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Palliative CareResearch Paper

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¶ … Life

Legal Issues to Consider

End of life presents several issues to consider for the person dying and the people responsible for them. There a number of ethical and legal issues when approaching end of life such as euthanasia, possible, organ donation, and legal testament. Among the essential staff involved in end of life are critical care nurses. Critical care nurses are indispensable participants of any health care team when it comes palliative/end of life care and frequently aid patients as well as patients' families that may be facing end-of-life apprehensions. When in this position, a nurse requires a comprehension of several significant factors, together with legal consequences accompanying end of life.

Background

Since the 1970s, several cases decided on by courts have recognized certain legal doctrines in end-of-life care. Courts decided that knowledgeable and capable adults have the right to decline or suspend medical interferences. For incompetent children and adults, judgments are made by a proxy. In the nonappearance of an advance directive or documentation of goalmouths of care, the proxy, in partnership with the medical crew, regulates and governs a plan of care, together with choices concerning end-of-life care. (McGowan, 2011) When matters of medical ineffectiveness happen, efforts to work with patients and their respective families must be commenced, but if the disagreement cannot be determined, a handover in care may be the only selection.

Roles and Decisions

From the staff needed to accommodate end of life decisions, especially legal decisions, it is the role of the procurement coordinator to handle several matters from course of medical treatment to awareness of possible surrogacy. "Procurement coordinators have access to critically ill patients during the course of medical treatment with no donation consent and with family or surrogates unaware of their roles. How these programs affect the medical care of these patients has not been studied" (Rady, Verheijde & McGregor, 2010, p. 1069). Without such people involved in the process, things could get confusing for families having to deal with end of life care. People usually in end of life are usually experiencing some form of terminal and/or chronic illness. The most common is cancer. Cancer is fairly expensive to treat and so many times terminally ill cancer patients elect to end treatment and take their lives.

Although this is recent in terms of legality, people are now allowing terminally ill patients to elect to die or not with one of the latest ones being a recent bride with terminal cancer who took her life shorty after getting married. She did not want to leave her husband with medical bills as well as experience a painful last days that so many terminally ill patients endure. This is often the controversy surrounding end of life issues is the legality behind euthanasia and patients electing to kill themselves over waiting to die.

Euthanasia and Assisted Suicide

Although it is legal for patients to elect to die by refusing medical treatment, there is still some grey area surrounding electing to perform euthanasia on themselves through medical assistance. Physician assisted euthanasia or assisted suicide is still illegal to some extent across the country, although in Europe there are some countries that view it as legal. Euthanasia in fact is legal in Luxembourg, Belgium, and the Netherlands. Assisted suicide labeled different for legal purposes, where the patient delivers the final act on themselves (different from euthanasia), is legal in the Luxembourg, Netherlands, Switzerland.

The United States has some states that allow terminally ill as well as mentally capable, end of life options for those who are not mentally competent must be given to proxies. Although the role of proxies in euthanasia and assisted suicide has still not been adequately acknowledged, proxies can refuse care. That is why it is important to discuss the importance of proxies and advanced care directors. "Given the observed individual variability, we stress the importance of advance directives and identification of proxies when discussing end-of-life issues in patients with disorders of consciousness" (Demertzi et al., 2011, p. 1058).

End of life has been a hot button topic and subject of interest in recent decades. "Examining developmental periods of the human lifespan has been a useful tradition for focusing HCI research (e.g., technologies for children or the elderly)…identify the end of life as another period of the human lifespan" (Massini, Odom, Banks & Kirk, 2011, p. 987). People want to know more about what to do towards of end of life and who decides what kind of treatment options are available, especially when it comes to euthanasia and assisted suicide. Along with these interests, there's the growing awareness that end of life also means possible organ and tissue donation.

Advanced Care and other Decisions

Advanced care directors and proxies can make the choices needed to facilitate a smooth transition for end of life choices and end of life care. Especially when it comes to organ donation. "International policy advocates the development of approaches to raise public awareness about end-of-life-care issues, so that when people face a final illness, they may better articulate their needs for care" (Clarke & Seymour, 2010, p. 857). Some controversy has been raised when it comes to end of life and organ donation as seemingly healthy adults may experience life-ending events that can make the prime candidates for organ donation. If the person choose to donate organ upon death, some say hospitals and other medical facilities may not treat the person as needed in order to gain the organs. Although this hasn't been proven, there is some belief that hospitals and medical facilities do this. Hence why it is important to designate healthcare proxies and organ donation decisions before death along with any possible will and testament.

After framework analysis, three themes arose: communicating about end-of-life issues, factors that influence individuals' concerns about death and dying, and advance care planning. The heterogeneity of stories told not only illustrates how people's responses and needs at the end of life vary greatly but also reveals shared reactions, experiences, and some confusion (Clarke & Seymour, 2010, p. 857).

As Clark & Seymour discussed in their article, communication of end-of-life issues an important part of making decisions when it comes to quality of care and what to do when the person dies. Aside from terminally ill patients, there are patients that die from old age and other unexpected, acute conditions. That is why will and testament should be communicated and dealt with along with end of life treatment. Communication of desired location for treatment, how to deal with cardiac arrest and other things must be discussed. People even have the options to declare: "Do not Resuscitate" when they experience cardiac arrest. All these things cannot be considered unless proper communication is in place.

Any factors that may influence a person's worry over death and dying must also be addressed. Death is a scary and sometimes painful process. If the person dying needs religious or spiritual assistance, this also must be taken into consideration. "Death is more than a mere biological occurrence. It has important legal, medical, and social ramifications that make it imperative that those who are responsible for determination of death be accurate and above suspicion" (Souter & Van Norman, 2010, s502). Nothing is worse than dealing with something alone or having to do things without being properly aware of available options. So these should be addressed.

Advanced care planning is also an important aspect to consider. Advanced care planning involves a myriad of things. Advance care planning comprises learning about the sorts of choices that may be required for the responsible party to make, bearing in mind those choices ahead of time, and then making aware of such preferences to the ones in charge of care, frequently by placing them into an advance instruction.

An advance instruction or directive is an authorized document that will only go into effect if the person becomes incapacitated and/or is unable to speak for him/herself. This could be the consequence of sickness or severe injury -- regardless of age. It benefits others by letting them know what kind of medical care is desired. It also permits the person to express certain desires and values associated to end-of-life care. An advance directive can be seen as a "living document" -- one that a person can adjust as situations change due to new information or a variation in health status.

These topics are important to discuss and should be acknowledge when it comes to the legal aspects of end of life. It makes the transition from treatment to death easier. It also facilitates communication and understanding of desires and wishes. It helps people connected with the dying person with resources and people to confer with in making decisions. It also provides awareness of any additional steps to take in order to avoid any further mishaps or misunderstandings.

End of life should be ideally painless and smooth. Dying is hard part of life and it should not be met with difficulties or hardships for the… [END OF PREVIEW]

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