The Principles of Medical Ethics - Term Paper Example

When it comes or in dealing with medical practice, there are a lot of ethical and moral issues to be considered as there are practices and provisionsin medicine that are in contrast with what ethics and morality dictates. With this, it is oftentimes considered that in order to settle issues revolving several provisions in medical practice in contrary to the morality and ethics of a certain case. It is oftentimes seen that there has to be compromises to be done on both ends in order to know the possible solution to a problem. In dealing with the aforementioned issue, citing an example is vital in order to know several issues in which medical practice could sometimes in contrast with what the law, morality and ethics dictates. In this case, perhaps in medical practice, particularly in Nursing, euthanasia is the most talked about phenomenon in dealing with this kind of conflict. The website britanica.com (2007) defined this kind of practice as "also called mercy killing act or practice of painlessly putting to death persons suffering from painful and incurable disease or incapacitating physical disorder. Because there is no specific provision for it in most legal systems, it is usually regarded as either suicide (if performed by the patient himself) or murder (if performed by another)" In this case, it could be regarded in layman's term as a practice not to prolong the suffering of an ill individual through killing or eliminating life saving device in which that certain individual is dependent. Up to present, this issue has been sending a loud message how medical practice and morality contradicts with each other. Before plunging into a much complicated example concerning euthanasia, defining what morality and ethics is, is a good pendulum to assess what medical practice concerning this and the aforementioned elements does have in contrast to further know several issues concerning this. Morality is defined as "Morality is the quality of being in accord with standards of right or good conduct or a system of ideas that fall into those same categories. We often hear words about religious morality or the phrase Christian morality in society. Items that fall into the morally sound category are qualities like good, goodness, rightness, virtue, and righteousness. When talking about a moral quality involving a course of action, we think of ethics. To define morality, a person will use the rules or habits with regard to right and wrong that he or she follows. It is a complex system of general principles and particular judgments based on cultural, religious, and philosophical concepts and beliefs. Cultures and or groups regulate and generalize these concepts, thus regulating behavior. When someone conforms to the codification, you consider this person to be moral. And yet, the notion of how we ought to behave and the reality of how we do behave are varied and real morality behaves in accordance with one's perception of morality. Often, doctrines or moral duties that support the quality of an action which renders it good, is moral-And so a system of standards used to produce honest, decent, and ethical results are considered moral( allaboutphilosophy.org 2007) On the other hand, Ethics is defined as "a major branch of philosophy, is the study of values and customs of a person or group. It covers the analysis and employment of concepts such as right and wrong, good and evil, and responsibility. It is divided into three primary areas: meta-ethics (the study of the concept of ethics), normative ethics (the study of how to determine ethical values), and applied ethics (the study of the use of ethical values). If we are to look into euthanasia as a medical dilemma both ethically and morally, there are a lot of premises that would suggest how this kind of practice in medicine contradicts both ethics and morality. It is an established fact that medicine exists to develop and prolong life. If this premise is indeed the reason on why medicine practice exists, then euthanasia must be avoided. However, there are claims and premises that suggests Euthanasia as a medical practice benefits the patient, the family and the doctors or in some instances, all of them. Though beneficial or not, there are medical people who are affected of this kind of occurrence. In this case, nurses are the ones who are seen and seem to feel the effects of it. There are a lot of instances wherein nurses are the ones who are instructed to conduct the said practice as ordered by the doctors and in this case, nursing as a profession also have dilemma in initiating and doing such a practice in most of the hospitals. In contrary to the belief of many wherein nurses must abide by the instructions of the doctor, such a practice also affects nurses and nursing as a profession. In line with this Dyer (1999) uttered that "A slow, painful, undignified death is a fate that most of us would not wish on our worst enemies. Proponents for assisted suicide argue that suffering in dying is a plight that many doctors and nurses force on their unwilling patients. When a patient dying of an incurable disease begs for a quick and easy death, how should health professionals respond The question of assisted suicide, and in particular the nurse's role in assisted suicide, is a topic that concerns all nurses. A look at the background, the arguments for, and the arguments against assisted suicide may suggest answers. By definition, assisted suicide is a type of euthanasia or "good death," a term associated with ending a patient's suffering by causing death (Webster, 1995). Euthanasia is categorized as either active or passive. Active euthanasia or "mercy killing" refers to actions taken with the intention of ending a patient's life (Potter, 1997). Active euthanasia is illegal in most settings, and some people consider it to be the same as murder. Passive euthanasia refers to allowing a patient to die, making no attempt to hasten or prolong the process even if the means are available (Potter, 1997). Allowing a patient to refuse life sustaining treatment and removing a feeding tube at the patient's request are examples of passive euthanasia. The patient will die, but the cause will be a natural process" Looking alone to this premise signals an alarming fact that majority of the nurses conduct such an activity against their will. In analyzing this kind of premise, one might ask if euthanasia and the practice of medicine could meet halfway and have their own compromises in order to answer the queries regarding the contradiction of the aforementioned elements. If this is the case, is there any claim or premise that would prove the benefits of this medical dilemma And in looking into this premise, the country that is practicing euthanasia is the Netherlands. In this case we can derive the idea how morality and ethics with what prescribed by the law have something in common. The website medterms.com (2007) described it as "The Netherlands is the only country in the world where euthanasia is openly practiced. It is not specifically allowed by statute, but Dutch law accepts a standard defense from doctors who have adhered to official guidelines. These guidelines hinge on the voluntariness of the request and the unrelievable-ness of the suffering. Euthanasia and assisted suicide are defined by the State Commission on Euthanasia. Euthanasia is the intentional termination of life by somebody other than the person concerned at his or her request. Assisted suicide means intentionally helping a patient to terminate his or her life at his or her request. Under Dutch law euthanasia is the termination of life by a doctor at the express wish of a patient. The request to the doctor must be voluntary, explicit and carefully considered and it must have been made repeatedly. Moreover, the patient's suffering must be unbearable and without any prospect of improvement. Pain relief administered by a Dutch doctor may shorten a patient's life. As is the case in other countries, in this is seen as a normal medical decision in terminal care and not as euthanasia" However, despite these claims, the ethical dilemma of euthanasia is still far from being accepted and almost impossible to coincide with medical ethics in particular. Due to the fact that nurses are those who are instructed to conduct such a procedure more often than not, then they are the ones who are being put into compromise with this due to the fact that they are expected to follow the instructions of the doctors. In this case there are nurses or majority of them still opposes this kind of idea. Furthermore, SULLIVAN (2001) pointed out that majority of the nurses still opposes the idea of euthanasia as she states, "Nurses join this ethical debate for two primary reasons. First, euthanasia is legal in many forms and patients have a right to ask about it. But respect for our patients must begin with respect for us. We have a right to conscientious objection; no nurse who feels an ethical or religious conflict should feel pressured to clinically participate in euthanasia or assisted suicide. The second reason nurses need to examine the ethics of assisted suicide is to understand that in the nursing profession, disagreement and uncertainty exist. For guidance, nurses can turn to arguments by respected philosophers and ethicists. The nursing profession is grounded in values of caring nonmaleficence. Nurses have a social contract to respect and protect human life. Nurses also help the patient and his loved ones find meaning in the dying process" This premise would suggest that though they do what the doctor says or sometimes as prescribed by the patients, what they are doing is against their ethical wills. If this is the case, it would seem to appear that like any life issues, ethics doesn't seem to compromise regardless of the intent as it would always contradict its core essence of existence and like any other subject, and even euthanasia is not spared. There is something or ethics has to stand firm with its credibility and as it was accepted by the people, then it is a no surprise that if it stated its grounds and premises, then if there is a thing that contradicts it, then it would be regarded as an opposite per se. Larue (1999)in contrary pointed that "..Longevity has become a global reality. The benefits of modern health research, the conquest of childhood diseases, improved sanitation, new medications, and technical procedures have raised the projected life span for newborns and contributed to dramatic increases in world population. Unfortunately, not all long-lived individuals die peacefully. Some die painful, torturous deaths. When life is without quality, when pain and discomfort rob life of its significance, some persons cry out for release through death-a good death through euthanasia. Euthanasia has become a complex global issue for the 21st century, with different cultures wrestling with the variety of ethical, religious and legal factors involved in helping someone to die legally " If we are to analyze, sans the ethics, then there would be no discussion with regards to this kind of dilemma. But since, ethics exists and the bounds of it are being