1. S. Tagapan- Feb1, 2012 right and virtuous action as opposed to what
guides actions in terms of rules and obligations
ETHICAL AND LEGAL CONSIDERATIONS IN PALLIATIVE
CARE Ethical principles- provides a sound foundation for our
own personal beliefs, morality and actions when
applied to modern-day living
Ethics- is a branch of philosophy that considers and A. Respect- respect for persons requires that each
examines the moral life individual be treated as unique and entitled to
- Systematic examination which seeks to provide treatment that is respectful of their human dignity
sound justification for moral decisions and B. Autonomy- is multidimensional and in its broadest
actions of people sense incorporates the following: having a minimum
- Deciding what is right or wrong, is not quite as of relevant information; self-determined choice;
simple in palliative care freedom to act on the basis of one’s choices; and
- Although it is nurses who spend the greatest self-governance
amount of time with a patient, all team C. Justice- involves the determination of what
members involved in caring for the patient someone or some group is owed, merits, deserves,
should contribute to the decision making or otherwise is entitled to
process D. Beneficence, Non-maleficence- doing good and not
causing harm
Ethical dilemmas- difficult problem for which there E. Application- reflect, analyse, and discuss in each
is no totally satisfactory solution, or which involves situation- apply the ethical principles of respect for
a choice between equally unsatisfactory individual, autonomy, justice, beneficence and non-
alternatives maleficence to the analysis
Ethical theories- adopting an ethical approach is Legal implications:
not always about having a set of rules to obey but is
rather about transforming oneself to someone for A. Right to die- an individual has a right to refuse
whom the duty of care for the individual is inherent. medical treatment and the refusal of such
treatment will cause death.
B. Advanced directive- a formal written advanced
statement by a pt refusing treatment in specific
A. Deontological ethics- doing what is right
stated situations that may occur in future illness
regardless of the consequences
1. Living will
- No lies; e.g. Not to tell pt his condition if the
2. Durable power of attorney- document that
health care team has decided not to tell him
permits individuals to designate another person
B. Utlitarian ethics- theory considers the value of
to make decisions for them should they lose
merit of an outcome of an action rather than
decision making capacity
the action itself, evaluates the ends produced
C. Do not resuscitate- for clients who are in terminal
by an action to determine its goodness or
state, irreversible illness or expected death
rightness
- Generally written when the client or proxy has
- It strives to maximize benefit and minimize
expressed the wish for no resuscitation in the
misery for the greatest possible number
event of CP arrest
- E.g: support for pediatrics or geriatrics?
D. Terminal weaning- gradual withdrawal of
- Utilitarianism/consequentialism
mechanical ventilation from a client with terminal
C. Virtue-based ethics- person-centered rather
illness or an irreversible condition with poor
than practitioner-centered, focuses on what is a
prognosis

2. E. Death certificate- prepared for each person who
dies
F. Organ donation- pts who express a wish to donate
functional organs such as heart, corneas, liver,
lungs, and kidneys can fill out an organ donor
consent card
G. Autopsy- examination of the organs and tissues of a
human body after death
- Consent is a legal requirement
- Closes surviving family member has the
authority to determine whether an autopsy is
performed