The Palliative Care

Running Head: Nursing
Palliative care
Name of the Student
Name of the University
Authors Note

Palliative Care1
Introduction
Palliative care and End of life care focus on improving quality of life by reducing
sufferings related to critical condition of patient’s health. The Case study has shown that
John, a twenty year old boy is suffering from renal disorders. He was in the last stage of the
renal failure and was told that he was not expected to survive more than three months on
dialysis. The patient decided to leave hospice care and return back to his indigenous
community. Through this essay , transition of care in the John’s treatment procedure will be
depicted and the role of health professionals in ethical and cultural decision making with
different approaches of care provision will be analysed.
Discussion
Collaborative ethical decision making
The case study has reflected that the patient preferred comfort above the cure
procedure. The interdisciplinary team should focus on comfort based care provision than
cure based approaches. Awareness and understanding, appropriateness and effectiveness,
leadership and governance and capacity and capability should keep in mind during the
transition of care in withdrawing of life support. The Ethical considerations which will be
helpful for clinical integrity, respect for persons, justice and beneficence (Laage et al., 2017).
The frameworks for ethical considerations are focused on beneficence, non-maleficence,
justice, autonomy and integrity. Transition of care approach might have some ethical
dilemmas among the members of interdisciplinary team members (Brooks, Manias &
Nicholson, 2017). According to a research, reframing of perceptions needs collaboration of
the family and healthcare professionals in preparing themselves for adverse condition,
tending the relationships and focusing on the quality of care. Health professionals should
understand the information related to the patient’s health status and process them

Palliative Care2
accordingly. They can make advance care plan by considering the severity of condition.
Clinicians are reluctant to convey the truth related to patient’s health but in this case “right to
self-determination” has not breached by the practitioners as they informed the patient about
his health status. The registered nurses will help the patient’s family to understand the
severity of the health by interpreting the information to the family members. Respect of
personhood is one of the key approaches should be considered by caregivers. Any
disagreements with the patient’s decision should not influence the communication and
treatment procedures for the patient. If the disagreements occurs between patient and his / her
family, nurses will act as the negotiators to establish 2017). Here in this case study, John has
realising the terminal condition and wanted to withdraw himself from the hospice care which
needs support of clinicians and every team members of interdisciplinary team. Lack of
consensus (between patient’s family and care givers, nurses and clinicians and among the
interdisciplinary team members ) will harm beneficence of patient and disrupts the clinical
integrity during comfort focused care approach(Meeker, McGinley & Jezewski, 2019). The
ethical dilemma might occur due to disagreements of conscience a health professional for
treating the patient and providing him high quality of care and preference of the patient to
withdraw the life support (for spending the last days with the family )( Long, Spronk &
Sprung, 2016). In this case, John’s decision might perceived by some health professionals as
passive euthanasia and non-compliance in their behaviours. Transition of care will always
have the confusion in establishing beneficence after preferring autonomy of the patient.
Cultural aspects of palliative care in the perspective of the patient
John is an aboriginal person, therefore cultural awareness and cultural competency
should be maintained in the care plan. Nurses should provide culturally sensitive care and
therapeutic care to the person. The nurses will help the family to understand and realise the
present condition and health complexities with rational thoughts. They nurse and other