Case Study: End Of Life Decisions—George Is A Successful Att

Case Study End Of Life Decisionsgeorge Is A Successful Attorney In Hi

Case Study: End of Life Decisions George is a successful attorney in his mid-fifties. He is also a legal scholar, holding a teaching post at the local university law school in Oregon. George is also actively involved in his teenage son’s basketball league, coaching regularly for their team. Recently, George has experienced muscle weakness and unresponsive muscle coordination. He was forced to seek medical attention after he fell and injured his hip.

After an examination at the local hospital following his fall, the attending physician suspected that George may be showing early symptoms for amyotrophic lateral sclerosis (ALS), a degenerative disease affecting the nerve cells in the brain and spinal cord. The week following the initial examination, further testing revealed a positive diagnosis of ALS. ALS is progressive and gradually causes motor neuron deterioration and muscle atrophy to the point of complete muscle control loss. There is currently no cure for ALS, and the median life expectancy is between 3 and 4 years, though it is not uncommon for some to live 10 or more years. The progressive muscle atrophy and deterioration of motor neurons leads to the loss of the ability to speak, move, eat, and breathe.

However, sight, touch, hearing, taste, and smell are not affected. Patients will be wheelchair bound and eventually need permanent ventilator support to assist with breathing. George and his family are devastated by the diagnosis. George knows that treatment options only attempt to slow down the degeneration, but the symptoms will eventually come. He will eventually be wheelchair bound and be unable to move, eat, speak, or even breathe on his own.

In contemplating his future life with ALS, George begins to dread the prospect of losing his mobility and even speech. He imagines his life in complete dependence upon others for basic everyday functions and perceives the possibility of eventually degenerating to the point at which he is a prisoner in his own body. Would he be willing to undergo such torture, such loss of his own dignity and power? George thus begins inquiring about the possibility of voluntary euthanasia.

Paper For Above instruction

The ethical, legal, and psychological implications surrounding end-of-life decisions, particularly voluntary euthanasia, are complex and multifaceted. For individuals like George, diagnosed with a degenerative disease such as amyotrophic lateral sclerosis (ALS), these considerations become even more poignant. This paper explores the moral and legal frameworks that inform decisions about euthanasia, the psychological impact of terminal diagnoses, and the societal debates that influence legislation and healthcare practices.

Ethical Perspectives on Euthanasia

Euthanasia remains one of the most contentious ethical issues in healthcare. From a utilitarian perspective, permitting euthanasia can be justified if it relieves suffering and maximizes overall well-being. Conversely, deontological ethics emphasize the intrinsic value of human life and caution against intentionally ending life, regardless of suffering. Kantian ethics, for instance, argue that humans possess autonomy and dignity that should be respected, but also caution against acting in ways that could violate moral laws, such as killing. The principle of autonomy supports respecting an individual's decision to end their life to avoid suffering, especially in terminal conditions where quality of life is severely diminished (Battin et al., 2007).

Legal Status of Euthanasia

Legally, euthanasia's legality varies worldwide. In the United States, euthanasia is generally illegal, but some states permit physician-assisted suicide under stringent conditions—Oregon being one of the pioneers with its Death with Dignity Act. This law allows terminally ill adults to request lethal medication, provided they meet specific criteria and are competent at the time of request (Oregon Health Authority, 2020). The legal framework aims to balance respect for autonomy with protections against potential abuses. Other countries like the Netherlands and Belgium have broader legislation permitting voluntary euthanasia under carefully regulated conditions (Onwuteaka-Philipsen et al., 2017). The legal debates often center on whether allowing euthanasia might later lead to abuses or erode societal respect for vulnerable populations.

Psychological and Emotional Dimensions

For patients like George, identifying the desire for euthanasia often stems from fears of loss of dignity, autonomy, and the ability to enjoy life's quality. The anticipation of progressive physical decline causes profound psychological distress, which can exacerbate feelings of hopelessness and despair. Psychological support and palliative care are crucial in alleviating suffering and helping patients navigate these complex emotions. Research indicates that open communication, psychological counseling, and spiritual support can significantly influence patients' decisions and improve their quality of life, even in terminal stages (Cherny et al., 2015).

Societal and Cultural Influences

Cultural norms and societal values significantly shape attitudes toward euthanasia. In Western societies, individual autonomy and self-determination are highly valued, often supporting the legality and ethical acceptability of euthanasia. In contrast, many religious traditions oppose euthanasia based on moral teachings that emphasize the sanctity of life. These cultural and religious perspectives influence legislation, medical practice, and public opinion. As societies become more pluralistic, policies continue to evolve, reflecting debates between respecting individual choice and protecting life (Eggen & Bilsen, 2016).

The Role of Medical Practice

Healthcare professionals play a pivotal role in end-of-life decisions. Ethical guidelines advocate for respecting patient autonomy while ensuring informed consent and withholding or withdrawing life-sustaining treatments when appropriate. The physicians' role includes providing comprehensive information about prognosis, treatment options, and palliative care, allowing patients to make voluntary and informed choices. The principle of beneficence guides clinicians to alleviate suffering, but they must also consider non-maleficence—avoiding harm—particularly when assisting in euthanasia. Medical codes of ethics emphasize the importance of respecting patient wishes while adhering to legal standards (American Medical Association, 2016).

Conclusion

Decisions about euthanasia are deeply personal, ethically complex, and influenced by laws and societal norms. For individuals like George facing terminal illness and impending loss of autonomy, these choices encompass not only medical considerations but also profound psychological and spiritual dimensions. It is vital to ensure that palliative care, psychological support, and legal safeguards are in place to uphold dignity and respect autonomy while safeguarding vulnerable populations. Ongoing societal debates and legislative reforms will continue to shape the future landscape of end-of-life choices.

References

• American Medical Association. (2016). Code of Medical Ethics: Opinions on End-of-Life Care. AMA Journals.
• Battin, M., Sabin, J. E., Clippinger, K., & Harris, J. (2007). Euthanasia, assisted suicide, and the law: a review of the ethical, legal, and social debate. Journal of Medical Ethics, 33(7), 415–418.
• Cherny, N. I., et al. (2015). End-of-life decision making in palliative care: Ethical and practical challenges. The Lancet Oncology, 16(4), e150–e157.
• Eggen, T., & Bilsen, J. (2016). Cultural influences on attitudes towards euthanasia. Asian Bioethics Review, 8(3), 251–267.
• Oregon Health Authority. (2020). Oregon Death with Dignity Act. Oregon.gov.
• Onwuteaka-Philipsen, B. D., et al. (2017). Trends in End-of-Life Care in The Netherlands. New England Journal of Medicine, 377(18), 1721–1723.
• Smith, R., & Emanuel, E. J. (2020). End-of-Life Decision-Making and the Law. New York: Oxford University Press.
• World Health Organization. (2018). Palliative Care: Symptom Management and End-of-Life Decisions. WHO Publications.
• Quill, T. E., & Meier, D. E. (2021). Physician-assisted death and the continuum of end-of-life care. New England Journal of Medicine, 385(4), 310–319.
• Ype, J., et al. (2019). Psychological Aspects of Decision-Making Near End of Life. Psycho-Oncology, 38(11), 1880–1886.