End-of-Life Decisions Nursing Essays

End-of-Life Decisions

End-Of-Life Decision Making

Making decisions in end -of-life circumstances is usually an intricate experience where individuals make difficult choices about their future. Determining whether to proceed or stop life support, starting a cardiopulmonary restoration comes hardy with a share of difficulties. When the patients are in a critical condition, their decision-making capability is usually impaired and hence delegating the role to close friends or family members becomes compulsory. Prognostic decisions and decisions on when to start end -of-life decisions is a barrier towards decision making process. In addition, the emotional and psychological difficulties for the care providers, patients, families and the friends are actual concerns that may influence the decisions.

Role of the Nurse

Making decision in End-of-life involves various parties including healthcare providers, patients and families to determine the kind of treatment to choose or to avoid in case the patient is undergoing through a life-threatening illness. This principle is quite prevalent in the ICU departments where the healthcare providers have to come up with appropriate decisions regarding the healthcare plan for the patients. Nurses play vital roles in making end-of-life decisions including facilitating collaboration and communication between the family members, the patients, and the physicians. In addition, nurses are obliged to offering professional advice to the patients on how to handle certain diseases, the consequences of medication and the possible outcomes of individual decisions. Therefore, the nurse plays the major role of providing relevant information to both the patient and the family members that leads to making sound decisions.

Advocacy is also a fundamental role played by the nurses. They communicate to family members and health care team on behalf of their patients. The nurses provide the family with the goals of care plan and use their professional skill to convince the family to honor the patient’s decisions. Besides, they provide information needed by the healthcare team about the patient’s condition and history to assist in future diagnosis and treatment. The physicians depend on such information to be able to meet the patient’s demands and requests.

Legislation That Generated End-Of-Life Health Care Policies

Most healthcare legislations are enacted to regulate various activities within the healthcare field. Legislation pertaining the end-of-life decision was enacted in 1944 from amendments to the Public Health Service Act (Morhaim & Pollack, 2013). The law is clearly defined in Title 42 of the United States Health Code. Other critical policies are also derived from amendments to Public Health Service Act. For instance, the HIPAA Act, which seeks to promote protection and privacy of information of the deceased persons for at least 50 years after their death (Morhaim & Pollack, 2013). The American College of Healthcare Executives points out that the healthcare givers should recognize and offer compassionate and competent care to the patients without discrimination. The laws require that the nurses should create awareness to the patients and the family concerning the health care plans. Other than the policy appealing for recognition and service to patients with such needs, it also recommends that the nurses should be ethical in the course of decision making and need to avail the necessary planning documents that guarantee satisfactory resolution (Morhaim & Pollack, 2013).

Another statute that affects decision making in end-of-life is the Aged Care Quality Agency of Australia, which mainly focuses on the aged population (Albers et al., 2014). The aged people are prone to making end-of-life decision because they often undergo treatment and they also stand a higher risk of suffering critical diseases that can even lead to death. This legislation outlines how the doctors should handle the aged people, and one of the provisions is that the healthcare givers should be able to honor treatment preferences of these patients (Bischoff et al., 2013). The legislation addresses diverse issues including conducting quality reviews of home care services and providing education, training, and medical support.  

Policies Regarding Current Health Care Practices

The current policies focus on the provision of timely and quality care to the patients, which may comprise various aspects such as pain management and control of distressing symptoms, promoting good relationships between the patients, care providers, and their family. The policies also address the significance of building effective communication and sharing of information among the different stakeholders. When the nurses are dealing with the end-of-life medical decisions, there are some considerations that guide and regulates their activities. First, the nurses must consider the quality of the service they give to the patient to ensure that such services foster compassion and are ethical (Albers et al., 2014). There must be respect for the dignity of the patients, and the healthcare givers should take their decisions very seriously. Another policy provides that the healthcare providers be respectful to the wishes of the patient and that of their family.  It means that the nurses and other hospital attendants should operate only within the confines of patient requirements.

All patients’ choices must be respected including the decision to refuse treatment. No matter the condition the patient is in, the nurses have to honor patient’s decision to reject treatment. Healthcare givers are also required to consider various evidence-based and clinical education in providing the most appropriate care to the patients. Besides, the policies require that the care provider’s decisions and suggestions be respected. Lastly, the hospitals are required to provide access to hospice care (psychological, medical, and spiritual support) and palliative care.

Effect of End-Of-Life Regulations

Considering the policy of Oregon’s Death with Dignity law that came into place in 1997, the doctors were allowed to prescribe although not to administer lethal doses of treatment for patients with terminal conditions and who wanted to end their lives (Albers et al., 2014). The patient would be the one to manage the medication and not the healthcare giver. Several states through the court have accepted these laws which allow the doctor-assisted suicide for the patients who are considered terminally ill. These regulations, therefore, gives the doctors and the nurse’s responsibilities that they can undertake help the patients achieve their choice needs.

The regulations ensure efficiency in care delivery and can amount to a legal case if some of them become violated. The doctor has to stick by these laws and the decisions of the patient. The hospital attendants including the nurses, doctors and other staff are supposed to operate within the consent of the patients and the family of the patient. Any action must receive accreditation from both the patients and the family. The doctors should only act to their jurisdiction offered by the family and patient and should not involve any action beyond this agreement even though it might contribute to the well-being of the patient.

Ethical considerations that have influenced policy decisions regarding end-of-life decisions

Ethical considerations continue to confound the decision-making process of the nurses in palliative care and Hospice care situations. The nurse is required to base their decisions on the professional code of conduct to make informed medical decisions (Jensen, Ammentorp, Johannessen, & Ørding, 2013). The first dilemma facing most nurses is that they should adhere with patients requests despite their health condition. The patient must have their free space for making a decision that suits them best. The doctors should honor patient’s decisions and should not violate the patients because of their weak conditions. The physicians and the nurses have the moral obligation to provide the right information to the patients before making diagnosis and treatment decisions (Albers et al., 2014). The healthcare providers should provide information such as the possible drawbacks of the suggested medication. The healthcare givers should not conceal any information or mislead the patient in any way. Other ethical considerations include protecting the privacy of the patient including the decisions made by the patient. The dignity of the patient is also important, and the health caregivers must protect it completely.