Palliative Care: Reflective Media of Laurie Strike - Essay Example

Palliative Care Insert Insert 05 May Palliative Care Reflective media report of Laurie Strike – A Terminal Cancer Patient seeking Euthanasia The patient Laurie is a terminally ill patient diagnosed with cancer. He is in advanced age and the complications of the disease have wasted greatly. Despite exploring various treatment options for his conditions, he does not seem to get any better. This makes him seek assisted euthanasia to avoid further suffering. Moreover, the catheter and the colostomy bag are a burden to handle, and he is further unable to move freely. Having fulfilled his family obligations, he feels that he has no reason to live and ask his family to support his decision to have his life ended. The Illness Cancer is an incurable condition that is growingly becoming common among the elderly people as well as a bigger segment of the population. With early diagnosis and timely intervention, the patient’s quality of life can be gratefully improved. The challenge of managing chronic pain usually makes many patients to give up the fight to carry on with life. However, there has been progress in better pain management that seeks to extend the life of patients and improve their condition, thus limiting the option for assisted euthanasia. The family The family is the immediate primary care giver that should be listed in the care of the patient; it forms a useful link in the provision of service in palliative care. They provide psychosocial support and necessary home-based care for the patient. Key decisions that affect the patient’s medical condition should aim to incorporate their decision. Conflict of interests over the individual and family arises when the family’s expectations exceed the individual’s, hence the need to balance societal expectations to meet individual needs. The health care team The health care team should provide the best care and support for the patient to meet varying needs of the patient. They have to stick to the guidelines of the nursing or medical care when managing patients in palliative care or at any stage of medical treatment. The necessary link is provided in the Australia guidelines for medical provision of palliative care that stipulates the standards of practice, which should be used as a yard stick for performance. The patient rights are usually guided by the code of standards for practice outlined for reference. The key obligation should always be to ease pain and prolong lives, which are aspects of good care. Death in the social context Laurie’s experience with a terminal illness depicts the moral lessons that the media shapes following events that pity the societal structures in explaining causation that draws parallel from the various arguments, which point to the ideal situation in which death should occur. This is often faced with different contrasts and in some instances, unexplained death is treated as occurring due to human error, medical negligence or self inflicted as painted in the western media. People who die alone are seen as lacking social bonds and live in isolation. As such, family members will strive to provide the ideal environment for dying to prevent blame from the society. The media has shaped our thinking to believe that when death occurs in isolation, it is justified to believe that it is undesirable (Seale, 2004). Terminal conditions are usually interpreted based on the context. When one emerges through various stages of the illness having coped with the challenges, he is treated a hero and the success is celebrated widely. This is evidenced by the various analogies used to describe the situation. Women in the English speaking world who survive cancer have been defined as going through a journey of personal discovery (National palliative care program, 2014). The main issues identified and explored from varying viewpoints This leads us to the critical issue regarding right to life. Dying in isolation is usually treated as a disgrace and a sign of unresponsiveness on the individual. When death takes place in isolation, one is regarded with suspicion and sometimes labeled as not being responsible. The division that plays in public as a result of the conflict between the individual and the society often fails to capture the patient’s side of story. For instance, a terminally ill patient faces the dilemma of finding a balance over his/her choice for medical treatment and the society expectation on the right way to die (The National Palliative care, 2014). Hillman (2012), from the reflection of an intensive care physician, recognizes the experience the aging population go through as determined by the societys expectation. The belief that conventional medicine would reverse the effect of aging has compromised the quality of life. He points to the dilemma of having to receive phone calls from relatives who would want him to assist their patient seek voluntary euthanasia (Duffy, 2011). Moreover, he recognizes that modern medicine does not offer much of the benefits it is touted for. Aging should be regarded as inevitable and a supportive environment offered for the terminally ill patient. He further adds that 70 percent of patients are likely to die away from t heir homes; a research shows that not all aging population benefits from prescription drugs and intensive care treatment. We can then ask the question if it is right to deny a patient the autonomy to live (Rodney, 2008). This requires balancing act by looking at the whole picture. Ethics would mean acting responsibly and having the interests of others in mind (Paterson & Sorell, 2012). At the same time, we have a duty to self and others. This is the basis of social contract that promotes peaceful existence in society. Doctors are bound by the Hippocratic Oath and they have a duty to protect and save life, which prevents them for allowing the patient’s will to dominate. Given that the patient also has the sovereign life to live, it is not appropriate to take his life based on divine laws; it is also important to respect those who care (Birnbacher & Dahl, 2008). Questions that may