End-of-Life Care: Legal and Ethical Issues, Holistic Care Plan, and Self-Care Strategies

Nursing
Student’s name:
Institutional:

According to Chan, Webster, and Bowers (2016), End-of-life care is defined
as the care given to patients with chronic and advanced illnesses during their
last days of life or as they near death. It aims at improving the quality of life
and helps the patient to be as comfortable as possible. It also extends to
care given to the family during the period of illness to grief and bereavement
period.
1. Legal and ethical issues and decision making for Mac’s end-of-life care.
Autonomy is an ethical principle that calls for the patient to make their own
decisions concerning their health (Long et al 2016). The patient has a right to
self-determination and every caregiver should respect that. This principle is
mainly applied when the patient still has the capacity to make their own
decisions. They can make decisions concerning the place of care,
medications and even the people who should visit them. In cases where the
patient is not capable of making their own decision for example if the patient
has mental disorders such as dementia and delirium, the decisions can be
preserved by the use of an advanced directive and the physicians should
respect that. At times, caregivers may make decisions for them even when
they still have the capacity to do so and this is considered a violation of
patient's rights (Connolly, Galvin and Hardiman 2015).
Secondly, the principle of beneficence advocate that the healthcare provider
should do what is of benefit to the patient. Whatever procedure or option
that the physician is going to choose, it should have advantages to the
patient and it should of the patient's interest. However, if the patient desires
to choose anything it should be respected even if the physician views it as it
is not of best interest to the patient (Katz and Johnson 2016). Patient's
autonomy should always be respected. According to Cohen (2018), the
principle of nonmaleficence states that a physician should not inflict any
harm or cause any harm to the patient. All actions should be geared at
providing a high quality of life to the patient. Activities that can be seen as

causing harm include helping the patient commit suicide for example
through drug use.
In addition, justice states that there should be fairness when delivering
healthcare services to patients (Moller 2018). Patients should never be
discriminated based on gender, race, skin color, tribe, and level of education.
Instead, services should be provided equally to all patients. The patient
should have access to fair treatment including fair procedures from all
physicians. Finally, fidelity requires that the physician should be truthful and
faithful to the patient during the end of life care. The physician should give
the right information concerning the diagnosis and prognosis to the patient
appropriately. The patient should also be defended based on their decisions
even if they cannot speak for themselves (Venkatasalu, Kelleher and Shao
2015).
2. Means of creating a holistic care plan for Mac in collaboration with his wife
Dorothy.
Holistic care is total care given to a patient including, physical care, spiritual
care, psychological care, social and cultural care. This is care given to
patients as they near death in patients with chronic illness. Families and
relatives of patients with terminal illnesses go through difficulties especially
with coping due to changes caused by the disease process (Tiller, Lipson and
Ramos 2016). From the case study, it is clear that Dorothy, Mac’s wife is
going through challenges due to Mac’s illness. It is therefore important to for
healthcare providers to provide both patient and family care services.
Physical care is important to patients as they require close attendance
concerning their treatment, nursing care and also pain management a very
important aspect in a patient's comfort. They also need psychological
support such as listening to them and being available whenever they need
someone to talk to. Counseling is also important for these patients especially
those on denial of the diagnosis. Counselors can help them understand and