Encapsulation Of Local Culture And More With Practice †Free Samples

Questions: 1. Is Mr B legally able to refuse the provision of life sustaining nutrition and fluids? 2. If we comply with Mr Bs request, does this constitute euthanasia? 3. What is the difference between withdrawal of treatment and euthanasia? 4. What risks, if any, might staff face if they comply with his request? 5. On a professional level, can you personally refuse to comply with Mr Bs request? Answers: Introduction: Health Care is now providing us with a lot of options and benefits which had been unimaginable a few decades ago. The most important necessity of human civilization has evolved drastically in the past few decades by the virtue of technological innovations and the implementation of different evidence-based practices in the healthcare scenario. One of the most important benefits that the healthcare service now provide is a person centred and specialized end of life residential care which has eased the restrictions of many critically ill palliative patients. End of Life Care usually into supporting and caring for a patient that is critically ill for a prolonged period of time and is completely dependent on the care provider for basic necessities of everyday life. The improvements of healthcare has Incorporated marriage has made end of life care easy and effective while integrating holistic nursing care to the concept in an attempt to reduce the restrictions and difficulties that a palli ative patient goes through every minute of every day (Parsons et al., 2010). However despite all the innovations and advancements, there are still a few issues that an end of life care receiving patient faces. A very significant and frequently observed challenge that a palliative patient goes through while in a comprehensive end of life care is the dependency and restrictions. It has to be understood that are critically ill or disabled palliative patient has to depend on the care provider for each and every aspect of daily life starting from eating bathing to even moving if possible at all (Phua et al., 2015). The dependency on the care provider for the purpose of living every day often is a huge psychological burden on the patient, and most of them often lose the will to live any longer. This assignment will attempt to discover the end of life issues faced by a patient and voluntary elective death requests with respect to health care ethics and laws. Case description: This case study represents the 48 year old patient Mr B, who had went through a spinal cord injury I had to suffer from quadriplegia. Now it has to be mentioned in this context that quadriplegia is a paralysis of all four limbs which is generally brought about by a severe injury to the spinal cord. This type of paralysis is mostly irreversible and restricts any movement by the patient suffering from it without assistance. It has to be understood that a quadriplegic patient is cognitively intact, capable of all normal brain functions although the patient is capable of any activity. The patient in the case study as well had been capable of cognitive functions es but was completely dependent on the end of life care he was receiving in the nursing home for everything else. Now it has to be mentioned here that prior to the accident, the patient had been a lively young energetic man with a profession in the industry of adventure tourism. The accident and the mobility restriction therefore can be considered a huge burden on the consciousness and psych of the patient. However, the patient had been very courageously went through the quadriplegia for a prolonged period. However recently the condition of the patient had deteriorated significantly and he had been unable to receive nutrition in his own and has to be fed through feeding tubes. In fact even his respiration needed to be assisted by a diaphragmatic pacing. All the added complexities had been facilitating extreme stress and had been a contributing factor behind the patient losing his will to live any longer. That is the reason the patient requested that his tube feeding should be cased and he requested to die peacefully. However, there are various different laws and health care policies that define the use of assisted death or the broader concept of euthanasia. Question 1: The end of life medical decision is a very delicate subject and different nations have differential policies and protocols regarding the end of life medical decisions that a patient can take. In the most of the developed nations the right to die is an operational health law. However in order to be able to exercise the right to die, the patients will need to be in a competent cognitive health. In case of rightfully competent patient the option to refuse life sustaining treatment and nutrition is legal in many of the developed Nations (Bloomer et al., 2010). Considering the Healthcare law and practices of Singapore, the concept of Euthanasia and assisted suicide is illegal and