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ethics in health


ethics in health End of life care in the U.S. is far from perfect, and in many ways lags behind other nations in terms of meeting the psychosocial needs and overall wellbeing of the patient. Poor pain management, a lack of support services and unaddressed fear are all components of end-of-life care that are often missing from a patient’s care plan. While each of these is a major concern, one of the greatest fears at the end of life is losing one’s dignity. So overpowering is the fear that a recurrent paradox in care of the dying is the patient who loves life yet chooses an early death as you saw in all four videos. In Final Exit and the Suicide Tourist, the patients chose to end their life directly, either by their own hand, or potentially with assistance from others. In the same vein, but less overt, the patient in Cost of Dying: One nurse’s end-of-life choice was surprisingly simple — and liberating opted for Hospice, foregoing invasive treatments that would have potentially extended her life. In each of the scenarios, the underlying motivation given was a desire for control and the fear of losing their dignity, two concerns often stated interchangeably. Ironically, the ideology behind PAS and Hospice are surprisingly similar, although the mechanisms for preserving the patient’s dignity are markedly different. In fact, they are so similar that the motto for Hospice is Death with Dignity, while the name of Oregon’s PAS law is the Death with Dignity Act. Many argue that PAS and Hospice are not mutually exclusive, as Oregon has both PAS and an excellent reputation for Palliative and Hospice Care. On the surface, it would appear that allowing both options provides the greatest amount of autonomy for all concerned. In a bizarre twist, however, those suffering from progressive, disabling, chronic but non-terminal disease, those who have a terminal disease but are severely physically handicapped and those who do not have capacity can all cry foul. For these patients, PAS is not an option, as two of the requirements under current US law are that the patient must have decision-making capacity and must be able to ingest the lethal medication without assistance. With these thoughts in mind, please discuss the following: What does it mean for a person to have dignity, and is it something that we give away or something that is taken away? Neither? Both? Do you agree with Craig Ewert’s decision? Why or why not? Support your answer beyond only giving an opinion. 250 word min


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