Death and Dying

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Use case examples from the module or your experience to discuss three ethical choices that might arise when providing end-of-life care to children.

Introduction to my essay
In this essay I have been asked to discuss three ethical choices that might arise when providing end of life care to children. End-of-life care is also known as palliative care and it is the care that is given to someone who is terminally ill and dying. Palliative care, as defined by the Department of Health (200b), is the holistic, individualised care of someone who has been diagnosed with an incurable or life-limiting illness. (The Open University 2009). Here in the UK the NHS is responsible for people’s health and palliative care has been a medical speciality since the early 1980s and it is commonly seen as the founder of modern palliative care and exemplar of good practice. (The Open University, 2009). It is crucial with palliative care that the standard of care is high because there are no second chances to get it right. In the House of Commons Health Committee (2004) on palliative care it was recommended that an urgent review of the training in palliative care to be part of the training for all health care staff. This has meant that more staff are training and the standards of care are higher.

Ethics, also known as moral philosophy is the study of right conduct and good character. There are two different approaches to ethics, one is a person’s actions and the other is the character of the person. Although both ethics and the law deal with ‘right conduct’ they are not the same thing. To take an example of this, it is legal for a woman to terminate a pregnancy and have an abortion but there are a lot of people who think this is ethically wrong.

We all make ethical choices throughout our lives. These may not necessarily be big medical choices but day-to-day choices for example our diet and if we choose to eat meat. Peter Singer is a moral philosopher who has written about end-of-life ethics and argues that ethics requires people to move beyond self-interest and engage with a level of objectivity and judgement that is universal (Singer, 1995). (The Open University, 2009).

In care situations however, care professionals may have their own ethical codes of practice they need to follow when making decisions and these could conflict with those of the dying person, the family, the law and courts, or other professionals involved. End-of-life care can be very complex and difficult and especially when it involves children. Where a child is not able to make their own decisions it is usually passed to the parents to make the difficult decisions about their child’s treatment and care. In this essay I will look at the ethics and conduct using the case study of Jaymee Bowen and also two other ethical choices which could arise.

The first ethical dilemma is as follows:

| |A child who wishes to continue with treatment against the advice of professionals (as with our case study of Jaymee Bowen) | |1. | | | |Looking at the case study of Jaymee Bowen and her case during the 1990’s it highlighted the difficulties and complexities of | | |decisions that have to be made about treatment at the end-of-life with children. Jaymee Bowen was aged just 6 when she was first| | |diagnosed with non-Hodgkin’s lymphoma in 1990. After having three years of treatment Jaymee was then diagnosed with a second | | |cancer acute myeloid leukaemia. After a relapse the paediatrician told Jaymee’s parents that she had less than 8 weeks to live | | |and that it was unlikely Jaymee would benefit from further treatment. | | |...
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