is considered a criminal offence. Hence the concept of assisted suicide or providing the means to the patient to directly end their life the targeted measure is completely illegal in Singapore and health law. According to the authors by the virtue of s 309 of the Singapore Penal Code any abetting direct Euthanasia and attempted suicide is considered a criminal offence and any person any person assisting the procedure will be punished with imprisonment for even leading up to 10 years and will also have to submit a monetary fine. Hence, considering the engaging indirect active Euthanasia for assisted suicide will cost the Healthcare professionals associated with it criminal offence with respect to the s309 and s107 codes. However it has to be mentioned that under the AMD act, the patients going to incurable critical illness of disability with no hope of recovery can legally refuse the continuation of life sustaining mediation (Moh.gov.sg., 2018). Similarly in case of Australian law, an adult patient with optimal cognitive health and competency has the right to refuse any life sustaining treatment as well. Hence, according to the health care laws and regulations of both Singapore and Australia, the patient in the case study had complete rights to refuse the life sustaining treatment. Question 2: Euthanasia can be considered a considerably controversial topic in terms of the health care and there are numerous laws and protocols regarding the practice of euthanasia in the different nations. According to the Bloomer et al. (2010), Euthanasia can be defined as intentionally causing the death of the patient with the underlying motive of benefiting the patient and protecting the patient from any further suffering. The different forms of euthanasia, it can be voluntary where the patient will give competent and complete consent to the action that will eventually cause his or her death. The second type is non voluntary where the patient involved will not provide competent consent on where is regarding the euthanasia. The last type of euthanasia is involuntary will inevitably die due to it. Now each of the type mentioned can be further subdivided into active and passive form of euthanasia. In the active form of euthanasia the actual act that will cause the patient's death will be a di rect and it will not depend on any other confounding factor rather than the normal metabolic processes of the patient's body (Martin, 2010). On the other hand the passive form of euthanasia generally involves the natural causes of death. In this case, the healthcare professionals are the family of the patient usually takes the resistance of discontinuing or withdrawing medical treatment or life-sustaining methods so that the patient will eventually die (Ebrahimi, 2012). This type of euthanasia is considered to be the most merciful to the patient as the patient will be released from the suffering of the treatment methods and the critical illness that he is going through. Hence, it can be mentioned that if the life sustaining nutrition is discontinued are withdrawn from the patient Mr B then the healthcare professionals will not constitute euthanasia. This verdict is justifiable as patient himself has requested to the withdrawal of life-sustaining nutrition so that he can eventually the die, hence due to the withdrawal when the patient eventually dies, the death of the patient is considered as a direct result of the wishes of the patients and not due to the act of any other individual (White Willmott, 2012). Question 3: Euthanasia according to many authors is very different from withdrawing any life-sustaining treatment from a patient, when considering the point of view of a medical practitioner. It can be mentioned that euthanasia is constituted only when the patient is provided a direct means of death. Along with that euthanasia can be carried out with or without detect consent from the patient as well in case of involuntary euthanasia (Goldney, 2012). In case of withdrawing or discontinuing a life sustaining treatment on nutrition is not a direct at that could lead to instantaneous death of a patient. It has to be understood that in this case the patient and his cognitively completed decision to see any treatment and eventually face death is considered to be autonomous decision of the patient entirely. According to the Medical Treatment Act of Australia patient on his legal guardian can refuse continuation of any medical treatment or life sustaining care procedure if it is of no beneficial use of the patient or is not adding to any possibility of recovery. In this provision the main contribute in fact behind the withdrawal of the medical therapy or treatment is to relieve the pain suffering and discomfort that the patient is going through and letting the nature take the cause of death with the patient providing him ultimate relief (Alberthsen et al., 2013). According to the author the most important difference between kids drawing treatment and