Paper Example on Ethical Theory in Nursing

Introduction

Euthanasia is one such controversial ethical topic that has been debated for decades yet the proponents and those against do not seem to agree any time soon. It is defined as a practice of administering lethal drugs to a patient by someone with the intention of ending the life (Quaghebeur, Dierckx de Casterle & Gastmans, 2009). Although the practice has only been legalized in 7 countries worldwide, it is an ethical dilemma that confronts doctors and nurses across the globe. Empirical research in Netherlands and Belgium (countries that have legalized euthanasia) as well as Japan, USA, Canada, Australia, and New Zealand (countries where the practice of euthanasia is illegal) indicate that due to nurses' expertise in palliative care and specific position in care of dying patients, they are intimately engaged with patients who have requested euthanasia (Quaghebeur et al., 2009). These nurses undergo complex feelings ranging from moral uncertainty, guilt, personal conflict, fear and frustration (Quaghebeur et al., 2009). This is because of the ethical dilemma that their role of caring for such patients presents.

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Whose Rights, Needs, Desires, Views Are Being Represented In The Euthanasia Debate?

Euthanasia debate represents the rights, needs, and desires of the patient on one hand and in the other hand the views of the nurses and doctors. The proponents of the debate argue that euthanasia concerns an individual's right to freedom which means he or she can choose what do to with their life. Further, proponents argue that euthanasia is the patient's desire to relieve pain and seek relief from a lower quality of life.

On the other hand, the debate focuses on the views of the nurses regarding the administration of euthanasia. There exist four principles that guide ethical conduct of health care providers which are autonomy, justice, beneficence and non-maleficence (American Medical Association, 2016). Based on these principles, some nurses view euthanasia as an ethically good practice justified on the basis of the individual's autonomy. A person organizes his or her own private life and a nurse should not counteract what a patient requests because a nurse would deem processing the request as a realization of a patient's autonomous choice (Quaghebeur et al., 2009). On the contrary, some nurses consider the fundamental nursing responsibilities outlined in the International Code of Ethics which requires that a nurse prevents illness, promote health, restore health and alleviate suffering (Epstein & Turner, 2015). Following this directive, some nurse argues that whereas palliative care focuses on relief of suffering (which in some way may provide a leeway to considering administration of euthanasia), such focus cannot the other nursing responsibilities including tireless efforts aimed at restoring health. It is quite evident that fundamental nursing responsibilities and principles of ethical practice provide a center stage for differing nurses views on euthanasia which also deepen the debate and the dilemma involved.

Ethical Theories on Euthanasia

The above rights, needs, desires, and views on euthanasia fall into utilitarianism, natural law theory, and hedonism.

Utilitarianism

Utilitarianism is a form of consequentialism proposed by Jeremy Bentham where an act is considered wrong or right based on its consequences to the subjects. There are two perspectives of utilitarianism; act- and rule-utilitarianism. Act-utilitarianism argues that the right action is one that has better consequences to the agent from a variety of available action choices (Landau, 2017). Rule-utilitarianism, on the other hand, argues that the right action is one that is in accordance with the rule and if followed leads to better consequences than any other rule that could be followed in that situation. Utilitarianism also considers pleasure and pain or happiness and suffering as being intrinsically significant (Landau, 2017).

According to utilitarianism, the focus when debating on euthanasia should be based on the consideration of increasing happiness and decreasing suffering as much as possible (Crocker, 2013). As such, euthanasia is morally right because it decreases the misery of everyone involved including the patient, family, friends, and caretakers. The suffering that the family members and friends, both emotional and material, are alleviated. The patient's poor quality of life and pain is also alleviated (Crocker, 2013).

Natural Law Theory

Natural law is a theory that strikes a connection between the law and human morality. The natural law considers law and morality as one thing because they believe that laws should be defined by morality. Human morality is derived from nature implying that everything in nature has a purpose. Human beings, being part of nature, has a purpose to live a good life. Therefore, natural law theory considers any actions that would prevent a human being from living a happy and good life as immoral or unnatural. The natural law considers both interior and exterior actions as being important as both should result in a good act. In a nutshell, natural law theory argues that any law that is good is moral and any moral law is good (Landau, 2017).

The natural law emphasizes morality and actions like euthanasia as easily considered immoral because they amount to killing, an act that is considered unnatural. Although euthanasia is good at addressing the needs of the patient which include relieving pain, the act of assisting someone to kill himself or herself is a serious moral wrong (Ramis-Barcelo, 2011). Furthermore, human beings are part of nature created for a purpose and killing through euthanasia goes against the purpose of life.

Hedonism

Hedonism is a philosophical doctrine which argues that intrinsically all pleasure is good. It argues that a happy life is as a result of maximizing feelings of pleasure while minimizing pain. In an ethical sense, hedonism supposes that whether people pursue pleasure or not, they ought or should do so. Always, a right action will produce pleasure whereas a wrong one will lead to pain (Landau, 2017).

On euthanasia, hedonism evaluates its morality based on the consequences of the action. Based on hedonism, denying euthanasia will lead to more pain for the suffering patient as well as the caretakers, family members, and friends. The dying patient also experiences poor quality of life characterized by pain and in absence of pleasure. On the other hand, allowing euthanasia will lead to the elimination of pain for the patient and the caretakers, family members, and relatives which soon afterwards lead back to pleasure (Barilan, 2009). Hence, euthanasia, viewed on the lenses of hedonism, is morally right as it allows people to pursue pleasure rather a pain.

Conclusion

Euthanasia is an ethical dilemma that nurses experience every day in their practice. Euthanasia has implications to the nurses' fundamental responsibilities and principles of ethical care where the nurses should consider patient autonomy but still ensure they do not overlook the other responsibilities of nursing. Whereas there exist ethical theories that would assist in determining a solution to the ethical dilemma posed by euthanasia, these theories differ. Utilitarianism and hedonism seem to support euthanasia as it is a means to the attainment of pleasure. Natural law, however, differs from that position as it views the human being as part of nature and with a purpose. Killing is immoral and thus euthanasia is wrong.

References

American Medical Association. (2016). AMA code of medical ethics. American Medical Association.Barilan, Y. M. (2009). Nozick's Experience Machine and palliative care: revisiting hedonism. Medicine, Health Care and Philosophy, 12(4), 399-407.

Crocker, K. (2013). Why Euthanasia and Physician-Assisted Suicide are Morally Permissible.

Epstein, B., & Turner, M. (2015). The nursing code of ethics: Its value, its history. OJIN: The Online Journal of Issues in Nursing, 20(2), 1-10.

Landau, R.S. (2017). The fundamentals of ethics. Oxford University Press.Quaghebeur, T., Dierckx de Casterle, B., & Gastmans, C. (2009). Nursing and euthanasia: a review of argument-based ethics literature. Nursing ethics, 16(4), 466-486.

Ramis-Barcelo, R. (2011). Assisted Suicide and Euthanasia: A Natural Law Ethics Approach. Journal of Moral Philosophy, 8(2), 296-298.