trespassed by euthanasia, then it would remain conflicting. However, there are those who still claim that people tend to become traditional and dogmatic rather than practical which oftentimes attributed to consequentialism. The website euthanasia.cc (2007) states "The first question that arises about Universal Consequentialism is: what counts as good consequences One popular answer is the one given by John Stuart Mill in his famous essay, Utilitarianism good consequences are simply happiness, and happiness is pleasure and freedom from pain - not only physical pain but also distress of other kinds. According to this view, then, the right action is that which produces the most pleasure and least pain for all those affected. Another kind of answer is also found in the works of Mill, notably in his Essay on Liberty but also in Utilitarianism: the view that good consequences depend not only on the quantity of pleasure but also on the quality of the experiences which produce it and of the human being which is developed by them. According to this second conception of good consequences, the right action is that which promotes in oneself and others what we may call a higher happiness, one which stresses self-development and the fostering of the distinctively rational nature of human beings" If people would be traditional, then the understanding of this would be a far-fetched dream and would never be able to understand the real essence of euthanasia. The dilemma that is being faced here is to kill or not to kill. Will you turn off the button or not This is still the biggest question that if one tries to answer, it would lead to a more complicated question and these queries would not be answered. This was proven in the continuation of Sullivan's article (2001) as she further pointed out "Nurses must balance their commitment to caring and beneficence with respect for the autonomy and values of patients and their loved ones. The option of assisted suicide may give a patient control over an unacceptable death, which enables her to focus on enjoying her remaining life. The option can also affect nurses' credibility, planting insecurity in patients' minds as they wonder, "Does my nurse kill patients" In addition to planning for death, nurses' desire to alleviate pain creates moral tension. Research indicates that the desire to end unbearable and protracted pain often drives the request for euthanasia or assisted suicide. Patients' fear of dying supercedes their fear of death. How would further incorporating assisted suicide and euthanasia into practice affect nurses While some nurses take a judicious look at this prospect, others view the results as a slippery slope and raise thought-provoking scenarios" These actions and doings of the nurses are still a big question to tackle and answered due to the fact that such scenarios oftentimes causes dilemma to the nurses and such things prompted them to further delve the bounds of law, morality and ethics. The claim that these subjects (euthanasia with law, ethics and morality) could meet halfway seem to be impossible. Telfer (1999) further states "There are two negative rights, found in most lists, which are particularly relevant to voluntary euthanasia. These are: the right not to be killed, corresponding to a duty not to kill, and the right to liberty corresponding to a duty to respect others' liberty. I shall say a little about each of these. The notion of a duty not to kill seems at first to rule out euthanasia of any kind, and those who oppose euthanasia sometimes seem to think that all they need to do is to say 'Thou shalt not kill' in a suitably solemn voice. But we do not regard the prohibition of killing as absolute: we may think there can be justified wars or justified capital punishment, or that killing in self- defence or defence of others is justified. And it is easier to justify voluntary euthanasia than the killing in these other cases, where the person who dies does not choose to do so. If the reason why in general we ought not to kill is that life is a person's most precious possession, then that reason can be overturned if the person no longer wants to live." This is really indeed a dilemma which is uncertain to be answered. Whatever the premise or the situation is, it would only be and would always be answered differently by the people who experience such a dilemma. Reference: 1) britanica.com (2007). Euthanasia. Opened May 23, 2007 URL available http://www.britannica.com/eb/article-9033299/euthanasia 2) allaboutphilosophy.org (2007). What is the definition of morality Opened May 23, 2007 URL available http://www.allaboutphilosophy.org/definition-of-morality-faq.htm 3) Wikipedia.com (2007) Ethics. Opened May 23, 2007 URL available http://en.wikipedia.org/wiki/Ethics 4) Dyer D. (1999) Assisted Suicide. Opened May 27, 2007 URL available http://juns.nursing.arizona.edu/Dyer.htm 5) medterms.com (2007) Definition of euthanasia. Opened May 27, 2007 URL available http://www.medterms.com/script/main/art.asparticlekey=7365 6) SULLIVAN (2001).Ethics of Assisted Suicide and Euthanasia. Opened May 28, 2007. URL available https://www.springnet.com/content/nm/9903/ethics.htm 7) Telfer (2007).Philosophical approaches to death with dignity. Opened May 28, 2007.URL available http://www.euthanasia.cc/telfer.html 8) Sullivan (2001) ).Ethics of Assisted Suicide and Euthanasia. Opened May 28, 2007. URL available https://www.springnet.com/content/nm/9903/ethics.htm 9) Telfer (2007).Philosophical approaches to death with dignity. Opened May 28, 2007.URL available http://www.euthanasia.cc/telfer.html 10) Read More