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Essay Subject: Examines moral, ethical & legal aspects in general & as they impact nursing practice. Appendix (nurse interviews).... More...

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Paper Abstract: Examines moral, ethical & legal aspects in general & as they impact nursing practice. Appendix (nurse interviews). Paper Introduction: This research examines the moral, ethical, and legal aspects of euthanasia, especially as they have an impact on nursing practice. The research will set forth the historical and moral context in which the issue has emerged then discuss legal, philosophical, social, and practical elements that figure into what has become a feature of discourse of medical care in general and nursing practice in particular. One of the most notorious news stories of 1976 centered on New Jersey, where Karen Ann Quinlan's physicians disconnected artificial life-sustaining equipment from her body. For nearly three years, Karen's parents had sought permission to have the equipment turned off. Drama and conflict had surrounded the case, partly because Karen had been in her photogenic twenties, partly because the Quinlans were fighting the full weight and autho Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. which the issuehas emerged then discuss legal philosophical of centered on New Jersey partly because Karen had been in her photogenictwenties But by the time comatose Karen AnnQuinlan California's Natural Death Act legalized use of the livingwill By By states had enactedliving-will statutes totell patients at the time of admission about their rights Pope John Paul II said that euthanasia after the Quinlansfirst entered the of the culture Karen AnnQuinlan the U S Supreme Court The annual the law and fate into their own hands Humphry term meanings may vary with Association's Council on Ethical and Judicialaffairs suicide also physician assisted suicide is the namegiven to the act of providing increasing drug proxy in the form of although since the Quinlan case sometimes differentlyby the same commentator The phrase can mean a right to kill oneself which would be be killed by another at one's own request act But he goes on to describe the third two main and several subsidiary questions about the right Am I upholding the dying person's autonomy his free about the patient's responsibility to his family Humphry Wickett p Patients' Self-Determination Act of which right to refuse medical treatment however community on the other Greve the issuing of Do-Not-Resuscitate DNR orders by doctors in although the result of conscious decisions to terminally illpatients not only to guarantee physician needs This has most or againstlife is concerned The so-called slippery slope modern Germany's use ofcyanide in its euthanasia reply advocates of personal autonomy not worthy of life Theycontinue There is no record of Less easy to answer are the agony of seeing a killing as the treatment used nurses who openly challenge established they are acting on behalf of and enhance topatient's right to self-determination Nurses obliged to followphysicians' of morphine to relieve a terminalpatient's pain caring profession that nursing is appears tohave caused her to insist in extremis and while beggingto be for nurses because of the of heart in otherwords are bound to be is unjustified for a physician to think that on relief in Oregon where in the Death in themedical community more generally In limits of the information it has know nothing about the physical psychological of the context in which these patients live and are but there is noinformation on the financial positions of participate in PAS are not required to Oregon Under the law doctors are not suicidal or parasuicidal patients whether program is characterized as too much doses of PAS drugs attending physicians would merely information gatherers andtransmitters Foley and Hendin would argue for stronger controls on homes alike provide written information regardingadvance directives Because the details nursing-professioninput is that it is one thing on the record where euthanasia surfaces as an issue For whether right-to-life advocates or members ofthe Hemlock Society that is not quite true if the traditional practice of mental-health treatmentteams by Yank Barber and Spradlin found that treatment teams Further to this figure is more than Nurses are uniquely that complaining would be anything other be adduced to account fordifficulties or more the physician or institutionrefuses What happens when to Life Committee gets into theact It's all very visphysician or institutional authority And what about troubling to them Are nurses to where end-of-life issuesare at stake or to does all of this say about theautonomy or value of patient good than whether they J M Hammes B J April Ethics and pain management position is both pivotal andprecarious in H May The Oregon report L O July Health law JAMA The Journal of theAmerican right to die understandingeuthanasia New York Harper Row Kubler-Ross Clinical Supervisor McClung J A Kamer R S July Legislating July Ethics analysis of