Ethics

Decisions on the nature and time of death are issues which may lead to conflicts regarding the ethical and legal points of view of the public and the health professionals. Sometimes, there is dilemma regarding when to preserve life and when to let go. This paper gives an analysis of both aspects and offers a conclusion on the issues.

End of life decisions refers to the options given to a person regarding deciding on the time to die. Some diseases like cancer cause a lot of suffering and the patient may prefer being left alone to die rather than living in agony. Techniques like Cardiopulmonary resuscitation (CPR) have been used for a long time. However, in some disease conditions like dementia, it might be ineffective. The survival rate of these patients is low. Due to the poor prognosis of CPR in frail patients who are old, there is no need of trying this technique. In the advanced stages of Alzheimer for example, only comfort measures are provided. These include offering pain medications and oxygen.

Advanced directives are written documents by a person when he or she can make decisions. It implies that heshe would not need any artificial life sustenance technique incase of mental incompetence. These include respirators and or Cardiopulmonary resuscitation (CPR) and other techniques available. It only applies when a person cannot make decisions or he or she is mentally unstable. Most people, especially the elderly, do not prefer CPR.

Sometimes, a physician may end the life of a patient through euthanasia. Euthanasia is an act whereby a health practitioner directly and deliberately causes the death of a patient using a medical technique like giving a lethal injection of Potassium Chloride. It is considered merciful unlike murder which is malicious. Voluntary euthanasia is when such an act is done with the consent of the patient whereas involuntary euthanasia is against the patients wishes. .Physician assisted euthanasia is considered a voluntary type of euthanasia.

Moral Positions
On an ethical aspect, all life is sacred and should be preserved. It is therefore morally wrong to engage in any step aimed at ending the life of a person. This is a wide perception of what should be done by every health provider. However, there are times when the life of a person is poor and not worth living. Secondly, a doctor is allowed to withhold any treatment when the quality of life of the patient is poor. This is applied when the patient feels that the burden of medication is much. Thirdly, an act which leads to good consequence is considered right but this is achieved using the harmful side effects. In a terminally ill patient for example, large doses of pain alleviating drugs may be used to shorten the life. This is the doctrine of double effect.

It has also been argued that the right of the patient should be respected. This is the principle of Respect for Autonomy. However, this does not imply that the doctor is compelled to offer treatment he or she thinks is not necessary, even if the patient asks for it. In health provision, the duty of beneficence requires that the patients interest is considered first (The UK Ethics Network, 2010). It is not easy to understand how death can be of benefit to a patient or in his or her interest. The principle of non-maleficence states that no harm should be inflicted intentionally. It is difficult to agree to this since most drugs have harmful effects but save lives.

Legal considerations
It is worth noting that the legal and ethical principles are related in one way or the other. Most of the legal issues are derived from the moral principles. It is illegal to end someones life whether he or she consents or not. This broadly includes both assisted suicide by a doctor and killing an incompetent patient using a lethal injection.

Conclusion
The decisions regarding when a person should be allowed to die are important. This reduces suffering of the patient. Most diseases like cancer cause a lot of pain and suffering while there is no improvement even with long time medication. In frail, elderly patients suffering from Alzheimer, it is not advisable to do CPR to the patient since there will be no improvement in the condition. It will also be costly to continue managing such a patient hence the best way is to withdraw any efforts aimed at supporting life. Therefore, the decision to die or not to die should solely be left in the hands of the patient but care should be provided so that they die comfortably.