Bioethics

4.
dignity in death and dying
 Moral and ethical principles involved in euthanasia and suicide
Autonomy
Autonomy means a person's self-determination to make decisions that affect their life, their health, their
physical-psychological integrity, their social relationships. It refers to a human being's ability to decide
what is "good" or what is his or her "well-being" .
Therefore, the autonomous person is one who has freedom of thought, is free of internal or external
constraints to choose among the alternatives presented to him.
In addition to the freedom of choice, the autonomous act also presupposes freedom of action, it requires
the person to be able to act according to the choices made and the decisions made. Therefore, when
there is no freedom of thought or options, when there is only one alternative of choice, or when there is
no freedom to act according to the desired alternative or option, the action undertaken cannot be
considered autonomous
Non maleficence
- more complex, issue raised by the question of euthanasia in a

health care setting is the question as to exactly what a physician's
responsibility is toward a patient who wants to die. In effect, the question
becomes that of what creates the doctor's duty to help such a patient end
his life. An important ethical principle that, applied to biomedical ethics,
can be used to justify a doctor's role in euthanasia is nonmaleficence.
- The principle of nonmaleficence asserts that "a doctor ought not to inflict evil or harm or
bring his patients into the risk of evil or harm." Because of the way technology has advanced
the practice of medicine, doctors today are able to provide a host of life-prolonging
treatments that were previously unimaginable.
Beneficence
- Beneficence requires a doctor to act in ways that best promote the welfare of his patients.
However, there is controversy over what courses of action a doctor should take to properly
fulfill this duty. While some assert that beneficence requires a doctor to preserve life no
matter what the cost, others argue that a patient's interests are best served by a doctor who
respects the patient's autonomy, is sensitive to the pain he is suffering, and is willing to take
action to end that pain. In the case of a terminally ill patient, suffering uncontrollable pain
and asking for an end to his life, it seems that the most helpful act would be to end his life in
a merciful way.
Justice
- This principle, the principle of justice, can be thought of as expressing "fair, equitable, and
appropriate treatment in light of what is due or owed to persons." In regard to existing laws
against euthanasia, many people see it as unjust that a patient who is in pain is denied the
chance for an easy death, and made to suffer longer because of legal constraints.
- Some opponents might argue that a patient who truly wanted to die would find a way to end
his life, with or without the help of a doctor. This assumption, however, is problematic in
ways that hearken back to the issue of justice.
 Ethico- moral responsibility of nurses In euthanasia and suicide

- Nurses can offer much to the process of assisted dying. At the end of life, the person is
particularly fragile and dependent and unless their autonomy is recognized, their dignity
may be compromised. The essential aspect of care is that in it the person is an autonomous
being, and their active participation is an inherent part of the caring process. In keeping with
the ethics of care, morale is built up in relation to others: in close interpersonal, group or
community relationships people may consolidate and formulate their ethical values and
consequently take decisions.
- helping someone to die is no simple matter, and acting in accordance with a preference to
bring forward death may lead to ethical conflicts. Although nurses frequently occupy
positions where their responsibility in direct care is very high, they command little room in
care option decision-making. This may lead to them having to take actions on occasions to
cover medical prescriptions which they are doubtful about or even disagree with, be it due
to indication, dosing, time of administration,
- These are situations where the nurses cannot accept their participation in shortening
someone’s life, regardless of the request, due to the conflict of values the situation
represents for the nurse on a personal level. Conscientious objection is regarded as an
ethical conflict between the individual’s right to their request and the nurse’s right to
preserve their own personal values. Both rights depend upon each other, and they therefore
cannot be respected at the same time, unless another professional, who is a non-objector,
interjects.

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4.

dignity in death and dying

 Moral and ethical principles involved in euthanasia and suicide

- more complex, issue raised by the question of euthanasia in a

 Ethico- moral responsibility of nurses In euthanasia and suicide

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