Euthanasia and

Stages of Grieving
Physician Assisted
Suicide
Hospice and
Withholding and Palliative Care
Withdrawing
 DEFINITION
• It is the termination of a very sick person’s life in
order to relieve them of their suffering.
• The term is derived from the Greek work,
euthanatos, which means easy death.
 DEFINITION
• Sometimes known as “mercy killing”
• It is also the intentional ending of a patient’s life by
a physician, usually by lethal injection, over-doze
or withdrawal.
 ACTIVE EUTHANASIA
• Taking specific steps to
cause patient’s death

• Some thing is done.

 PASSIVE EUTHANASIA
• Withdrawing medical
treatment deliberately
causing a death.

• Some thing is not done.

 NON-
VOLUNTARY VOLUNTARY
• Patients request an action • Death without the
to be taken to end their patient’s knowledge.
life.
 ASSISTED EUTHANASIA
• The doctor provides the
patients the means to end
their own life.

• Sleep without any

treatment.
 REASONS…
• Unbearable pain

• Right to commit suicide

• People should not be

forced to stay alive
 FOR EUTHANASIA…
• Provides a way to relieve • Frees up medical funds to
extreme pain. help other people.

• Provides a way to relief • It is another case of

when a person’s quality of freedom of choice.
life is low
AGAINST EUTHANASIA…

Not in the
correct
frame of mind

Too much power to the

medical practitioner
ON FAMILY
 ON PATIENT
• Offers the patient a
source of relief from their
pain.

• Provides dignity to the

patient by empowering
them to be in control of
their life/ death choices.
 ON DAILY LIFE
• More cost effective than
sustaining life for the
terminally ill patient.

• Allows the client to take

charge of their life/ death.

• Brings the closure of the

decision being made.
 ARGUMENTS
• More cost effective than
sustaining life for the
terminally ill patient.

• Allows the client to take

charge of their life/ death.

• Brings the closure of the

decision being made.
WHEN THE PATIENT AND DOCTOR AGREE
there is no benefit in carrying on or starting a
new intervention

THE RIGHT ACTION IS CLEAR…

though skill is required on the doctor’s part to
manage these discussions sensitively
when patient requests to continue or initiate
a treatment BUT… It is not in the benefit of
the patient?

WHAT TO DO?
THERE ARE LIMITATIONS TO PATIENT
AUTONOMY

PATIENT CANNOT DEMAND a treatment

that is not in their best interests and
doctors need not strive to preserve life
 REASONS
• It is PATIENT’S DECISION to
withhold a life-saving • It results in unnecessary/
intervention. unequal distribution of
RESOURCES

• HARM OF TREATMENT
outweigh any potential • Requires doctor to act
lengthening of life AGAINST A PROFESSIONAL
CODE OF LAW

• The treatment will not achieve

its SPECIFIED AIM
CLINICALLY-ASSISTED NUTRITION AND
HYDRATION
• Hydration and nutrition is • When nutrition and hydration
ESSENTIAL FOR HUMANS become clinically-assisted,
they are CLASSED AS
TREATMENT rather than basic
• Families and doctors FIND IT care.
DIFFICULT TO WITHDRAW
clinically assisted hydration
and nutrition up to the end of • Hence, as treatment when
life of patient they cease to offer overall
benefit, THEY CAN BE
WITHDRAWN.
CARDIOPULMONARY RESUSCITATION
• MAY FAIL TO RESTART
THE HEART as patients
approach the end of their
lives, or

• May result in a SHORT

PERIOD of impaired
quality of life.
 Agreement should be reached among
the multidisciplinary team that this is a
FUTILE EXERCISE and decision
carefully recorded and conveyed.
Patient autonomy has limits.

Doctor should be mindful of other

responsibilities:
a. To benefit and not harm the patient
b. To use resources justly
 GRIEF
• The reaction we
experienced after a loss.

• There is no “right” way to

grieve.
 STAGES OF GRIEF
• Denial: refusal to believe the • Depression: feelings of
loss has occurred. sadness, regret, fear,
uncertainty, loneliness, loss of
interest.
• Anger: experiencing anger or
rage after the loss.
• Acceptance: accepting the
reality that the loved one is
• Bargaining: making physically gone and that this
promises to change if the loss new reality is permanent.
is returned to them.
 GRIEF MANAGEMENT
STRATEGIES
• Write it down.
• Tell your story.
• Talk to a trusted friend.
• Learn to manage your stress.
• Find a different kind of
“normal”
• Always remember: Life must
go on. The end of grief does
not mean you have forgotten
your loved one.

• Exercise, eat well & rest

 LETS DEFINE HOSPICE
• Hospice is a special • Hospice care provides
concept of care designed support, choices, and dignity
to provide comfort and during very difficult time for
support to patients and patients and family.
their families when a life-
limiting illness no longer
responds to cure-oriented • Hospice care allows
treatments individuals and families to
take control of what in many
cases is an evitable
situation.
LETS DEFINE PALLIATIVE
• Palliative care is specialized • Its goal is to improve quality
medical care focused on of life for such patients at
identifying and relieving the any stage of illness
pain and other symptoms of a
serious illness. regardless of current
treatment plans and it is
tailored to the needs of the
• It is focused on quality of life patient and the family.
rather than curing disease.
 WHY NURSES?
• Nurses are on the front • Every nurses provide palliative
line of healthcare, we care to patients, no matter
work at the bedside. what setting they work,
making end-of-life care an
essential component of
• Nurses spend more time nursing education.
with dying patients and
their families than ay • Simply put, patients and
other health professional. families trust nurses and in
many cases are more willing
to listen to us.
NURSES ROLE

Timely education and

referrals
• Nurses are on the front line. • The nurse patient-relationship
• We spend a significant often creates a unique which
amount of time with each allows for the
patient and it is the nurse circumstances nurses
who has the ability to gain suggestions and education to
trust and provide be more widely accepted.
influence.
• Nurses have the opportunity • …to advocate when end of life
to change thinking. care is needed.