End-of-Life Issues: Ethical Issues

End-of-life care presents healthcare professionals with many ethical challenges and dilemmas. Advancements in medical sciences have created the possibility of reshaping the circumstances during death and can prolong lives. Understanding ethical theories and ethical principles can provide a foundation for decision making and for providing more compassionate, informed care.

Purpose/GoalThe outcome of this course is for the learner to describe key ethical considerations at the end of life and identify the tools necessary to make ethical decisions when providing care for patients at the end of their lives.

Course Objectives – Upon completion you will be able to do the following:

1. Describe the role of ethics in end-of-life care in health care today.
2. Define ethics.
3. Describe the key elements of the ethical theories of utilitarianism, deontology, Ross’s ethics, natural law ethics, ethical egoism, and virtue ethics.
4. Describe the key ethical principles of autonomy, beneficence, nonmaleficence, veracity, confidentiality, justice, and fidelity.
5. Outline a method for analyzing ethical dilemmas.
6. State the relationship between culture and ethics.
7. Define brain death.
8. List key items from the Dying Patient’s Bill of Rights.
9. Describe two types of advance directives and explain their purpose.
10. Define euthanasia and compare active versus passive euthanasia.
11. Compare involuntary active euthanasia with voluntary active euthanasia.
12. Describe assisted suicide and medical futility.
13. List important considerations relevant to do-not-resuscitate (DNR) orders.
14. Define terminal sedation and describe how and why it is utilized.
15. Define the double effect.
16. Describe considerations for the health care provider relevant to the voluntary refusal of hydration and nutrition.
17. Describe issues related to the removal of mechanical ventilation and organ donation.
18. Identify key issues related to end-of-life care of the neonatal and pediatric patient.