virtue-based ethics- person-centered rather illness or an irreversible condition with poor than practitioner-centered, focuses on what is a prognosis
- 2. E. Death certificate- prepared for each person who dies F. Organ donation- pts who express a wish to donate functional organs such as heart, corneas, liver, lungs, and kidneys can fill out an organ donor consent card G. Autopsy- examination of the organs and tissues of a human body after death - Consent is a legal requirement - Closes surviving family member has the authority to determine whether an autopsy is performed