Patient Self-determination Act RN Ufema J July Death dying Bedside vigils Nursing theright to die Grand Rapids Mich R McElmurry B J January Moral an impact on nursing practice Theresearch of medicalcare in general and nursing practice in Karen's parentshad sought permission to have practice andprevailing social policy refused to hospital protocol it was nonetheless a more Nevada New Mexico North Carolina Oregon and treatment McCord That same year thePatients' Pellegrino By no means did the Quinlan case dispose of out to be a majorlegal became an increasinglyprominent subject of moral professional and public-policy parents' wish to withdraw her life support was and assistedsuicides of the terminally ill increased which are sometimes used interchangeably but which hardlycarry a uniform historically been identified with themercy killing of hopelessly sick human death such as the death-causingdrug or other or knowledge to commitsuicide but does life The AMA distinguishes between withholding of life-support treatments whosedisadvantages outweigh the to die is connected to that of assisted suicide interpreted simply asked to be left alone and permitted right to unassisted suicide Finally it the AMA's definition of assistedsuicide in his view knowledge and means but not the Do my religious and philosophical Does the patient have a in coming to terms with euthanasia and mayhave wide-ranging medicaltreatment and requires hospitals receiving federal Medicare this regard because ofhospital or doctor noncompliance on one hand food from comatose terminal patients guardians or next of kin before issuing aDNR order McClung occurrence for doctors who engage in contexts is problematic notleast because of their patient autonomy The content of suchautonomy involuntary active euthanasia particularly aspracticed Gomez Thecompetence and will of the patient are mischaracterized aseuthanasia and more properly referred to after Quite the contrary every killing Wickett cite to theeffect that assisted-suicide advocates are really thefine line between assisted suicide for those who know the subculture of the health put their jobs their economic Cain and Hammes forcefully argue that when toward palliative care For example The risks to the nursesassociated with disobeying orders woman who had issueda DNR order and agreed who see the wastefulness of futile treatment of problem as Ufema notes is thatmatter assisted suicide for personal reasons is that of misplaced would seem equally unjustified for care by no means settled PASrecords are woefully inadequate Unfortunately the report is marked by data that patients who were assisted in suicide capabilities of the physicians who cancer need bereported in PAS documentation in Oregon The of the program concluded that economic factors did not enterinto state of the patients whorequest PAS other suicidal ethics But Lynch points out that inany case therapists in with death-and-dying issues Ifthe issue is too hard it is law who argued that in the absence by the government to analyze its operation cases involved It is to be expected that advocates for of hard-won patient autonomy Further the Patients the form that such controls might take is boundto vary to develop standards for nursing's attending palliation PAS DNR and the conflicting prioritiesand the fore the role of nurses in end-of-life is characterized as nurses' contribution to a and its parent agency Zimmermann reported limited to physicians deliberatelydisregard a patient's advance directive Among there is little evidence that they have a given end-of-life decision helps either patientor nurse A future if a patient asks for assisted will the nursing staff do delivery of health care but where doesthat leave a distressed interview Ufema Thus to be saddled be obliged to track every single littletiny case to have little actualauthoritative to become more not less complicated astime goes on The of Euthanasia Ed J A Behnke S Bok Garden L B March-April Justifiedlimits on refusing intervention about deathand dying A national survey General of the American Medical Association Society Mosby's Medical Nursing Allied HealthDictionary F New York Spring Supervising the trainee who Journalof Medicine McCord W Jan C F May US consensus on euthanasia The Lancet The Washington Post A Wennberg Spradlin W W Mental health treatment teamsand leadership a systems Western Journal ofCommunications This research examines the moral ethical and legal social and practicalelements that figure into what has where Karen Ann Quinlan's physicians disconnected artificial life-sustaining partly because the Quinlans were fighting the full weight andauthority died in if the withdrawal the year after the Quinlan decision fifty or laws that otherwise guaranteed to accept orrefuse medical treatment and to create advance directives wouldbe the great moral issue New Jersey judicial system with each succeeding andtroubling Nancy Cruzan Baby Doe Jack Kevorkian rate of so-called mercy-killings rose tenfold from Wickett p xi Under the general category the definers' professionaldiscipline Euthanasia derived from the Greek combining euthanasia is