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PICOT Question-Ethics of Euthanasia for Terminally Ill Patients

PICOT Question-Ethics Of Euthanasia For Terminally Ill Patients

This paper aims to investigate the ethics of euthanasia as an intervention for terminally ill patients and compare its impact on symptom relief and quality of life with palliative care. The PICOT question guiding this research is as follows: In sick terminal patients (P), how does euthanasia (I), compared to palliative care (C), influence symptom relief and quality of life (O) over a specified duration (T)? This paper will analyze and synthesize relevant sources through a comprehensive literature review to provide a complete understanding of the ethical considerations surrounding euthanasia and its effects on patients’ well-being.

Terminally ill patients face significant physical and emotional challenges, necessitating interventions that prioritize symptom relief and enhance their quality of life. While palliative care is commonly provided to alleviate suffering, the ethical dilemma surrounding euthanasia arises as an alternative approach. Euthanasia involves intentionally ending a patient’s life to relieve their suffering, raising complex ethical considerations related to autonomy, the sanctity of life, and the potential for abuse. This paper critically examines the ethical implications of euthanasia and compares its impact on symptom relief and quality of life with palliative care.

Methods

The PICOT question will be thoroughly investigated by doing a literature search utilizing relevant academic sources, including PubMed, Scopus, and Google Scholar. Keywords about euthanasia, palliative care, terminal illness, ethics, symptom alleviation, and quality of life will be used in the search approach. Studies from primary research, systematic reviews, and meta-analyses published within the previous ten years will all meet the inclusion requirements. The chosen sources will be examined and synthesized to present a thorough topic overview.

Results and Discussion

The outcome of this review will be presented thematically, organizing the information according to critical ethical considerations and the impact of euthanasia and palliative care on symptom relief and quality of life. Ethical principles, including autonomy, beneficence, non-maleficence, and justice, will be examined concerning euthanasia (Akdeniz et al., 2021). The effectiveness of euthanasia and palliative care in providing symptom relief and enhancing the quality of life will be compared, considering factors such as pain management, emotional support, and the overall patient experience (Watt et al.,2019).

PICOT Question

Population/Problem/Patient

Most Patients who are terminally ill and in the latter stages of their diseases make up the population of interest for this study. Due to their terminal illnesses, these patients frequently experience extreme physical and mental pain. People with various terminal conditions, such as cancer, organ failure, or neurological disorders, may be included in this patient population (Pant, 2022). They might display several symptoms, such as discomfort, exhaustion, dyspnea, nausea, and emotional distress.

Intervention

The appropriate treatment or exposure under investigation is euthanasia. Euthanasia is the deliberate termination of a terminally ill patient’s life by administering drugs to alleviate their suffering and provide them with a peaceful death (Pant, 2022). It is vital to remember that euthanasia can be classified as voluntary, non-voluntary, or involuntary based on the patient’s express agreement and competence to make decisions (Kono, Arai, and Takimoto, 2023).

Comparison

The alternative intervention being considered is palliative care. Palliative care is a holistic approach aimed at improving the quality of life for terminally ill patients through the management of pain and other distressing symptoms and addressing their psychological, social, and spiritual needs (Sobanski et al.,2020). It focuses on providing comprehensive support to patients and their families to enhance their well-being and dignity.

Outcome

The measurable effects include symptom relief and improved quality of life for terminally ill patients. Symptom relief encompasses reducing or alleviating physical symptoms such as pain, nausea, dyspnea, and constipation (Sobanski et al.,2020). It also ameliorates psychological symptoms such as anxiety, depression, and existential distress. Quality of life outcomes may involve assessing domains such as physical functioning, emotional well-being, social support, spiritual fulfillment, and overall satisfaction with life (Kono, Arai, and Takimoto, 2023).

Timeframe

The research design and study objectives will determine the period of data collection. Depending on the nature of the interventions and the time required to see changes in symptoms and quality of life outcomes, it might take a few weeks to several months. Extended follow-up examinations may also be required to capture long-term impacts (Kono, Arai, and Takimoto, 2023).

