Euthanasia: Autonomy and Spiritual Care

In this essay I will argue that euthanasia should be provided to patients who are chronically and/or terminally ill if those patients request as much. Euthanasia is the intentional putting to death of a person to lessen the pain and suffering for compassionate motives someone who are chronically and/or terminally ill, when those persons requested to die (Grainger, 2011). In this way, I would like to focus on active voluntary euthanasia. Active voluntary euthanasia is the person makes the choice actively to end of their life through requested for assistance from others that allow them to end of their life (Grainger, 2011).In this essay, I will use preference utilitarianism perspective, and apply with autonomy, role of nurses as patient advocate in end of life care, professionalism of nurses with apply ANMC code of ethics value statement two and conclude my arguments. Firstly, utilitarianism is one of the well known consequentialist theory (Kerridge, Lowe, & Mcphee, 2005).

Utilitarianism’s perspective, “the central principle of utility is absolute and all moral rules, actions or behaviours must be justified solely on the basis of an analysis of their consequences” (Thompson, Melia,& Horsburgh, p, 11, 2006).Therefore, Killing, euthanasia may justifiable in certain circumstances (Thompson, Melia, & Horsburgh, 2006). Also, John Stuart Mill argued that individuals are, lastly, the best judges and guardians of their own interests (Singer, p, 2003). So, he says that if they are capable to make their choice, we should allow them to decide whether or not their lives are worth living. Preference utilitarianism insists that we should always maximize individual preferences (Singer, 2003).

From this point of view, preference utilitarianism is relates to one of the principle of ethics that autonomy.The ethical principle of autonomy claims that individuals ought to be permitted personal liberty to determine their own actions according to plans that they have chosen (Beauchamp & Childress, 2009). Preference utilitarianism is also concerned to maximize the autonomous individual’s choice. It argues that we should respect for patient autonomy and individual choices (McCabe, 2007). So, it can be ethically right but does not mean legally right. John Stuart Mill’s point of view, “what we have chosen is “good” simply because we have chosen it” (McCabe, p.

168, 2007).As well as, Kant says that an autonomous person acts like independently to take their own will (McCabe, 2007). Secondly, I would like to talk about that the role of nurses as patient advocate in end of life to decision making. “One of the largest groups among a health care professionals, nurses play important role in end of life care for patients”. Nurses often involves directly in the care of terminally ill patients and patient often talk to nurses about end of life wishes and needs.

To advocate the patient as a nurse, nurses are not only support physical, also nurses needs to support spiritual and emotional support in end of their life as well as, their families make sure that suffering at life’s end is minimized (McMillen, 2008). Spiritual is most important that we need to concern is emotional support. In order to provide emotional support, we need to understand spiritual care and able to provide appropriate spiritual care. Spiritual care is now realized as an integral to health care, especially, in end of life settings.The meaning of spiritual care is linked to the concept of patient’s wellbeing.

It is important to recognize patient’s spiritual needs in their end of life as encompassing respect for their privacy, dignity, and cultural belief (Glasper, 2011). Providing support and reassurance to patient’s in time of need, showing kindness and especially, cheerfulness, sharing their burden when giving end of life care. Also, spiritual care is fundamental aspect of nursing care even if the patient has no religious belief.In modern practice suggests that spiritual needs should be assessed regularly, and spiritual assessment is important to identify of patient’s spiritual needs (Glasper, 2011). To identify patient’s spiritual needs, we need to consider about patient’s attitude, beliefs, ideas, values and concerns their own life with death issues, including hopes, fears, and anxiety (Glasper, 2011).

Spiritual pain and distress issue has been raised from loneliness of the dying (Glasper, 2011).Callahan says that when patient is unable to control their spiritual needs, they are required to be provided provision of spiritual care (Glasper, 2011). The examples of spiritual support practice are effective communication and emotional connection between nurses and patients to minimize patient’s spiritual pain and distress (Glasper, 2011). Nurses should provide spiritual care in simply way by their presence of caring and empathetic approach, and aware of their own personal beliefs and faithsThe setting of spiritual care will help nurses to provide patient’s spiritual needs, as well as develop the necessary skills, knowledge and attitudes to deliver appropriate spiritual care (Shotton, 2000). These spiritual cares setting is providing benefit for the patient’s wellbeing, relationship between nurses and patients, as well as, it will help nurses support patients decision making in their end of life.

Thirdly, I would like to discuss about professionalism of nurses, and apply relevant aspects of the ANMC Code of Ethics value statement.Florence Nightingale said that "Nursing is an art, and, if it is to be made an art, requires as exclusive a devotion, as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or cold marble, compared with having to do with the living body- the temple of God’s spirit? It is one of the fine Arts; I had almost said the finest of the Fine Arts. " This Florence Nightingale’s words are essential to understand the value of professionalism in nursing. The art of caring is professionally contained in a therapeutic relationship that develop between nurses and patient.This relationship will bring on peaceful within their capacity to accept the dying process (Williams & Wilkins, 2005).

Nurses need to aware of that the therapeutic relationship is not a social relationship. Therefore, it is important to set professional boundaries. Consistent professional boundaries are an important component of establishing a nurse and patient relationship (Williams & Wilkins, 2005). Professional boundaries are limits to protect the space between the professional’s power and the patient’s vulnerability (Williams & Wilkins, 2005).It is important to maintain appropriate boundaries manages nurse’s empowerment and allows for a safe connection between the nurses and patient according to patient needs in end of life. Also, as nursing professionals, nurses need to hold themselves take account into the gold standard by treating others with kindness, dignity and respect.

Nurses should always choose to behave in a professional manner in end of life care as well as, nurses must be aware of patient’s own moral values and beliefs, and be consider about how those beliefs can influence professional judgement (Schwartz, 2004).According to ANMC code of ethics value statement two, “Nurses value respect and kindness for self and others” (Australian nursing & midwifery council, p. 5, 2005). Nurses should actively preserve the dignity of patient through practiced kindness and by recognising the patient’s vulnerability and powerlessness increases from the experience of illness and the need to engage with the health care system (Australian nursing & midwifery council, 2005). The power relativities between a patient and a nurse could be significant such as, the patient’s are limited knowledge, experiences pain, illness and fear.

This power in the relationship between nurses and patient in their care that should be recognised and managed (Australian nursing & midwifery council, 2005). In conclusion, I discuss about definition of euthanasia, active voluntary euthanasia, used utilitarianism perspective related to autonomy, as well as, role of nurses as patient advocate in end of life care, professionalism of nurses with apply ANMC code of ethics value statement two to support my argument. Preference utilitarianism insists that we should always maximize individual preferences (Singer, 2003).It is lead to maximize the autonomous individual’s choice, so we should respect for patient autonomy and individual choices (McCabe, 2007).

Nurses play important role in end of life care for patients to support decision making such as, emotional and spiritual care is fundamental aspect of nursing care for patient’s respectful attitude and dignity. These emotional and spiritual cares are providing benefit for the patient’s wellbeing, relationship between nurses and patients, as well as, it will help nurses support patient’s decision making in their end of life.Nurses should behave in professional manner, judgement, and professional boundaries to support in end of life care. According to ANMC code of ethics value statement two, nurse should consider about kindness and respectful care for self and patients to promote effective professional relationships and practice (Australian nursing & midwifery council, 2005).

Therefore, euthanasia should be provided to patients who are chronically and/or terminally ill if those patients request as much.