arise following Laurie’s case may be summarized as follows: first, what would be the reaction if a medic in palliative care consents to his request for assisted death, which is against Australian Regulation? Is it justified to refer his case for palliative care to other quarters? A health promoter should rally politicians and exit strategy targeting social groups that support the course. This brings us to the argument whether attention should be shifted to allow support groups in the debate. One would also like to establish is screening medical employees is a viable option in the future. Nevertheless, cases have been reported where employees have been implicated in assisting patients to access Euthanasia (Pereira et al, 200) Death and dying in the Australian context The Australian Government remains adamant over the legislation to allow for voluntary euthanasia tracing back to the time when the practice was briefly allowed in 1996 by the state. The federal government would later rescind this legislative piece after two years and the country has since censored the practice in all avenues. The practice is illegal and one who commits it may be liable for imprisonment. This however has not escaped critics from many fields. While the state has censored all media outlets, information on euthanasia can still be accessed by the public despite the strict legislation that exposes them to other forms of violent deaths, hence the need to strike a balance (Martin, 2011). The Australian Palliative care guidelines recognize the care of the terminally ill patients as paramount, and seek to improve in the provision of care to this group of people, recognizing their dignity and that of their families without compromising on care offered. However, unresolved questions have cropped up. Principles that call for balancing the practice in palliative care cut across patient’s self- direction verses caregivers’ role in providing services. Concerns over non- abandonment have been disputed by medics that require strict discipline on the doctors’ part (Pereira et al, 2008). Barriers to the Australia palliative care provision It is clearly evident that efficient networks in the provision of palliative care are missing; we particularly see lack of coordination in Laurie’s case when the necessary referral links miss and are not clearly shown in what steps the medical team is taking to manage the situation. Community is not pictured working together, and primary care givers have no active role in the patient situation. Laurie admits the complex nature of seeking medical care from different places, a pointer to the fact that palliative care does not meet adequately, the needs of people in their homes and community. This may point to the need to extend coverage of Australia palliative needs for meeting primary care services and other special care needs. The provision in standard 13, according to the guide, stipulates care based need that suits different settings according to the patients’ need across the referral ladder (Standards for providing Qualitative Palliative Care for all Australians, 2005). The Australian provision expects better chronic pain management for the terminal ill patient to die in a dignified manner, an aspect that misses in Laurie’s case when he admits incessant pain as a reason to seek assisted euthanasia (Terminal Cancer Patient Laurie Strike says he wants to end his own life by voluntary Euthanasia, 2014). Further, the symptoms accompanying the disease are not adequately managed. The patient complains of not being able to move easily and admits that the catheter and the colostomy bag have becoming a burden. A poor communication skill by the Nurses is pointed at the phase where a medical attendant asks Laure if he may opt for suicide. The Hippocratic Oath bounds the medical professional to such practices since they are obliged to medical ethics code of conduct that aim to improve the quality of life of in palliative care by helping to prolong life. The provision of patient receiving medical care is critical in the palliative care guidelines, which should suit his choice; however, this is seen to lack in Laurie account of seeking care in different places. An effective response to palliative care would have been flexible to meet the changing needs of patients; it also offers provision for residential and other services away from home. The role palliative care The WHO defines palliative care as geared towards improving the outcome of the patient overall health condition. It extends this to the family of the patient and gives the nature of condition as one that is debilitating and causing suffering to the patient. The care undertaken in such circumstances include early diagnosis, continuous assessment, and managing pain and other supportive services. Palliative care provision The 2005 Australian guide for palliative care gives guidelines for the practice in different contexts that are used as a manual for palliative care in Australia. The standards of providing palliative care are based on 12 premises: The first standard guides decision making and provides guide to the care given at health units; it recognizes the role of respecting culture and allocating resources for palliative care. Holistic needs of the patient and the family are recognized in the second standard, which ensures that the context of care is exhaustive in meeting all of societal needs. The third component involves continuous assessment, which is geared towards updating the patient’s progress during care. Building networks for care and coordination are covered in the fourth standard, which allows for meeting referral needs of the terminally ill. Information is very important in furnishing the gaps and relaying progress that is necessary to caregivers who are close to the patients. The seventh standards aim to improve the overall quality of life by incorporating desirable cultures and values. These are further supported by the societal platforms for addressing grievance in the eighth standard. The ninth standard seeks to builds community capacity to cope with issues; this is closely followed by the tenth standard