Type of Study

Many study designs might be used to answer the PICO question. A thorough review and meta-analysis of current research would allow for data consolidation from different studies on euthanasia and palliative care for terminally ill patients (Pant, 2022). A comparative cohort study might also examine the results of individuals receiving euthanasia against those receiving palliative care (Akdeniz, Yardmc, and Kavukcu, 2021). Alternatively, a prospective randomized controlled trial (RCT) might be considered to directly compare the effects of euthanasia and palliative care on symptom relief and quality of life with patients randomized to different treatment arms (Sobanski et al.,2020). The choice of this study design will depend on factors such as ethical considerations, feasibility, and available resources.

References

Akdeniz, M., Yardımcı, B., & Kavukcu, E. (2021). Ethical considerations in end-of-life care. SAGE Open Medicine, 9, 20503121211000918.

Anderson, J., & Brown, L. (2021). The ethics of euthanasia: Examining societal implications and the risk of abuse. Journal of Medical Ethics, 47(3), 165–172. doi:10.1136/med ethics-2020-106882

Kono, M., Arai, N., & Takimoto, Y. (2023). Identifying practical clinical problems in active euthanasia: A systematic literature review of the findings in countries where euthanasia is legal. Palliative & Supportive Care, 1-9.

Pant, B. (2022). Euthanasia: Are we ready for it, or is it too late? Nepal Journal of Neuroscience, 19(4), 1–2.

Sobanski, P. Z., Alt-Epping, B., Currow, D. C., Goodlin, S. J., Grodzicki, T., Hogg, K., … & Larkin, P. J. (2020). Palliative care for people with heart failure: European Association for Palliative Care Task Force expert position statement. Cardiovascular Research, 116(1), 12-27.

Watt, C. L., Momoli, F., Ansari, M. T., Sikora, L., Bush, S. H., Hosie, A., … & Lawlor, P. G. (2019). The incidence and prevalence of delirium across palliative care settings: a systematic review. Palliative Medicine, 33(8), 865–877.

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Analyzing Published Research

Analyzing Published Research

It is essential to consider the ethical issues surrounding euthanasia for terminally ill patients because this is a delicate and complicated subject. This study will interpret two important research articles on the topic, emphasizing the literature on nursing ethics and the care provided to dementia patients at the end of their lives. This work aims to employ research methods to examine the articles’ content, assess the articles’ reliability and clinical relevance, and offer evidence-based solutions to the clinical issue.

The deliberate ending of an individual’s life to eliminate suffering, often known as euthanasia, is a contentious ethical issue. Euthanasia is a controversial topic for terminally ill patients because it involves important issues relating to patient autonomy, quality of life, and the responsibility of medical personnel in delivering compassionate care. Additionally, because of their increasing cognitive deterioration and problems with their decision-making ability, persons with dementia pose extraordinary obstacles.

It is crucial to review the nursing ethics literature and look at the context of end-of-life care for dementia patients to comprehend the ethical issues surrounding euthanasia. This essay will analyze two essential papers that offer insightful commentary on the subject.

The first piece, “Nursing and Euthanasia: A Narrative Review of the Nursing Ethics Literature” by Pesut et al. (2020), thoroughly examines the nursing ethics literature about euthanasia. This narrative Review investigates nurses’ thoughts on euthanasia and their ethical considerations. The authors highlight the significance of respecting patient autonomy and having open discussions regarding end-of-life options by integrating the research to provide light on different moral viewpoints held by nurses.

The following essay, ” Euthanasia and other ends of life in patients with dementia. ” by Cipriani and Di Fiorino (2019), focuses mainly on the moral and legal ramifications of euthanasia and end-of-life care for dementia patients. This review article explores the difficulties and ethical issues when deciding how to provide end-of-life care for individuals with dementia. The writers examine the autonomy of patients, their ability to make decisions, and healthcare workers’ responsibility to ensure that these people die in a dignified manner.

Through critically evaluating the articles, this discussion tries to determine their accuracy and practical relevance in resolving the moral dilemmas surrounding the euthanasia of dementia and terminally ill patients. The analysis of the available research and the thoughts supported by the available data presented in this work can advance current discussions and impact upcoming studies and practice in this challenging and ethically complex area.

Clinical Question

Problem: What is the focus of your group’s work?

Our group’s work examines the ethical considerations surrounding euthanasia for terminally ill patients.

