6 comments to my peers – Ethical and Spiritual Decision Making in health care
Comment 1:
Working as a clinician for greater than twenty years, I’ve seen my share of dying patients. At the start of my career death took a toll on my heart. As a twenty year old kid, I didn’t view death as a natural part of life. I viewed it as a person exiting this earth and leaving their love ones behind to navigate life alone. At such a young age with immature thoughts, witnessing death and suffering heighten my sensitivity towards patients’ emotional needs, fostering deeper empathy. With repeated exposure and years of experience, I gained the knowledge that “Death is not the opposite of life, but a part of it” (Murakami, 2017). I can honestly say that I have watched myself change over the years. I can remember in my twenties and early thirties employed as a hospice home care nurse, the death of my patient whom I assessed the decline daily would have my feelings down in the dumps for days. It was to the point where I gave up in a journey of my career in which my mind had great passion for but my heart was too weak. This lead me into the journey of long-term care (LTC). LTC taught me many ways in which I could show empathy to patients and their families in such ruff times such as how to be an active listener, how to show and treat others with respect, express cultural competence, offer comfort, show support, and embrace humanity. In so many words, death has showed me how to appreciate life more and understand the importance of quality of life over quantity.
Comment 2:
As an X-ray tech, my clinical experiences with dying patients are limited. I believe clinical experiences with patients who have terminal illnesses can have a profound impact on a healthcare worker’s view of death and their ability to demonstrate empathy. These experiences can shape one’s understanding of death and dying, making them more aware of the emotional and physical challenges that come with end-of-life care. When healthcare workers bear witness to the pain and anguish endured by patients and their families, it can be a transformative experience. This firsthand exposure, I believe, can cultivate a heightened sense of compassion and a deeper appreciation for the value of emotional support and tender care, particularly in the context of end-of-life care. This newfound sensitivity can empower healthcare workers to deliver more personalized and meaningful care, thereby enhancing the patient and family’s experience. However, it’s crucial to acknowledge that clinical experiences with death can also have adverse effects on healthcare workers. The constant exposure to mortality can lead to emotional exhaustion, compassion fatigue, and burnout. Therefore, it’s imperative for healthcare workers to prioritize self-care and seek support when needed to mitigate these potential negative impacts on their ability to provide quality care. I also advocate for the utilization of hospice services, which can help alleviate some of the stressors experienced by healthcare workers.
Comment 3:
As a home health nurse, I have had numerous patients pass away, some were unexpected, others weren’t. As I’ve seen how different patients approach death or even the topic of death I have learned how to provide end-of-life care with compassion and empathy. When a patient’s health is declining I recommend a patient transfer to hospice. However, some patients chose not to. I am currently working with a patient in her 70s who has been fighting metastatic breast cancer for 10 years. Her most recent scans indicate it has metastasized throughout her body including her liver and bones. Both her husband and oncologists have suggested they discontinue treatments. The patient is weak, losing weight, and on a feeding tube. Her oncologist does not think the patient will be able to handle the treatments. However, the patient is not ready to give up. She’s not ready to die. My duty is to continue providing the best care possible while also giving my patients all the information to make informed decisions. I show empathy by acknowledging the difficult situation she is in and show compassion in my care for her. This patient appears to fear death and my heart feels for her. I happened to also have this patient’s father as a patient and he at the age of 94 unexpectedly passed away. He had lived a long life and was active in his religion. The days before his death he and his wife bore their testimony of Jesus Christ and there was definitely a sense of peace with them. I think it is our textbook states, “Those who live in Christ, meaning those who place their hope in the finished work of Christ and not their own good works, can experience the present reality and certainty of eternal life and communion with God” (Hoehner et al., 2024 apge 210).
Comment 4:
I have not had too much clinical experience with death and dying. In nursing school, I only did post-mortem care one time when an ICU patient withdrew care and passed on my shift. Being in the NICU, now, I’ve indirectly seen a handful of neonates pass, but none that I have directly worked with. Seeing the adult pass in nursing school, I remember trying to hold it together as her entire family was present and grieving the passing of their mother, grandmother, aunt, sister. I remember crying when the family left and my nurse saying it was ok and that she’d be more concerned about me if I didn’t express any emotions. We are healthcare providers, but we are people first. I remember how humbling doing the post-mortem care was. We prayed over her before we started and my nurse spoke to her as if she were still with us. We cleaned her up, removed anything that indicated healthcare. I just remember thinking I wanted to treat her with the same respect and dignity I’d want my family members to be treated with. Now as a NICU nurse, I am extremely empathetic toward parents who are going through the loss of their baby. It is a challenging situation, as no one should have to lose their baby…it’s unnatural in the state of life and death. I have empathy for them as a parent myself. I can only imagine and the pain of losing a child. The pain of leaving the hospital without your baby that you carried for 9 months. I have all the empathy in the world for them.
Comment 5;
As a follower of the Christian faith, I hold the belief that human life is a divine endowment from God, which makes it inherently sacred and valuable. Christians believe that every individual is created in the divine image of God, and as such, taking one’s life or intentionally ending another’s life is seen as a direct affront to the sanctity of life. Suicide and euthanasia are considered grave transgressions, and they are vehemently opposed by Christians worldwide. To Christians, life is a precious gift from God, and as such, it is cherished, safeguarded, and respected. The Christian perspective is that hardships, suffering, and challenges are inevitable and essential in forging a closer bond with God. Christians believe that persevering through adversity is an integral part of the journey of faith and serves as a means of strengthening one’s relationship with God. Humans are, therefore, called upon to endure their struggles with faith, hope, and trust in God’s plan and purpose. In light of this, the Christian stance on suicide and euthanasia underscores the importance of valuing and safeguarding human life. Christians believe God has a specific plan and purpose for every human life, and it is essential to trust in his divine plan, even in the face of adversity. The Christian conviction is that every life is valuable and that taking one’s life or someone else’s is a deviation from God’s will. Therefore, the Christian faith places a high value on the sanctity of life and holds that it is vital to respect and cherish the gift of life that God has bestowed upon us.
Comment 6:
The practice of assisted suicide for Christian practitioners and patients, is considered a sin, in my opinion. While that sounds harsh to say, and I know there are complex situations in medicine where assisted suicide may seem like the best option to prevent suffering both emotionally and physically, but as a medical provider, I do not see how assisted suicide would ever be justifiable. One might argue that withholding treatments that would prolong life is the same thing as assisted suicide because you know the end result is the same, but they are actually very different. In an article on the ethics of physician-assisted suicide (PAS) by Sulmasy (2021), he compares the difference between martyrdom and suicide to the same concept as the difference between suicide and PAS – one is intentional harm on oneself while the other is death inflicted on you by another person, which have two different connotations. I do not believe that as human beings, and especially as healthcare providers who are entrusted to heal patients and never intentionally harm them, I cannot see how PAS could be justifiable before God. According the the Christian perspective, all humans, regardless of physical, mental, or emotional status have innate dignity and worth and therefore, should not intentionally end their life that was gifted to them by God (Bogue et al., 2024). While this can be a very heated debate and touchy subject for many, I know that I wouldn’t be able to ever feel good about the intentional killing of another human being.
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