carrying out euthanasia is the fact that in case of euthanasia the patient is given a direct method of instantaneous death with or without competent consent of the patient. Whereas withdrawing treatment is considered as Justice by mercy as the patient is given the opportunity to attend natural death by discontinuing any complicated treatment procedure (Bartels Otlowski, 2010). And the eventual death of the patient is considered to be the consequence of the autonomous and valid decision of the patient himself. According to the law of good medical practice, withholding treatment is classified as the patient's own underlying conditions leading to death rather than a direct act by a medical care provider. Hence withholding treatment is completely different from Euthanasia in accordance with the good medical practice of any medical practitioner (Krishna, 2014). Question 4: Although the consent for withdrawing the life sustaining treatment comes directly from a cognitively components patient. There are a few legal issues and restrictions that Healthcare professional may face while listening to the request of the patient. In case of both Singapore and Australia the withdrawal of life support treatment or facility is lawfully justified in case that informed consent and inform if you still has been taken from the patient. Good medical practice constitutes of the medical practitioner engaging in a filthy practice that is based on school principals of Healthcare integrity truthfulness Fidelity compassion and confidentiality (Toh Yeo, 2010). The most important consequence of adhering to the request that the patient has made for a natural death following withdrawal of life-sustaining fluids can be considered the moral distress and deletion of professional ethics when it comes to providing care and support to the patients (Murugam, 2016). Along with that another very important risk that the health practitioners can be faced with is the account of negligence to the care needed by the patient despite the patient refusing it. It has to be understood that there is a fine line between passive voluntary euthanasia and withdrawal of life sustaining treatment. Hence the medical practitioners associated with complying with the request of the patient must have thorough documentation and follow the legal protocol for the entire procedure so that there is no confusion regarding this activity being practice of euthanasia in any circumstances (Pereira, 2011). Question 5: According to the provisions of patient centred care, adhering to each and every wish and Desire expressed by the patient or his family members is the most important area of practice standard in case of health care delivery both in Australian and Singapore and context. However when a patient willfully decides to discontinue any medical therapy that can potentially lead to the consequences of the patient there are certain professional provisions which can allow how medical practitioner to refuse engaging in such an activity. Conscientious objection can be considered a professional provision in the healthcare delivery that provides the opportunity to the healthcare professionals to consciously refuse to participate in any medical practice on organizational procedure that clash with the moral obligation and professional ethics of that particular individual (Fletcher, 2015). However it has to be mentioned in this context that conscientious objection is only valid when there is a distinctly model motivation behind the objection of a healthcare professional. It should never be based on personal convenience or prejudice and it has to be performed on the basis of autonomous informed and critically reflective choice at all circumstances (Dworkin, 2011). In this case, as the patient has been going through condition that was a reversible and no amount of therapy or treatment could provide any potential possibility of recovery of the patient, the conscientious objection can be very difficult to establish. It has to be understood that the condition of the patient has been deteriorating everyday and the existing treatment procedures for only increasing the difficulties and complications of the patient. Hence the most ethical and morally correct decision at this stage should be relieving the patient of any pain or suffering that he might be going through and provid ing him the opportunity to embrace at its most natural course. Hence, it can be mentioned that under as the treatment procedure or the life sustaining fluids in this case were only prolonging the inevitable death of the patient (Caresearch.com.au. 2018). Hence the moral justification of continuing the service despite the competent consent of the patient and his family members to withdraw the LST is not valid. Hence, personally I cannot refuse the desire expressed by a mentally healthy and competent patient. Conclusion: On a concluding note it can be mentioned that the importance of the end of life care is optimal to the health care