identified with a situation in or PAS the situation inwhich a physician dosages for pain relief thatmay have the living will durable power of attorney or it has been commonly referred right to be allowed to die which would be a a right to take one's own life free from i e a right to assisted meaning in more general terms as theright to todie from the point of view of choice in life's decisions by helping The very fluidity of term definition speaks to the difficulty went into effect inDecember specifically guarantees as late as at least some patients were unaware of Tammelleo As early as some doctors were going public the lawessentially codified protocols that had been in place stop medicaltreatment Walters By the mid s assisted suicide pain relief but also to recentlybeen complicated by the shift in medical or slippery rope or wedge argument holds that movement insisting that legalized euthanasiawould result and informed consent Humphry Wickett say for example the Nazis assisting in a suicide or killing anyone the objections of such health-care-deliveryveterans as loved one suffer p Caught in the middle of this to achieve a morally permissibleend pain relief Cain authority structures or powerful physicians in the patient and have strong justification orders and advance directives however know on the theory that excessive pain affected attitudes of nurses toward end-of-life practice Ufema reintubated that it be rescinded This is balanced potentiallegal complications that could arise if the rescinding a permanent part of the mix A the grounds ofbeneficence the best' management excludes as unreasonable all with Dignity Act waspassed This law which permits a review of the second annual reportof the available overreaching its data to draw unwarranted conclusions Most striking and existential needs of the patients requesting assisted suicide cared for Foley Hendin p Only the underlying the patients involved or theextent of their engage in or be trained incounseling required to encouragealternatives to PAS Foley and Hendin observe terminallyill or not DiMaggio cites the a laissez fairematter a fact of be using terminalpatients as guinea pigs call for more extensive case-by-case patientdata any enablinglegislation along those lines However of advance directives livingwills and durable powers of attorney to recognize that the issue it is nurses who are likely to which was organized to disseminate information abouteuthanasia Hemlock At a regardingnurses as support staff rather they were subject toregression into dysfunctional partial systems point Tammelleo cites a survey positioned towatch supposed patient autonomy become than adifferent kind of suicide Nor is it exactly to raise difficult questions in the patient and family enlist the well to say that the nurse's role is to the feelings of the nurses regarding euthanasia Manyare reluctant to become clerks or perhapstattletale gatekeepers with secret records of refrain from recording what they judge to be nursing as a helping profession But the issue can avoid doing harm References Behnke J Respecting patient wishes Journal of Pain and assisted-suicide debate JAMA The Journal of the AmericanMedical Association Don't ask don'ttell The Hastings Center Report Glasson J Medical Association Greve P J D Feb E On death and dying New York MacmillanPublishing ethics implications of New York's JAMA The Journal of the Weiser B Nov doctors take W B Eerdmans Pub Co foundation ofnursing Advances in Nursing Science Zimmermann S Spring Social will set forth the historical and moral context in particular One of the most notorious news stories the equipment turned off Drama and conflicthad surrounded the case allow withdrawal of life support characterized as passive euthanasia usual practice inhospitals around the country In Texas they were signedinto law Humphry Wickett p Self-Determination Act required federally funded hospitals the issue of euthanasia passive or otherwise In issue Humphry Wickett In the years debate and thenames in the cases a prominently bleak aspect opposed by thestate of Missouri but finally granted by forty times as desperate elderlypeople felt obliged to take meaning in the literature Where more precise definitionsare given beings and animals In a reportby the American Medical agent Glasson p The AMA's definition ofassisted not perform the act Palliative treatment these definitions and a situation inwhich doctor patient or patient's advantages The AMA assigns no term to such asituation differently by different commentators and to die a natural death It also can mean a can mean a right to that the person assisting the suicide performs the deed On the other hand Humphry andWickett pose beliefs permit me to participate in this requested death civic duty to remain alive What implications for clinical praxis Behnke Bok The and Medicaidfunding to inform patients of their and some degree ofphilosophical opposition from the health-care Weiser New York was the first state to formally regulate Kamer By an estimated of deaths inall modern hospitals were palliative care administering increasingly large doses of morphine to historical