Pathophysiological Issues of the End of Life Option

This paper explores the pathophysiological issues of the end of life option and provides statistical facts on the same. It discusses the stages of grief and how nurses should support patients and their families during each phase. The paper also presents statistics on Americans' opinions regarding end of life options.

Running head: HEALTHCARE ISSUES
Healthcare issues from the scientific and mathematical perspectives of inquiry
Name
Institution

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Introduction
End of life option refers to a choice that terminally sick patients with the
capability to make informed medical decisions make to be prescribed medicines that will
assist them in dying if specific criterions are met. However, the illness must be
ascertained by at least two doctors to be irreversible and incurable, and the sickness will,
in a rational medical decree, cause the person's demise in six months. This paper
expounds on the pathophysiological issues of the end of care option and also gives the
statistical facts on the same.
Pathophysiological Issues of the End of Life Option
According to the Nephrology Nursing Journal (2018), the pathophysiology of
patients going through the end of life should be highly regarded. Many works have been
circulated on stages of dying; however, the most popular is the Kubler Ross' five phases
of grief. He lists the steps of grief as; denial, anger, bargaining, depression, and
acceptance.
In the course of the denial phase, the patient is not ready to accept as right on the
projected death and is yet not prepared to cope with their problem, so, nurses should
support denial and not contract a similar denial mannerism (transference) but give oral
care.
During the phase of anger, the patient and relatives might be easily angered on
small things (displacement defense mechanism); thus, nurses ought not to take the anger
personally but instead assist them in comprehending that it is a usual reaction and then
look into their needs. It is still not the proper time to converse with the patient and the

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relatives on radical directions in the course of these initial two stages lest they say so
(Russell, 2018).
In the course of the bargaining phase, the patient and the relatives might try to
bargain and might show remorse or distress for previous incidents, so, nurses ought to
listen keenly and hearten them to open up on their experience, and offer spiritual care if it
fits them.
During the phase of depression, the patient and the relatives might mourn on the
end of life and converse openly without limitations or pull back from communication, so
nurses may employ non-oral communication styles and let the patient and family show
their misery (Salins, Gursahani, Mathur, Iyer, Macaden, Simha, and Rajagopal, 2018).
Finally, in the course of the phase of acceptance, the patient and the relatives have
come to terms that the impending demise is unavoidable and have reduced curiosity in
interaction, so nurses may assist them in comprehending the necessity for communication
and it is similarly the ideal time for nurses to converse radical directions health care
information.
However, what is not confirmed is whether the doctor or nurse should discuss a
radical choice in end of life care in the course of the initial phases of grief when such
discussions will be uncomfortable for the patient and relatives, or whether they should
wait for the acceptance phase. Most policies, strategies, and laws do not regard the stage
of grief in letting patients and families know about these radical choices. The healthcare
workforce might provide these choices initially to the patient and relatives, but ought to
comprehend if they are not willing to discuss it yet.

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Wilmont (2015) denotes that, as the phase of grief advances, there is an affinity
that the patient will need reduced information, but the relatives or caregivers may require
additional information on all the stages of grief. Nurses could voluntarily address them if
the patient or relatives preferred to.
Statistical Issues on End Of Life Option
A Pew Investigation Institute on end of life options discovers that a majority of
Americans say there are situations in which physicians and nurses ought to let a patient
die (Lastrucci, Collini, Lorini, Zuppiroli, Forni, Vannucci, 2018). However, an increasing
marginal says that health experts ought to do everything likely to protect a patients’ life
in all situations.
When questioned on the end of life choices for other individuals, approximately
65% of Americans say there are at best certain circumstances in which a patient must be
allowed to die, whereas about 34% say that health experts at all times must do everything
likely to protect a patient’s life. Over the past 25 years, the steadiness of outlook has
progressed discreetly away from the mainstream stand on this matter. While still a
marginal, the segment of the civic that says physicians and nurses ought to do everything
probable to protect a patient’s life has risen eight percentage points since 2017 and 15
points from 2015 (Dahlin, and Pirschel, 2018).
The uptick originates partially from an uncertain decrease in the share that says
there are conditions in which a patient must be left to die and somewhat from an
escalation in the percentage of the civic that speaks out an outlook; the fragment that
lacks a prospect or refuses to respond to the study query decreased from 10% in 2015 to
6% in 2015 and is currently at 2%.

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According to Burg (2019), when contemplating another personal circumstance, a
majority of the Americans show inclinations to end of life medical therapy that differs
based on the particular situation they may experience. A mainstream of grownups says
there are at best specific circumstances in which they, individually, would need to stop
medical therapy and be left to die. For instance, 56% say they could tell their physicians
to halt treatment if they had an illness with no expectation of getting better and were
experiencing too much pain. And approximately 51% say they would request their
physicians to halt therapy if they had a terminal illness and were entirely reliant on
somebody else for their care. However, approximately 34% say they would ask their
physicians to do everything probable to ensure they are alive; even in awful situations
such as having an illness with no prospect of improvement and going through a lot of
pain. In 2015, by contrast, 27% spoke out this outlook. This uncertain uptick shoots
fundamentally from an escalation in the share of the citizens that shows an inclination on
these inquiries; the fragment is saying they would halt their therapies so they can die
stayed almost the same over the previous two years.
Conclusion
End of life option is a hard decision to make for most terminally ill patients and
their relatives. A majority of the patients go through all the five stages of grief
(Baughcum, Fortney, Winning, Shultz, Keim, Humphrey, and Gerhardt, 2017). Nurses
and physicians may have a hard time contemplating the right time to inform patients and
their relatives on the radical directives available. Statistics show that a majority of
Americans would prefer to tell their physicians to halt therapy if their illness has no
prospect of improving. A few Americans would instead not express their opinion on the

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matter. End of life option is a serious matter that needs to be deliberated upon keenly
before a decision is made.

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References
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