industry. Although the continuation of the end of Life Care should always depend on the needs and desires of the patient who is receiving the palliative care. It has to be understood that the will to live is very important for any human being to continue to sustain a complex and difficult treatment procedure which only leads to more suffering, and in cases where the patient has no hopes of recovery at any circumstances the patient has a right to refuse to the complicated treatment procedure and embrace death in peace. It also has to be mentioned that euthanasia can be brutal while the patient is being given I did it means to end his or her life and the moral stress of ending a life consciously can also be a huge psychological burden on the healthcare professionals associated. That is the reason many healthcare professionals exercise their rights to conscientious objectio n when they have to undergo a procedure that can lead to direct or indirect euthanasia. Although the case study utilized for this assignment represents a patient who has wished to discontinue life-sustaining fluids and let nature take its own course for eventual death which is not necessarily a practice that can be considered as euthanasia. The moral distress in this case is also much lower as the patient is not being provided a direct means two and his life but is being given an opportunity to see any suffering that the medical treatment is causing him and wait for his eventual death in peace and with his loved ones. Hence the provision of conscientious objection does not apply here and I would not have refused the patient of his last wish and would have given the opportunity to die peacefully. References: Advance Medical Directive Act | Ministry of Health. (2018).Moh.gov.sg. Retrieved 22 February2018,fromhttps://www.moh.gov.sg/content/moh_web/home/legislation/legislation_and_guidelines/advance_medical_directiveact.html Alberthsen, C., Rand, J. S., Bennett, P. C., Paterson, M., Lawrie, M., Morton, J. M. (2013). Cat admissions to RSPCA shelters in Queensland, Australia: description of cats and risk factors for euthanasia after entry.Australian veterinary journal,91(1-2), 35-42. Bartels, L., Otlowski, M. (2010). A right to die? Euthanasia and the law in Australia. Bloomer, M. J., Tiruvoipati, R., Tsiripillis, M., Botha, J. A. (2010). End of life management of adult patients in an Australian metropolitan intensive care unit: a retrospective observational study.Australian Critical Care,23(1), 13-19. Dworkin, R. (2011).Life's dominion: an argument about abortion, euthanasia, and individual freedom. Vintage. Ebrahimi, N. (2012). The ethics of euthanasia.Aust Med Stud J,3, 73-5. Ethical Issues. (2018).Caresearch.com.au. Retrieved 22 February 2018, from https://www.caresearch.com.au/caresearch/ProfessionalGroups/NursesHubHome/Clinica l/EthicalIssues/tabid/1473/Default.aspx Fletcher, J. F. (2015).Morals and Medicine: the moral problems of the patient's right to know the truth, contraception, artificial insemination, sterilization, euthanasia. Princeton University Press. Goldney, R. D. (2012). Neither euthanasia nor suicide, but rather assisted death.Australian New Zealand Journal of Psychiatry,46(3), 185-187. Ho, Z. J. M., Krishna, L. K. R., Yee, C. P. A. (2010). Chinese familial tradition and Western influence: a case study in Singapore on decision making at the end of life.Journal of pain and symptom management,40(6), 932-937. Krishna, L. K. R. (2013). Personhood within the context of sedation at the end of life in Singapore.BMJ case reports,2013, bcr2013009264. Krishna, L. K. R. (2014). Is the encapsulation of local culture and mores within the practice of palliative care liable to result in a slippery slope to euthanasia in Singapore?.Pall Med and Care. Martin, B. (2010). Techniques to pass on: technology and euthanasia.Bulletin of Science, Technology Society,30(1), 54-59. Murugam, V. (2016). Terminal Discharges and Passive EuthanasiaTwo Fundamentally Different Entities That Should Not Be Likened to Each Other.Asian Bioethics Review,8(4), 290-301. Parsons, C., Hughes, C. M., Passmore, A. P., Lapane, K. L. (2010). Withholding, discontinuing and withdrawing medications in dementia patients at the end of life.Drugs aging,27(6), 435-449. Pereira, J. (2011). Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls.Current Oncology,18(2), e38. Phua, J., Joynt, G. M., Nishimura, M., Deng, Y., Myatra, S. N., Chan, Y. H., ... Wahjuprajitno, B. (2015). Withholding and withdrawal of life-sustaining treatments in intensive care units in Asia.JAMA internal medicine,175(3), 363-371. Soh, T. L. G. B., Krishna, L. K. R., Sim, S. W., Yee, A. C. P. (2016). Distancing sedation in end-of-life care from physician-assisted suicide and euthanasia.Singapore medical journal,57(5), 220. Toh, P. S., Yeo, S. (2010). Decriminalising Physician-Assisted Suicide in Singapore.SAcLJ,22, 379. White, B., Willmott, L. (2012). How should Australia regulate voluntary euthanasia and assisted suicide?.