End of Life Issues

Medical ethics
Introduction
• End of life defined: usually refers to the last year of life, although for
some people this will be significantly shorter.
• The care of the dying patient must be considered within the context of
the psychological, physical, and social experiences of a person's life.
How long does end of life last?
• The end-of-life period is when body systems shut down and death is
imminent which typically lasts from a matter of days to a couple of
weeks.
• Some patients die gently and tranquilly, while others seem to fight the
inevitable.
Other cares given to patients:
• Palliative care:
Making life as easy as possible for patients with their serious illness.
Example: cancer pain management.

• Hospice care:
It is given when life expectancy is of 6 months or less.
Example: attending to patients pain at their emotional and spiritual
needs at the end of life.
End of life presents many challenges to:
1. Clinicians for management of pain and sufferings
2. For patients
3. For their families or relatives
 Five most common symptoms of end of life:
1. Pain
2. Nausea/ vomiting
3. Fatigue
4. Respiratory depression
5. Weight gain or weight loss
Euthanasia
• It is described as the deliberate and intentional killing of a person for
the benefit of that person in order to relieve him from pain and
suffering.
• Euthanasia is derived from Greek word.
• ‘Eu’ Good; ‘Thanatos’ Death
Euthanasia Types
1. Active Euthanasia
When a person directly and deliberately does something which results in
the death of a person.
It is considered crime in many countries and in India.
But Netherlands, Belgium, Switzerland allows active euthanasia
under “ Termination of Life on Request and Assisted Suicide (Review
Procedures) Act.
Euthanasia Types
2. Passive Euthanasia:
i) Voluntary: euthanasia carried out at the request of the patient.
ii) Non- voluntary: where the person is unable to ask for euthanasia
due to patients unconsciousness, a surrogate person takes the
decision on his behalf.
Care of dead body
1. Organ donation
Like eyes, heart, kidneys, liver, etc, could be donated on signing the
consent for organ donation.
This could help the other living person to carry out the normal life.

Otherwise dead body donation can also be put forth, which might be a
resource of learning anatomy for medical students.
Care of dead body
2. Care of dead body to prevent early decay is necessary.
Eyes are made to be closed.
Mouth to be closed.
All the orifices to be closed.