that seeks to ensure palliative care is accessible to all who need the services without discrimination. Research and quality care are instrumental that is furnished in the eleventh standard. Finally, the twelfth standard recognizes the role of volunteers and employees to deliver palliative care based on the needs of the patients (Standards for promoting Quality palliative care, 2005) Coping with the issues raised as a Nurse Issues arising in the death and dying debate revolve around the society, individual dilemma and a balance between professional and patient autonomy. Nurses who have a different opinion regarding euthanasia should not be compelled to consent to the practices. In Laurie’s case the Nurse may be bound by medical code of conduct to exercise moral ethics hence liable to make an independent choice. As a Nurse my greatest duty would be to provide the best care possible while seeking to balance the patient need. Patients deserve dignity and the choice over their treatment option should be respected. In situation where conflict arises over the patient demand like in Laurie case I will strive to improve in the care of terminal illness with a goal of improving the patient quality of life and prolong life. Suggestions for change in the palliative care Bailey (2013), on coping with the fear of talking over euthanasia, points to the following concerns as put forth by the NHS. Goal number one should be to make the public informed about the issues surrounding the death and dying to fill the gap left in information. Second, it is important to build capacity of the nurses to respond better to the various dilemmas that surround the dying experience. There is need to improve investment in Palliative care through research to improve the quality of life for terminal ill patients. This would improve the life outcome and reduce the demand for euthanasia. Laurie is battling chronic pain that makes him susceptible to give up the fight to stay on. With better pain management of the discomfort surrounding the terminal condition, the patient may choose to live. It is important also to present the patient with factual information in the event he requests for assisted Euthanasia (Pappas, 2012). This would inform the decision of choice. The legal and medical stance regarding euthanasia should guide the patient in accessing the rationale of choice. It is important to allow the patient to make decision over medical choice, and emphasis should regard providing quality life and respect for the patient. The Australian Legislation remains tight over euthanasia, which makes Laurie to have minimum options. Ability to explore their own coping mechanism Laure is faced with the different options to cope with his medical conditions. It is necessary to present him with the legal and medical provision on the issue, which will inform better decision. Currently Australia Legislation prohibits euthanasia in any form. Medical practitioners are also barred from giving consent to the practice. However, the Australian standards for palliative care outline best practices that are expected to improve the outcome of life for the terminally ill. With improvement in care and better pain management, Laurie can cope with his condition and his life may prolong drastically. Provision number 13 gives room for tailoring the medical intervention based on the progress of the disease. This would allow for effective response and improved outcome in care (Gorsuch, 2009). Laurie has a capacity to make decision over the choice to continue living, which according to me would be considered admissible based on the circumstance he was facing. The right to consent should not be denied to willing adult. This regulation can benefit from legislative changes to include debilitating illness or chronic conditions. Such reform should seek to change the legislation that depicts voluntary euthanasia as an offense punishable through imprisonment (NHS, 2012). References Birnbacher, D., & Dahl, E. (2008). Giving Death a Helping Hand: Physician-Assisted Suicide and Public Policy. An International Perspective. Berlin, Germany: Springer. Australian Nursing Federation. (2012). Voluntary Euthanasia/assisted suicide Duffy, M. (2011). Voluntary Euthanasia-is there a Slippery Slope?. The Sydney Morning Herald. Retrieved from http://www.smh.com.au/federal-politics/society-and-culture/blogs/crime-and-punishment/voluntary-euthanasia--is-there-a-slippery-slope-20110310-1bp7b.html. Gorsuch, N. (2009). The Future of Assisted Suicide and Euthanasia. NJ, USA: Princeton University Press Hillman, K. (2012). Reflection on the dying from an intensive care Physician. Retrieved from https://ama.com.au/ausmed/node/4114 Martin, B. (2011). Deadly censorship games: keeping a tight lid on euthanasia debate. Retrieved from http://theconversation.com/deadly-censorship-games-keeping-a-tight-lid-on-the-euthanasia-debate-2549. NHS. (2012). Euthanasia and assisted suicide. Retrieved from http://www.nhs.uk/conditions/Euthanasiaandassistedsuicide/Pages/Introduction.aspx Pappas, D. (2012). The Euthanasia/Assisted-Suicide Debate.CA, USA: ABC-CLIO. Paterson, M., & Sorell, T. (2012). Assisted Suicide and Euthanasia: A Natural Law Ethics Approach. Hampshire, England: Ashgate Publishing, Ltd. Pereira .J et al. (2008). The response of a Swiss University hospitals’ palliative care consultant team to assist suicide within the institution. Palliative Medicine, 22(5), 659-667 Rodney, S. (2008). A Good Death: An Argument For Voluntary Euthanasia. Victoria, Australia: Melbourne Univ. Publishing. Seal, C. (2004). Media constructions of dying alone: a form of ‘bad death’. Social science & Medicine 58(5) 967-974. Standards for providing Qualitative Palliative Care for all Australians. (2005). Palliative Care Australia. The National Palliative Care. Providing culturally appropriate palliative care to the Aboriginal and Torres Strait Islanders people. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/1AB857E724E8DBDCCA257BF0001D7A0B/$File/principles.pdf. Terminal Cancer Patient Laurie Strike says he wants to end his own life by voluntary Euthanasia. (2014). ABC News. Read More