Ethics

Ethics Study Guide 3. Terminal sedation: Terminal sedation uses sedatives to make a patient unconscious when death from the underlying disease is imminent. This may be the only way to relive the agonal suffering, the profound pain that may occur when a patient is dying. Since terminal sedation is a risky treatment, some bring up ethical questions about its use, including: • Terminal sedation may have an unknown effect on hastening death. • Patients who are unconscious and cannot speak for themselves are at potential risk for abuse. • How does one value consciousness vs. suffering? • Is terminal sedation for patients who really don’t need such potent relief ethical? • How far should people go to attempt to relieve pain and other uncomfortable symptoms? 4. Advance directives: In order to avoid ethical conflicts related to withholding or withdrawing treatments and to encourage the appropriate care of those nearing the end of life, patients are asked to draw up an Advance Directive or Living Will. An Advance Directive or Living Will is a document used to: • State the patient’s own goals and wishes with regard to medical care; • Give specific instructions about treatments, including DNR orders, organ donation, feeding tubes, etc.; and • Designate a power of attorney for healthcare who will speak for this person should be/she become unable to express his/her own wishes. Unfortunately, advance directives and living wills are tools that are underused. Many who need them don’t have them; sometimes, even when patients have them, they are not followed. Physicians may believe that following these directives would not be in the best interest of the patient.

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