Significance of Problem: What health outcomes result from your problem?

The ethical dilemma of euthanasia for terminally ill patients impacts end-of-life care decisions, patient autonomy, and the emotional well-being of patients, families, and healthcare professionals (Pesut et al., 2020).

Purpose of the Paper: What will your paper do or describe?

This paper will review two critical articles to understand the nursing ethics literature on euthanasia better and explore the specific challenges and considerations regarding euthanasia for patients with dementia (Cipriani & Di Fiorino, 2019). It aims to provide evidence-based insights to inform future research and practice in this domain.

References

Cipriani, G., & Di Fiorino, M. (2019). Euthanasia and other end of life in patients who have dementia. Legal Medicine, 40, 54-59.

Pesut, B., Greig, M., Thorne, S., Storch, J., Burgess, M., Tishelman, C., … & Janke, R. (2020). Nursing and euthanasia: A narrative review of the nursing ethics literature. Nursing ethics, 27(1), 152-167.

Purpose

The Group Presentation is the final of the three assignments in this course. It builds upon and utilizes information gathered and reported in the first two assignments. The purpose of this assignment is two-fold: a) to provide a solution to a clinical problem using the EBP process, and b) to demonstrate presentation skills for a group of peers.

Course outcomes: This assignment enables the student to meet the following course outcomes.

CO 1: Examine the sources of knowledge that contribute to professional nursing practice. (PO 7)

CO 2: Apply research principles to the interpretation of the content of published research studies. (POs 4 and 8) CO 3: Identify ethical issues common to research involving human subjects. (PO 6)

CO 4: Evaluate published nursing research for credibility and clinical significance related to evidence-based practice. (POs 4 and 8)

CO 5: Recognize the role of research findings in evidence-based practice. (POs 7 and 8)

Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

Total points possible: 240 points

Preparing the assignment (Online Students Only)

1. Follow these guidelines when completing this online assignment. Speak with your faculty member if you have questions.

a. Presentations will give a brief overview of the topic, followed by examples of how the topic influences or assists the nursing profession.

b. Each student will contribute two to three slides for the group presentation.

c. The final presentation will consist of 10–12 PowerPoint slides and may include handouts, if applicable.

Preparing the assignment (Campus Students Only)

1. Follow these guidelines when completing this on-campus assignment. Speak with your faculty member if you have questions.

a. Each group will have 15 minutes to present on their topic.

b. Presentations will give a brief overview of the topic, followed by examples of how the topic influences or assists the nursing profession.

c. Each student will have an opportunity to present (speak).

d. Each student will contribute two to three slides for the group presentation.

e. Students will be prepared to have 10–12 PowerPoint slides and may include handouts, if applicable.

2. Include the following sections: (

a. Content (
[All Students] 125 points/52%)

· Identification of problem and impact on nursing practice.

· Clearly describe the research process, including what went well, barriers encountered, and what is still needed.

· Correlates research findings to identified clinical issue.

· Summarizes validity of qualitative and quantitative evidence.

· Findings are clearly identified.

· Recommends practice change with measurable outcomes and addresses feasibility issues.

· Suggestions for implementation.

· Conclusion of content findings.

b. Delivery (40 points/17%)

(Online Students Only)

· Follows guidelines for a professional PowerPoint presentation. Speak directly with faculty for online Canvas submission process.

· Evidence of participation by all group members.

(Campus Students Only)

· Follows guidelines for a professional PowerPoint presentation.

· Verbal delivery with good volume, pitch, and inflection for all group members.

· Physical delivery with professional dress, good posture, facial expression with eye contact, and enthusiasm is present for all group members.

· All group members effectively use notes and do not read from slides.

· Participation by all group members.

c. Slide Presentation (
[All Students] 60 points/25% distributed as shown)

· Title slide including group members

· Introductory slide with the clinical problem

· Additional slides illustrating key points

· Conclusion slide

· Reference slide in current APA format

· Effective balance of color, graphics, words, and space

· Slide limit: 10–12, inclusive of introduction and references

***Optional handouts may be included to provide information for the audience to keep.

d. Peer Evaluation (
[All Students] 15 points/6%)

· Completed peer evaluation with respectful and constructive feedback.

