Health Care Systems Discussion: End of Life and Value of Life (Essay Sample)

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End of Life and Value of Life
Introduction
The end of life, as well as, value of life is a source of unending conflicting views between medical practitioners, family members, patients and legal practitioners. The conflicting views of the above parties emanates from the varied intellectual backgrounds, cultural and religious beliefs. End of life is a major source psychological distress among nurses who attend to patients in the Intensive Care Unit. As various researchers indicate, the end of life requires critical evaluations, which facilitate appropriate, decisions to be made by both nurses and family members regarding withdrawal or withholding the life supporting equipments. The role of informal family members has of late been one of the considerations in deciding whether to end life or not.
The process is not easy because taking away life is seen by different cultures and religions to be wrong. Over the years, there have been legislations relating to the end of life under critical conditions as a way of saving the patient pain and the family resources. The western part of the world has had constant developments in this area while the East had remained faithful to its religious beliefs. The cases from the United States and Saudi Arabia will form the basis of divergent perspectives, which this discussion, seeks to explore. This discussion will also focus in exploring these varied perspectives as well as examining the challenges wholly, regarding decision to end of life and value of life.
Discussion
Saudi Arabian context offers one of the complex situations within the health care systems. Research conducted to determine the top ten challenges affecting the population revealed that ethical challenge is one of them. Specifically, the ethical challenges were mentioned to be the source of conflict between medical team and family members. Conflicts arise from the expectation that, with huge spending on medical equipments, the healthcare system will eventually improve, the quality of life will improve, and the longer the lifespan would be.
Thus, with such expectations, people have not given proper thought the issue of end of life. The end of life in patients with critical conditions still remains unresolved. It is then important to highlight the fact that ethical challenges in the health system continue to affect people (Alkabba et al 5). The intention of ending life under critical conditions from the medical point of view is to save the patient pain and discomfort. However, this consideration has not been given the due consideration by the Saudi’s, and it is why this issue still causes friction between patients, family members and the nurses.
The end of life situation is also a source of moral distress among nurses and other medical practitioners taking care of patients in critical health conditions. Often, patients with critical conditions are placed under an intensive care unit where life supporting equipments are used. In such situations, nurses and other medics are confronted with issues to do with end of life. Judging whether patients in ICU are worth living is never an easy decision to determine. Many factors need to be considered. For nurses, such state is not only complicated, but a source of moral distress especially if they make decisions of fail to make decisions they ought to have made (Browning 143).
Nurses who fail to make critical decisions out pressure faces guilt, and as a result, develop moral distress. This is not good as it leads to reduced confidence in performing their duties and as such, they need training of ways of dealing with the situation. As research indicates, nurses who attend to trainings on moral distress management are less affected by end life process and in fact, exhibit much confidence in handling such matters. Thus, the need to have constant training of nurses on how to manage moral distress as a way of enabling them handle end of life decisions (Browning 147).
Moreover, at the end of life state, a lot of conflicts arise between the nurses and the family members. Often, the conflicts arise out the failure of the family members to comprehend what life saving measures entail and their implications, or when family members ask for use of life saving measures without considering the wish of the patient. In addition, the request by family members to continue treating the patient even if the condition is painful or uncomfortable is also another source of distress among nurses (Browning 144). Essentially, life saving measures is meant to prolong life in critical conditions. It involves the use of machines such as those sustaining heartbeat or breathing. It is a delicate state, and the guarantee of such patients recovering to normal state is often minimal. As such, nurses and family members are suppose to make the right decision on whether to withdraw or continue using the machines.
According to research conducted in the Muslim world, most patients who die while in intensive care unit were associated with withholding and withdrawing of life support equipments. This is a source of moral and intellectual questions to ask for parents and nurses. Interpreted literally, the deaths that occur out of withholding or withdrawal of life supporting equipments are intentional deaths. As such, the parents who decided for such action as well as, the nurses confront dilemmatic situation. In the Muslim world, taking life is sin, and thus parents and nurses face such conflicting point of views (chehab 135).To resolve this, a clear policy, which aligns, the religious and medical perspectives need to be instituted and be applied accordingly.
In the American context, the process of decision making in end of life related issues, is marred with controversy. Historically, it is the nurses who were responsible for such decisions. Over time, there has been a paradigm shift in the decision making process. Lately, there has been emphasis to involve parents in making the decision to end of life of their children. Emphasis has been to have parents and nurses reach consensus on the matter. However, this has not always been the case; there has been a tendency among parents to contradict the nurses’ decision. In such situations, scholars have championed for the involved parties to consider decisions which serve the interest and wellbeing the child, and where consensus is not reached, healthcare givers must look for court intervention on the matter (Kon 35).
This may not be sufficient because the decisions of the courts will tend to rely on the legal provisions which may not be in line with the medical situations. In many jurisdictions in the world, no one has the right to take away life of another, euthanasia is illegal and in the medical policies, euthanasia has been permitted under some conditions. Therefore, to resolve the conflict, there is need to empower nurses so that they can convince the parents of the right decision for as long as the decision serves the interest of the unwell person. This will assist quick resolutions in cases where the patient’s brain is dead while the heart is still alive.
The decision of end of life also has the legal implications side of it. It is not in doubt that nurses plays a pivotal role in helping parents and patients in making end of life decisions. As a requirement, all nurses dealing with critically ill patients need to have specialized skills in the area. As such, critical care nurses are supposed to be involved in the processes involving end of life. Legally, the decision of end of life must be made by competent parents and patients. Competent patients and parents have the right to withdraw treatment and in case of incompetence or any impairment, a surrogate can be involved (McGowan 66).
However, the involvement of the court in deciding end of life matters needs to an approach which is not legal in nature. Usually, ending life involves moral and cultural believes which cannot be addressed by the courts. Especially in the Muslim world, ending life cannot be properly addressed in the courts because the interpretation is unlike it is in the USA. What is necessary in such situations is to have a consensus which does not bring about guilt of blaming on a later date. This can only happen through extensive debate and wide consultations.
Related with end of life in the quality of life concept, which is the worth of sustaining life a bit longer. In determining the quality of life, a specialized concept is used, Health Related Quality of Life. This is used to evaluate the worth of a life. Primarily, such a tool has been used in situations where the cost of saving a life is a major consideration. Patients with incurable conditions are a times considered to be uneconomical. This is because even after spending a lot of money prolonging his or her life, the patiently will eventually die resulting in wastage of resources which would have been used for other meaningful activities. However, this point of view is not welcomed in the Islamic world at att. Ibn Munzer argue that Islamic jurist believe that anyone who take the life of another person deserves no other punishment other that capital punishment. It does not get into deliberation if the murdered person was handicapped, paralyzed or blind or whether the murderer is of full health. It is then clear that the Islamic jurisprudence give equal treatment all human beings.
End of life has also been affected by the informal role of close family members in the process of decision making. Depending on the socio-cultural setting and other related backgrounds, various family members have had different stakes in decision making. Thus, in the process of making decisions related to end of life, their point of view should be considered as well. It is essential in order to avoid conflicts such as scapegoating and shifting of blame (...