Ethical Issues Involved in End-of-Life Decision-Making sample essay

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Ethical Issues Involved in End-of-Life Decision-Making sample essay

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End-of-life decision-making entails looking into ethical, cultural, as well as, legal concerns. All of the aforementioned has to be carefully considered if one has to decide to end his or her own life. This paper will look into the ethical, cultural, and legal issues that go along with end-of-life decision-making. It also intends to state what therapist can contribute in his or her participation in the discussion of end-of-life decision making together with his or her colleagues, as well as, patients & their families. Ethical Issues Involved in End-of-Life Decision-Making

There are ethical indispensable issues involved in end-of-life decision-making and some are the following: First of all is the issue on utilitarianism, since this is said to be the “foundation of morals” then it is linked to the end-of-life decision-making as well (Ebenstein & Ebenstein 1991, p. 580). Here, it is said that “actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness” (Ebenstein & Ebenstein 1991, p. 580). “Happiness” here is regarded as the “absence of pain” and “unhappiness” is the presence of the aforementioned (Germino 1972, p.

240). It is an issue because happiness is not all that matters in ending a life (Ebenstein & Ebenstein 1991, p. 580). In addition to that, how can one be sure that the absence of pain, which is death in this case, will lead to happiness of the person chiefly involved in the end-of-life decision-making (Ebenstein & Ebenstein 1991, p. 580)? The same is true with the family of main person involved, will they be experience happiness if the patient opts to end his or her life voluntarily instead of waiting for his or her ‘natural’ death to take place (Ebenstein & Ebenstein 1991, p.

580)? Second is the issue related with the Kantian model or what is technically referred to as the “deontological theory” (Bennagen, 2000, p. 50). This states that a person has to fulfill a certain responsibility or duty as a part of his objective (Bennagen, 2000, p. 50). This statement now seems to be irrational since the concrete definition of a responsibility or duty is not provided (Bennagen, 2000, p. 50). For example, is it the person’s responsibility to subject himself or herself to death (Bennagen, 2000, p.

50). It may be his or her right to choose to live or die but if asked if it is his or her responsibility remains a big question (Bennagen, 2000, p. 50). Last but not least, there are some health care providers who are extremely conscious about “how much money is spent on patients and how effectively it is spent” (Hinman, 2000, p. 9). Some individuals feel that the amount of money spent on terminally ill patients is not really worth it (Hinman, 2000, p. 9).

This is highly unethical; it is as if one is saying that money is far more important than actually trying to save a life (Hinman, 2000, p. 9). Cultural Issues Involved in End of Life Decision-Making Furthermore, there are several cultural issues involved in end-of-life decision-making as well and some are the following: First of all, there are some members of a cultural minority that prefers to be spoken to directly with regards to the disease that they are going through (Searight et. al. , 2005, p. 516). Although, there are also some who do not (Searight et.

al. , 2005, p. 516. ). In fact some immediate family members request that they be the ones to be spoken to only since they believe that informing the patient will only make the patient feel worse and will eventually negatively affect him or her (Searight et. al. , 2005, p. 516. ). The same is true when it comes to making decisions with regards to the medications/treatment that the patient will undergo; some family members prefer that they be the ones to be in charge about this instead of the doctor and/or the patient (Searight et. al. , 2005, p. 516. ).

Second, patients who belong to a cultural group sometimes opt “not to be directly informed” about the disease he or she is going through especially if it’s a life-threatening one (Searight et. al. , 2005, p. 516. ). Third, some patients also would prefer to carry out certain religious activities and spiritual traditions so as to assist in their medical treatment, and eventually, their healing as well (Searight et. al. , 2005, p. 516. ). Last but not least, some patients take into consideration their beliefs and outlook when it comes to the “medical experts, suffering, as well as, the afterlife” (Searight et.

al. , 2005, p. 516. ). Legal Issues Involved in End-of-Life Decision-Making There are also certain legal concerns when it comes to end-of-life decision-making: Most of the States disallows physician-assisted suicide; for example in New York, it is unlawful “under the general homicide laws” (Legal Status of Assisted/Euthanasia in the United States, n. d. , n. p. ). The same is true in Virginia wherein “there is no law that actually covers physician-assisted suicide but there is a statute which imposes civil sanctions on persons assisting in a suicide” (Legal Status of Assisted/Euthanasia in the United States, n.

d. , n. p. ). My Participation as a Therapist in the Discussion of End-of-Life Decision-Making along with Colleagues There are several things that I may contribute as a therapist to my colleagues. I can share with them my knowledge with regards to how to communicate with patients of diverse culture (Searight et. al. , 2005, p. 521. ). I can request them to “demonstrate an interest to the patient’s cultural heritage” for them to be able to give the patient “culturally-sensitive care” (Searight et.

al. , 2005, p. 521. ). In addition to that, I will also let them know that it is important to give the patient “autonomy” especially when it comes to “non-disclosure of medical information and family-centered decision-making” because through the aforementioned, the patient will eventually feel that their “cultural norms are being respected” (Searight et. al. , 2005, p. 521. ). My Participation as a Therapist in the Discussion of End-of-Life Decision-Making along Patients and their Families

Finally, I may also be of great assistance to patients and their families with regards to their discussion of end-of-life decision-making through the following: 1) I will respect it if the “patient prefers that his or her family members be the recipients of diagnostic and treatment information”; 2) I will make sure first who is the member of the family who’s appointed to make treatment decisions before speaking to him or her or giving them an advice with regards to the medical procedures or treatment; and 3)

I will help them find another therapist/physician in case they are uncomfortable with the current one and especially if their therapist/physician “belong to the different ethnic background” (Searight et. al. , 2005, p. 521. ). As a therapist, I will try to advise them the best I can while considering their cultural background, incorporating my ethical/moral standards, and making sure that I will abide by the laws as well.


Bennagen, P. (2000). Social Economic and Political Thought. Q. C. : UP Press. Ebenstein, W. and Ebenstein, A. 1991, Great Political Thinkers: Plato to the President.Harcourt Brace, Forth Worth. Germino, D. 1972, Machiavelli to Marx: Modern Western Political Thought. University of Chicago Press, Chicago. Hinman, L. M. (2000). Ethical Issues in End of Life Decisions: A Guide to Understanding Differences. Retrieved April 28, 2008 from http://ethics. sandiego. edu/presentations/sharp/index_files/v3_document. htm Legal Status of Assisted/Euthanasia in the United States. (n. d. ). Retrieved April 28, 2008 from http://www. nightingalealliance. org/pdf/state_grid. pdf Searight, H. R. & Gafford, J. (2005). Cultural Diversity at the End of Life: Issues and Guidelines for Family Physicians. American Family Physician, 71(3), 515 – 522.

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