function as support but not necessarilyauthority for institutional and raises moral and ethical issues where the decision for by the Nazis Some ethicists point to basic to the argument for assistedsuicide the German form aslebensunwerten Leben meaning life was unexpected by the victim and involuntary Humphry Wickett p in favor of puttingthemselves out of their own misery a morally objectionable means orintent care professions and the power structures of hospitals that welfare and their professional careers on the line even if curative therapy hasfailed pain relief can restore decision-making capacity aphysician may refuse to permit the use are therefore difficult to overstate On the other hand the to accept palliative medication but whoseexperience of a seizure those whorescind DNR orders The problem arises that end-of-lifedecisions are difficult for all human beings Changes medicalpaternalism that negates patient autonomy What Chervenak and McCulloughsay a nurse Complications attending end-of-life issues have been brought intospecific the issue in Oregon or its failure to address the were receiving adequate end-of-life care In fact we are responding to those requests And we know nothing reports do list advance-directive information and hospice participation the patient's PAS decision Foley Hendin Further doctorswho patients are required to undergo psychiatricevaluation in training are especially vulnerable to misjudgment ofand manipulation by possible for some health-care practitioners toavoid confronting it The Oregon of a reliable standard for determininglethal havebecome its advocates and not and against passive andvoluntary euthanasia Self-Determination Act specifically mandates that health-care institutions hospitals and nursing dramatically Tammelleo Unfortunately in the literature the evidence of role and fortracking that role values of affected patients caregivers families physicians andthird-party interventionists cases has not been strongly defined Well treatmentteam But in any case at least one analysis of similarfindings in analyses of hospice ICU and critical carenurses the mechanism that would enablethem to complain or whole range of hypotheticals can suicidein a state where it has been legalized and if a third-party intervenor such as the local Right patient's right of self-determination vis with the administrative details of the issue may seemdoubly detail of patient and practitioner behavior input into the matter what question then becomes less whether nurses can do an end-of-life City N Y Anchor Doubleday v-vii Cain Hastings Center Report Cotton P Feb Medicine's Hospital Psychiatry Foley K Hendin Issues In Law Medicine Gostin Mosby-Year Book Inc Humphry D Wickett A The treats thechronically suicidal outpatient Theoretical perspectives and practiceapproaches Feb Death with dignity The Humanist Pellegrino E D Tammelleo A D August Protecting patients' end-of-lifechoices R N Terminal choices euthanasia suicide and model Behavioral Science Oct Yarling R aspects ofeuthanasia especially as they have become a feature of discourse equipment from her body For nearly three years of the hospital that as a matter of custom of artificial life support was notan ordinary bills wereintroduced in thirty-eight states and in Arkansas California Idaho patients the rightto refuse life-sustaining which can takevarious legal forms about their own care Gostin of the s it also turned case a host of end-of-life issues In the late s NancyCruzan's to Between and murder-suicides double suicides of euthanasia fall a number of discrete end-of-life terms forms eu meaninggood and thanatos meaning death has which a physicianadministers to a patient some means of gives a patient either means so-called double effect of ending the patient's other advanced health-care directive authorizes withdrawal or toas passive euthanasia The term right right of non-interference and would be exercised when one interference by others i e a suicide Wennberg p Wennberg's third point differs from kill oneself through the agency of another which could implyonly the person assisting the suicide Am I playing God What about a possible miracle cure that thehealth-care community has had patients the right to refuse theiroptions or unable to exercise their rights in with the statementthat they routinely withheld for years such asobtaining advance consent from was believedto be a daily hasten death Cotton The position of nurses in end-of-life decision-making authority fromprofessional-expert paternalism to passive euthanasia leads to voluntary activeeuthanasia which leads to in widespread abuses Siegler Gomez that the Nazi program is suffering intolerably from a fatal illness Elisabeth Kubler-Ross whom Humphry and debate are nurses who may experience and Hammes p It is an indubitable fact a hospital bureaucracy most often for doing so Yarling and McElmurry p that not allphysicians have the same attitude relief euthanasia given the double effect of palliative treatment a nurse gives an account of a terminally ill by the view heldby other nurses of a DNR order wereto be ignored The larger danger for nurses who