The personal decision of terminally ill patients to commit suicide because of the unbearable suffering and pain is a challenge for the medical staff, including physicians and nurses. Thus, the decision to commit suicide is connected with a lot of ethical, moral, and legal dilemmas and issues, and the main task of a physician or a nurse facing the challenge is to manage the case according to the principles of ethics and morality without violating the legal aspects (Arries, 2005). The problem is in the fact that the situation when a terminally ill patient focuses on committing suicide as the way to relieve suffering is associated with dilemmas, but not with problematic questions. As a result, the resolution of a dilemma cannot involve the aspects satisfying the expectations of both parties.
If a terminally ill patient informs a physician or a nurse about his or her choice to commit suicide, the representative of the medical staff faces such ethical dilemmas as the necessity to prevent the situation because of following the Hippocratic Oath and contributing to the preservation of the patient’s life and the necessity to relieve the patient’s sufferings (Mohanti, 2009). On the one hand, it is necessary to act according to the principles of beneficence and non-maleficence to respond to the interests of the patient and not to contribute to suffering. On the other hand, a patient chooses death as the way to end suffering. From this point, it is important to persuade a patient to change the position and work out the plan to relieve suffering (James, Gilliland, & James, 2012).
The choice of committing suicide often depends on the terminally ill patients’ visions of their situations as the evidence of being burdens for their relatives. In this case, the moral dilemma involves the effects of the terminally ill patients’ decisions on the lives of their relatives and close people. According to the socially accepted moral norms, people have no moral rights to make decisions about their lives without references to the visions and attitudes of their relatives. In this situation, the representative of the medical staff faces the dilemma to regulate the case to meet the interests of the patient and his or her relatives’ from the point of morality (Arries, 2005). Relieving the patient’s pain, a physician or a nurse can draw the patient’s attention to the fact that pain is the cause for people’s being fearful and miserable, thus, a person should not discuss oneself as a burden for relatives.
The legal dilemmas which can be faced are the necessity to control the actions of the patient because the representatives of the medical staff are responsible for preventing the patients’ actions when they can pose a danger to themselves (James, Gilliland, & James, 2012). The next dilemma is the problem of confidentiality because the representative of the medical staff cannot involve the other persons in the discussion of the case without the will or consent of the patient.
Thus, to provide effective crisis intervention and to cope with the associated ethical, moral, and legal dilemmas, a representative of the medical staff should guarantee the safety of clients and provide the necessary physical and psychological support along with demonstrating the alternatives and developing the plan of actions.
References
Arries, E. (2005). Virtue ethics: an approach to moral dilemmas in nursing. Curationis, 28(3), 64-72.
James, R., Gilliland, B., & James, L. (2012). Crisis Intervention Strategies. USA: Cengage Learning.
Mohanti, B. (2009). Ethics in palliative care. Indian Journal of Palliative Care, 5(2), 89–92.