Question

There are many times that a nurse will encounter conflicting ethical principles at play, especially when administering care near the end of life. Check all the challenges below that lists as common dilemmas.

	Double effect- the conflict between giving a therapy that may alleviate suffering but may hasten death.
	Respecting the autonomy of the patient and the input of the patient's family when the wishes are in conflict.
	Medically futile care is ordered or requested.
	Attachment to the patient biases the caregiver to the point where objectivity and judgement are compromised.

Answer 1

Double effect ,in end of life care where patient are provided interventions which are good but it can also provide a bad effect on the patient which can cost the life of patient at the earliest. Like for instance in order to alleviate pain a stronger opioid analgesics is recommended in order to relieve pain but at the same time certain medication can hasten the death by suppressing the respiratory system .

In all scenario until the patient is compatible it is a must to respect their autonomy.The patient in these situations are mostly in physical pain .At the same time it is essential to respect the family members too who are in greater emotional pain. This can be managed by effective psychological support ,reassurance ,guidance and coping strategies to over come it.

Medically futile care is also involved in the EOL as a matter to respect the patient by providing the basic care in meeting the physical needs though it is not of any use .

Biases can easily arise when objectives and judgement are compromised by a nurse

Hence during the end of life care the conflicting ethical principles can arise from all the above challenges.