oppose implementation of DNR or for otheralternatives it cannot do so physician-assisted suicide typically byway of palliative state's Health Division Foley and Hendin complain that and least justified is its contention without substantiating patient We know little of the physical condition e g terminal participation in palliative care Yet the Oregonadministrators or formal evaluations of the emotional that failure to bring them upis a failure of professional reluctance of intern and resident-level physicians to deal straightforwardly particular concern to PAS opponents of the Oregon for the policy Meanwhile those administering thelaw and those sanctioned to get a more detailed picture of the such controls fly in the face ofissues for enforceable health-care proxies vary from state to state of euthanasiacharged and quite another be on the clinical front lines ofdifficulties time when team treatment of difficult cases has come to than as full participants in the decision-making apparatus both among team members andbetween team showing that of nurses have watchedcolleagues including but not subsumed by practitioner authority and clear whether becoming an antagonisticadvocate or opponent of a regard toeuthanasia What happens in aid of thehead nurse as a PAS advocate What provide the bestcare possible and facilitate the address the issue at all see colleague behavior in end-of-life cases And whether they are to abuses ofpatient preference in this area and in either seemshere to stay and seems destined A Bok S Preface The Dilemmas Symptom Management Chervenak F A McCullough DiMaggio J R May Educating psychiatry residents Summer Report of the council on ethical andjudicial affairs Has the PSDA made a difference RN Hemlock Co Inc Lynch V J Do-Not-Resuscitate law The New England American Medical Association Siegler M Gomez controversial stand on feedingthose near death Yank G R Barber J W cognition and evaluations ofhealth care team communication effectiveness which the issuehas emerged then discuss legal philosophical of centered on New Jersey partly because Karen had been in her photogenictwenties But by the time comatose Karen AnnQuinlan California's Natural Death Act legalized use of the livingwill By By states had enactedliving-will statutes totell patients at the time of admission about their rights Pope John Paul II said that euthanasia after the Quinlansfirst entered the of the culture Karen AnnQuinlan the U S Supreme Court The annual the law and fate into their own hands Humphry term meanings may vary with Association's Council on Ethical and Judicialaffairs suicide also physician assisted suicide is the namegiven to the act of providing increasing drug proxy in the form of although since the Quinlan case sometimes differentlyby the same commentator The phrase can mean a right to kill oneself which would be be killed by another at one's own request act But he goes on to describe the third two main and several subsidiary questions about the right Am I upholding the dying person's autonomy his free about the patient's responsibility to his family Humphry Wickett p Patients' Self-Determination Act of which right to refuse medical treatment however community on the other Greve the issuing of Do-Not-Resuscitate DNR orders by doctors in although the result of conscious decisions to terminally illpatients not only to guarantee physician needs This has most or againstlife is concerned The so-called slippery slope modern Germany's use ofcyanide in its euthanasia reply advocates of personal autonomy not worthy of life Theycontinue There is no record of Less easy to answer are the agony of seeing a killing as the treatment used nurses who openly challenge established they are acting on behalf of and enhance topatient's right to self-determination Nurses obliged to followphysicians' of morphine to relieve a terminalpatient's pain caring profession that nursing is appears tohave caused her to insist in extremis and while beggingto be for nurses because of the of heart in otherwords are bound to be is unjustified for a physician to think that on relief in Oregon where in the Death in themedical community more generally In limits of the information it has know nothing about the physical psychological of the context in which these patients live and are but there is noinformation on the financial positions of participate in PAS are not required to Oregon Under the law doctors are not suicidal or parasuicidal patients whether program is characterized as too much doses of PAS drugs attending physicians would merely information gatherers andtransmitters Foley and Hendin would argue for stronger controls on homes alike provide written information regardingadvance directives Because the details nursing-professioninput is that it is one thing on the record where euthanasia surfaces as an issue For whether right-to-life advocates or members ofthe Hemlock Society that is not quite true if the traditional practice of mental-health treatmentteams by Yank Barber and Spradlin found that treatment teams Further to this figure is more than Nurses are uniquely that complaining would be anything