End of Life Care: Legal and Ethical Considerations

This article discusses the legal and ethical considerations in end of life care, including assisted dying, palliative care, and pain management. It also explores the New Zealand Medical Association's advocacy for continued public awareness, equity in accessing end of life care, efficient communication between patients and healthcare providers, and respect for the patient's decisions.

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End of Life Care
Student’s name
Institutional affiliation

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According to Malpas, Mitchell & Koschwanez, (2015) the end of life refers to a
continued period where a patient is considered to be dying as no further medical help can be
accorded to the patient. This happens mainly when a patient is having a terminal illness. Such a
patient may consider assisted dying by appealing for help from care providers and healthcare
professional to terminate his/her life. Several conditions have made patients to desire to
terminate their life. Among these include too much pain, fear of burdening others with ones’ own
disease and future incapacity and other uncertainties. There are however legal and ethical issues
that has to be considered in end of life care and assisted death.
According to Johnson, et al (2017) medically assisted death also known as euthanasia,
assisted suicide or physician assisted suicide are considered illegal. However, efforts to legalize
euthanasia are on the move. The best care accorded to a dying patient should be centered on
pain management for the patient and allowing death to happen naturally and as comfortable as
possible if it seem inescapable. Fernando, Rea, & Malpas, P. (2018) explains that terminal
sedation which involves continuous administration of intravenous or subcutaneous sedatives to
relieve pain to a dying patient is considered the best available help for dying patients.
Palliative care is considered necessary in patients who have terminal illnesses on the
conditions that the disease has no more likelihood of cure and medical attention is focused on
improving the quality of life of the patient. Malpas, et al (2015) explains major legal and ethical
considerations which includes helping the family to recover from bereavement and undergo the
process of grief successfully, advancement of the patients psychological, emotional and social
wellbeing is also a vital role for the health worker. Pain relieving mechanisms adopted should
also be carefully examined not to prolong or shorten the life span of the patient as death ought to
occur naturally and with dignity.

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Oliver, Wilson, & Malpas, (2017) explains that the New Zealand Medical Association
(NZMA) advocates for several issues in the end of life care which includes continued public
awareness, equity in accessing end of life care, efficient communication between patients and
healthcare providers and respect of the patient’s decisions as they have a right to refuse medical
services accorded to them. Nevertheless, the NZMA code of ethics urges health practitioners to
always preserve life wherever possible.

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REFERENCES
Fernando, A., Rea, C., & Malpas, P. (2018). Compassion from a palliative care perspective. The
New Zealand medical journal, 131(1468), 25-32.
Johnson, S., Kerridge, I., Butow, P. N., & Tattersall, M. H. (2017). Advance Care Planning: is
quality end of life care really that simple?. Internal medicine journal, 47(4), 390-394.
Malpas, P., Mitchell, K., & Koschwanez, H. (2015). End-of-life medical decision making in
general practice in New Zealand—13 years on. New Zealand Medical
Journal, 128(1418), 27-39.
Oliver, P., Wilson, M., & Malpas, P. (2017). New Zealand doctors’ and nurses’ views on
legalising assisted dying in New Zealand. The New Zealand medical journal, 130(1456),
10.