Public Health

Ethical dilemmas in End of Life Care How it Affects Patients and Healthcare Facilities

Introduction to ethical issues in Healthcare

The increase in medical knowledge and the increase in technology have increased patients options for healthcare. When decisions arise concerning the treatment of dying patients, these options present complex ethical dilemmas. Many families and healthcare professionals alike are faced with decisions about the best treatment to ease a patient’s final suffering.   Often times a decision will need to be made about whether to allow a patient’s life to end by terminating treatment altogether. Moral dilemmas occur when health care professionals (HCPs), patients, and/ or other individuals are faced with a choice between two or more conflicting courses of action with no clear evidence to support one over the other as the correct choice. These decisions regarding one’s own care or that of a dying loved one confront people from all walks of life. How decisions are made, who participates, what criteria are used to decide whether to terminate end life care, and how to rank those criteria, are subjective variables considered during the decision-making process by both patients and Health Care Professionals. In 1990, the Supreme Court noted in the Cruzan decision that Constitutional protection for the right to refuse treatment could be inferred from the Court's earlier decisions (Cruzan v Missouri department of health 1990). Also, in 1990, the US Congress passed the federal Patient Self-Determination Act, which ties Medicaid and Medicare reimbursement for hospitals and other health care facilities to the requirement that patients be informed about their right to accept or refuse medical or surgical treatment and the right to formulate advance directives. The general agreement manifested in these rulings and laws also reflected in hospital accreditation standards. The Joint Commission's 1992 Accreditation Manual for Hospitals required institutions... [continues]

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