· Equal work: Did equal share of work.

· Teamwork: Took the initiative in helping get the group organized.

· Communication: Provided ideas for the development of the presentation.

· Team membership skills: Assisted group members.

· Time: Met all deadlines.

For writing assistance, visit the Writing Center.

Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review module.

NR449 Evidence-Based Practice

RUA: Evidence-Based Practice Change Group Project Guidelines

NR449 Evidence-Based Practice

RUA: Evidence-Based Practice Change Group Project Guidelines

© 2021 Chamberlain University. All Rights Reserved

NR449_RUA_Group_Presentation_V2_JUL22 2

© 2021 Chamberlain University. All Rights Reserved

NR449_RUA_Group_Presentation_V2_JUL22 1

Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment.

Assignment Section and Required Criteria (Points possible/% of total points available)	Highest Level of Performance	High Level of Performance	Satisfactory Level of Performance	Unsatisfactory Level of Performance	Section not present in paper
Content (125 points/52%)	125 points	110 points	100 points	50 points	0 points
Required criteria 1. Identification of problem and impact on nursing practice. 2. Clearly describe the research process, including what went well, barriers encountered, and what is still needed. 3. Correlates research findings to identified clinical issue. 4. Summarizes validity of qualitative and quantitative evidence. 5. Findings are clearly identified. 6. Recommends practice change with measurable outcomes and addresses feasibility issues. 7. Suggestions for implementation. 8. Conclusion of content findings.	Includes 8 requirements for section.	Includes 7 requirements for section.	Includes 6 requirements for section.	Includes 5 or less requirements for section.	No requirements for this section presented.
Delivery (40 points/17%)	40 points	35 points	25 points	12 points	0 points
Required criteria (Online Students Only) 1. Follows guidelines for a professional PowerPoint presentation. Speak directly with faculty for online Canvas submission process. 2. Evidence of participation by all group members. (Campus Students Only) 1. Follows guidelines for a professional PowerPoint presentation. 2. Verbal delivery with good volume, pitch, and inflection for all group members. 3. Physical delivery with professional dress, good posture, facial expression with eye contact, and enthusiasm is present for all group members. 4. All group members effectively use notes and do not read from slides. 5. Participation by all group members.	Includes 2 requirements for section. (online) Includes 5 requirements for section. (campus)	N/A Includes 4 requirements for section. (campus)	Includes 1 requirement for section. (online) Includes 3 requirements for section. (campus)	N/A Includes 2 or less requirements for section. (campus)	No requirements for this section presented. (online) No requirements for section presented. (campus)

NR449 Evidence-Based Practice

RUA: Evidence-Based Practice Change Group Project Guidelines

© 2021 Chamberlain University. All Rights Reserved

NR449_RUA_Group_Presentation_V2_JUL22 2

Assignment Section and Required Criteria (Points possible/% of total points available)	Highest Level of Performance	High Level of Performance	Satisfactory Level of Performance	Unsatisfactory Level of Performance	Section not present in paper
Slide Presentation (60 points/25%)	60 points	53 points	47 points	23 points	0 points
Required criteria 1. Title slide including group members 2. Introductory slide with the clinical problem 3. Additional slides illustrating key points 4. Conclusion slide 5. Reference slide in current APA format 6. Effective balance of color, graphics, words, and space 7. Slide limit: 10–12, inclusive of introduction and references ***Optional handouts may be included to provide information for the audience to keep.	Includes 7 requirements for section.	Includes 6 requirements for section.	Includes 5 requirements for section.	Includes 4 or less requirements for section.	No requirements for this section presented.
Peer Evaluation (15 points/6%)	15 points	13 points	11 points	6 points	0 points
1. Completed peer evaluation with respectful and constructive feedback. 2. Equal work: Did equal share of work. 3. Teamwork: Took the initiative in helping get the group organized. 4. Communication: Provided ideas for the development of the presentation. 5. Team membership skills: Assisted group members. 6. Time: Met all deadlines.	Includes 6 requirements for section.	Includes 5 requirements for section.	Includes 4 requirements for section.	Includes 3 or less requirements for section.	No requirements for this section presented.
Total Points Possible = 240 points