Dignity in Death and Dying

Is a movement that promotes the ability to meet death on your own terms
Euthanasia and Prolongation of Life:
What is Euthanasia?
 The term euthanasia comes from the Greek for good death and in English has
taken the meaning of easy death or the painless inducement of quick death.
The concept of easy death is further divided into two categories: passive
euthanasia, which involves doing nothing to pre¬ serve life, and active
euthanasia, which requires actions that speed the process of dying.
 Euthanasia is further divided, depending on whether the process is initiated
by patient request, and is therefore voluntary or involuntarily implemented
without patient permission.
 Voluntary is when it is conducted with consent
 Involuntarily when euthanasia is conducted on a person who is unable to
consent due to their current health condition.
Inviolability of Human Life

 Inviolability the fact or quality of being safe or protected from attack, infringement,
destruction, or interference.
 In religion and ethics, the inviolability or sanctity of life is a principle of implied
protection regarding aspects of sentient life that are said to be holy, sacred, or otherwise
of such value that they are not to be violated
 The phrase sanctity of life refers to the idea that human life is sacred, holy, and
precious, argued mainly by the pro-life side in political and moral debates over such
controversial issues as abortion, contraception, euthanasia, embryonic stem-cell
research, and the "right to die" in the United States, Canada, United Kingdom and other
English-speaking countries.
Euthanasia and Suicide

 Euthanasia is when a doctor is allowed by law to end a person’s life by a

painless means as long as the patient and their family agree.
 Suicide is the direct and willful destruction of one’s own life. It is direct
insofar as the primary object of thee act is the killing of oneself; it is willful
insofar as it is deliberate, voluntary and intentional. And it is destructive
insofar as the means of terminating one’s own life is, more often than not,
violent, brutal or very harsh. In some respects, the concept of active
voluntary euthanasia and suicide overlap, but there are several differences,
people who resort to euthanasia do so for the medical reasons, hence, it is
referred to as an easy and painless death.
 Assisted suicide is when a doctor gives a person the means to commit suicide
when requested for
Dysthanasia

 Dsythanasia or “painful or bad death”

 In a broad sense it can be understood as medical stubbornness or a futile
treatment. In good medical practice the treatment should be proportional to
the expected prognosis. If the treatment provided clearly overcomes the
expected prognosis retarding the process of dying and prolonging the agony
and suffering of the patient, than it seems clear that it is a case of
dysthanasia.
 It is a term used generally when a person is seen to be kept alive artificially
in a condition where, otherwise, they cannot survive.
Orthothanasia

 The word orthothanasia was used for the first time in the 1950s. It means
correct dying, or allowing to die or letting die.
 It is a natural or normal manner of death and dying
 Someties used to denote the deliberate stopping of artificial or heroic means
of maintaining life
Administration of drugs to the dying

 In medicine, specifically in end of life care, palliative sedation is the practice

of relieving distress in a terminally ill person in the last hours or days of the
dying patient’s life, usually by means of a continuous intravenous or
subcutaneous infusion of a sedative drug, or by means of a specialized
catheter designed to provide comfortable and discreet administration of
ongoing medications via rectal route.
 Palliative sedation is an option of last resort for patients whose symptoms
cannot be controlled by any other means. It is not a form of euthanasia, as
the goal of palliative sedation is to control symptoms, rather than to shorten
the patient’s life.
Advance Directives

 An advance decision (or Advance Directive, a Living Will, or Healthcare

Directive) allows an individual to provide instructions for future medical care
and treatment while still capable of making decisions for themselves and
provides an opportunity for an individual to discuss treatment opportunities
with healthcare professionals, including medical staff as well, as to discuss
and resolve difficult issues with family and friends.
 The living will is a legal document used to state certain future health care decisions
only when a person becomes unable to make the decisions and choices on their own
 Durable power of attorney for health care/Medical power of attorney is a legal
document in which you name a person to be a proxy (agent) to make all your health
care decisions if you become unable to do so
DNR/End of life care plan

 The goal of end-of-life care for dying patients is to prevent or relieve suffering as
much as possible while respecting the patients’ desires.
 DNR orders are written directives placed in a patient’s medical record
indicating that the use of cardiopulmonary resuscitation is to be avoided.
 DNR orders should be documented immediately in a patient’s health care
record, noting the reason the order was written, who gave consent and who
was involved in the discussion, whether the patient was competent to give
consent or who was authorized to do so, and the time frame for the DNR order
(American Nurses Association [ANA], 2003)
 DNR decisions require open communication among the patient or surrogate, the
family, and the health care team. This communication needs to include explicit
discussion of the efficacy and desirability of CPR, balanced with the potential
harm and suffering it may cause the patient.
 End of life care includes palliative care. If you have an illness that can’t be
cured, based on the understanding that death is inevitable, palliative care
makes you as comfortable as possible by managing your pain and other
distressing symptoms.
 End of life care begins when a person has an incurable illness such as cancer.
Nursing Roles and Responsibilities

 Nurses are responsible for recognizing patients’ symptoms, taking measures within
their scope of practice to administer medications, providing other measures for
symptom alleviation, and collaborating with other professionals to optimize patients’
comfort and families’ understanding and adaptation.
 Provide sensitive care and emotional support.
 Be an advocate for patients.
Ethical decision making process
 In the end-of-life care of a patient, the decision to implement practices to prolong
the patient’s life or to comfort the patient may be difficult for the physician, nurses,
patient, family members.
 They should make end-of-life care decisions according to the basic ethical principles
(autonomy, beneficence, nonmaleficence, and justice).
 Autonomy- is considered a patient’s right to self-determination. Everyone has the
right to decide what kind of care they should receive and to have those decisions
respected
 Beneficence-requires physicians to defend the most useful intervention for a given
patient.
 Non-maleficence- is the principle of refraining from causing unnecessary harm
 Justice- is about ensuring a fair distribution of health resources and requires
impartiality in the delivery of health services