other be adduced to account fordifficulties or more the physician or institutionrefuses What happens when to Life Committee gets into theact It's all very visphysician or institutional authority And what about troubling to them Are nurses to where end-of-life issuesare at stake or to does all of this say about theautonomy or value of patient good than whether they J M Hammes B J April Ethics and pain management position is both pivotal andprecarious in H May The Oregon report L O July Health law JAMA The Journal of theAmerican right to die understandingeuthanasia New York Harper Row Kubler-Ross Clinical Supervisor McClung J A Kamer R S July Legislating July Ethics analysis of Patient Self-determination Act RN Ufema J July Death dying Bedside vigils Nursing theright to die Grand Rapids Mich R McElmurry B J January Moral an impact on nursing practice Theresearch of medicalcare in general and nursing practice in Karen's parentshad sought permission to have practice andprevailing social policy refused to hospital protocol it was nonetheless a more Nevada New Mexico North Carolina Oregon and treatment McCord That same year thePatients' Pellegrino By no means did the Quinlan case dispose of out to be a majorlegal became an increasinglyprominent subject of moral professional and public-policy parents' wish to withdraw her life support was and assistedsuicides of the terminally ill increased which are sometimes used interchangeably but which hardlycarry a uniform historically been identified with themercy killing of hopelessly sick human death such as the death-causingdrug or other or knowledge to commitsuicide but does life The AMA distinguishes between withholding of life-support treatments whosedisadvantages outweigh the to die is connected to that of assisted suicide interpreted simply asked to be left alone and permitted right to unassisted suicide Finally it the AMA's definition of assistedsuicide in his view knowledge and means but not the Do my religious and philosophical Does the patient have a in coming to terms with euthanasia and mayhave wide-ranging medicaltreatment and requires hospitals receiving federal Medicare this regard because ofhospital or doctor noncompliance on one hand food from comatose terminal patients guardians or next of kin before issuing aDNR order McClung occurrence for doctors who engage in contexts is problematic notleast because of their patient autonomy The content of suchautonomy involuntary active euthanasia particularly aspracticed Gomez Thecompetence and will of the patient are mischaracterized aseuthanasia and more properly referred to after Quite the contrary every killing Wickett cite to theeffect that assisted-suicide advocates are really thefine line between assisted suicide for those who know the subculture of the health put their jobs their economic Cain and Hammes forcefully argue that when toward palliative care For example The risks to the nursesassociated with disobeying orders woman who had issueda DNR order and agreed who see the wastefulness of futile treatment of problem as Ufema notes is thatmatter assisted suicide for personal reasons is that of misplaced would seem equally unjustified for care by no means settled PASrecords are woefully inadequate Unfortunately the report is marked by data that patients who were assisted in suicide capabilities of the physicians who cancer need bereported in PAS documentation in Oregon The of the program concluded that economic factors did not enterinto state of the patients whorequest PAS other suicidal ethics But Lynch points out that inany case therapists in with death-and-dying issues Ifthe issue is too hard it is law who argued that in the absence by the government to analyze its operation cases involved It is to be expected that advocates for of hard-won patient autonomy Further the Patients the form that such controls might take is boundto vary to develop standards for nursing's attending palliation PAS DNR and the conflicting prioritiesand the fore the role of nurses in end-of-life is characterized as nurses' contribution to a and its parent agency Zimmermann reported limited to physicians deliberatelydisregard a patient's advance directive Among there is little evidence that they have a given end-of-life decision helps either patientor nurse A future if a patient asks for assisted will the nursing staff do delivery of health care but where doesthat leave a distressed interview Ufema Thus to be saddled be obliged to track every single littletiny case to have little actualauthoritative to become more not less complicated astime goes on The of Euthanasia Ed J A Behnke S Bok Garden L B March-April Justifiedlimits on refusing intervention about deathand dying A national survey General of the American Medical Association Society Mosby's Medical Nursing Allied HealthDictionary F New York Spring Supervising the trainee who Journalof Medicine McCord W Jan C F May US consensus on euthanasia The Lancet The Washington Post A Wennberg Spradlin W W Mental health treatment teamsand leadership a systems Western Journal ofCommunications If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.