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Ethical Issues - End of life decisions Ethical Considerations A number of ethical theories and principles are relevant when considering treatment decisions at the end of life.
This is in keeping with both traditional codes of medical ethics and a general perception of what doctors and other health professionals should do, that is save and preserve life. One challenge to this principle in the context of health care is to ask should life be preserved at all costs.
Is there no place for consideration of quality of life? One of the problems with considering quality of life is the question of how this is defined and by whom. However, this problem does not remove the challenge to the sanctity of life doctrine.
Some ethical arguments have been developed to address this challenge.
Thus it is morally wrong to push someone into a river to their death but we may not have a moral duty to leap into the river to save someone who is drowning. The doctrine of double effect allows that performing an act that brings about a good consequence may be morally right even though the good consequence can only be achieved at the risk of a harmful side effect.
Prescribing pain relieving drugs which in large doses shorten the life of a terminally ill patient is often used as an example of double effect. Current practice in palliative medicine and the range of drugs available may reduce the appropriateness of this doctrine.
Thus a competent person should be able to refuse life saving treatment in both current situations and future foreseeable situations. Some would argue that this is the case but as assisted suicide is currently illegal in the UK this is not an issue that a clinical ethics committee should need to consider.
|Encyclopedia of bioethics (Book, ) [timberdesignmag.com]||Finally, the Bible says that your truest or deepest desires are also important to God.|
In these situations the principle of respect for autonomy comes into conflict with other ethical considerations, such as preventing or avoiding harm, or distributive justice. A duty not to harm Nonmaleficence The concept of nonmaleficence - an obligation not to inflict harm intentionally, is distinct from that of beneficence - an obligation to help others.
In codes of medical practice the principle of nonmaleficence primum non nocere has been a fundamental tenet. However, in the context of health care it can sometimes be difficult to comply with this principle depending on the definition of harm.
Many medical treatments may have harmful side effects but save or improve lives. In end of life decisions the question of how much harm is caused by the treatment needs to be considered, as does the question of whether death itself is always a harm.This article examines the doctrine of double effect through case examples and presents supporting and opposing opinions about its relevance to clinical practice.
Implications for nursing care are discussed. The principle of double effect also called the doctrine of double effect normally applied in the medicine, palliative care and war fields is always invoked. The principle of double effect should assure us that, while a negative effect may be foreseen, if the positive effect is the intention, ethically pursuing the action is not the same as accepting or permitting the negative effect (Cavanaugh, , p.
). Is the doctrine of "Double-Effect" an exercise in sophistry? ethical rules of the profession always the good way? for the Doctrine of "Double Effect" to be defensible in the real world of. The doctrine of double effect argues that there is a moral distinction between acting with the intention to bring about a person’s death and performing an act where death is a .
The Doctrine of Double Effect Review of "The Union, the Confederacy, and the Atlantic Rim" by Robert E. May Us Foreign Policy , Expansionist or Isolationist.