Paper on Navigating End-of-Life Ethics: An In-Depth Analysis of Mr. Long's Pancreatic Cancer Journey

The Principles of Beneficence and Nonmaleficence

Mr. Long’s medical problem is that he is in the final stage of pancreatic cancer. Despite that, he recently developed liver failure, his health has declined, and according to the diagnosis, he is expected to die in the next few days. It is essential to document any patient care when he/she visits the medical facility. Department of Health v. Rahe (2009) explains that if care is not recorded during the time given, it is assumed that the maintenance did not occur. Following this, it was important for the nurse to document everything during Mr. Long's stay. So far, Mr. Long has spent six months in the medical facility and received chemotherapy during his stay, mainly used to help destroy cancer cells, which usually multiply compared to other cells.

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The goal of treatment is to help the patient get cured. To do this, the oncologist advised the patient to undergo chemotherapy, which is used to treat cancer in most cases. During the treatment, the patient was responding well. Still, after some time, his health started to decline, forcing the oncologist to stop the treatment because they could no longer see changes. The patient's health deteriorated due to therapeutic failure. The loss plans inform the patient's relatives and the patient and ask them if they would consider any other option. Due to the effect of the disease, there is no further alternative that can be used to help cure the disease, so both the patient, his relatives, and friends are told what will happen next to the patient, and the patient is advised to write his will that is if the will is not written. According to Congress, under the Tax Equity and Fiscal Responsibility Act (1982), a person needs hospice care, which enables them to receive nursing and medical care without the fear that they will be placed on life support in case death occurs.

The Principle of Respect for Autonomy

The patient is mentally stable and legally competent because he is well aware of the disease he has and can make an even tougher decision to allow the oncologist to perform chemotherapy on him knowing the given side effects and what might happen to him. He gives himself a chance to live because he understands that when chemotherapy is successful, he might fully recover and beat cancer, which will give him a second chance to live. According to research, people need to respect an individual's rights and autonomy irrespective of their age (Kunin, 1997). Due to this, both the doctor and the patient's relatives had to respect the patient's decision, but they could give their opinion to help the patient make the right decision.

Since the patient is competent, he states chemotherapy is his preferred treatment. Many people are usually scared of chemotherapy because of its side effects, and some state that they do not want it because they do not want to give themselves false hopes that they might recover from the disease. They have faced many challenges when facing cancer, which can lead to stress and depression. Before deciding that he wants chemotherapy, the patient is well informed of the risks and benefits, understands the given information, and gives consent. Lack of decision from the patient is the reason why chemotherapy was considered and performed. According to research done on medicine, a physician has to follow or ensure there is informed consent before administering a medication. The patient has a right to accept or reject an evaluation or treatment, and informed consent should be an exchange of ideas between the physician and the patient (Timothy J. Patrick et al., 2008). The Principles of Beneficence and Nonmaleficence, and Respect for Autonomy

There are zero chances for a return to everyday life either with or without treatment of the patient. The possibility of zero chances comes in because the patient has pancreatic cancer at the final stage and is about to take the patient's life. At first, the patient and his relatives thought that there was a chance to return to normal life, so they considered chemotherapy, which is normally used to treat cancer. It usually works depending on the type of cancer. In some cases, it is used to combine other methods for efficiency; for example, some may use surgery and chemotherapy to treat cancer. In Mr. Long's case, the treatment has failed, and the patient has a few days to live. The patient is then taken care of by the hospital and nurses instead of being released for home-based care. Due to the rule that allows them to stay in the hospital, patients can continue with some disease-directed therapies to serve more patients (Quill, 2008).

There are no plans to forego treatment because Mr. Long wants to recover from the disease to return to normal life fully. He then goes through other treatments before deciding which one he considers and would like to undertake. After the treatment, there are some plans for comfort and palliative care and an indication that the patient has a nurse assigned to him to make sure his well-being is taken care of (Quill, 2008).

The Principles of Loyalty and Fairness

In Mr. Long's situation, some family issues might or might not affect the program's rest since the treatment process is already complete. In this case, the problem is that Mr. Long has arranged for a meeting with his ex-wife and does not want his family to know anything about this meeting. He then asks his nurse to allow the ex-wife to see him during visiting hours but lies to his family, which might cost the nurse's job. The nurse needs to discuss this with the patient and her superiors (Jeanette I Erickson et al., 2005).

In this scenario, there are no financial and economic factors that might affect the treatment process because of chemotherapy, and the patient is in his final days of life. Furthermore, there are no limits on confidentiality because both the nurse and doctors, including the oncologist, have observed this and followed it later. The nurse needs to ensure all patients' confidentiality, and that's her duty (Jeanette I Erickson et al., 2005).

My Reflection

Patients need to consider every outcome before concluding what treatment they need to be administered to them. Some treatments have side effects that are not safe for a person. After all, they can lead to complications. Furthermore, the patient should not put a nurse in a tight situation, leading them to lose their jobs. For instance, Mr. Long's scenario asks the nurse to allow his ex-wife to visit him, and she should not inform his family. A challenge comes when the family might decide to sue the nurse or cause other problems because she did not inform them.

References

Guido, G.W. (2014). Legal & Ethical Issues in Nursing (6th Ed.). Boston, MA: Pearson Education

Jeanette Ives Erickson, & Sally Millar. (2005). Caring for Patients While Respecting Their Privacy: Renewing Our Commitment. The online journal of issues in nursing, 10(2).

Timothy L. Paterick, Geoff V. Carson, & Marjorie C. Allen. (2008). Medical Informed Consent: General Considerations for Physicians. https://www.mayoclinicproceedings.org/article/S0025-6196(1160864-1/fulltext#:~:text=Medical%20informed%20consent%20is%20essential,buttresses%20the%20patient-physician%20relationship