The Obligation of Doctors and Nurses to Care for Patient Emotions

This essay addresses the question of whether doctors and nurses have an obligation to care for the emotional needs of their patients, particularly in the context of end-of-life care. The author argues in favor of this obligation, drawing upon the stages of dying as proposed by Kubler-Ross. The essay begins by explaining the rationale behind Kubler-Ross's stages, then outlines the five stages (denial, anger, bargaining, depression, and acceptance) as premises supporting the argument. The core of the argument emphasizes the importance of emotional support throughout these stages, highlighting the roles of doctors and nurses in helping patients navigate their feelings and experiences. The paper references utilitarian and Kantian ethics to support the healthcare professionals' responsibility to maximize patient well-being and fulfill their duties. The essay concludes that healthcare professionals have an obligation to assist patients through each stage, ensuring they do not remain stuck in denial and can eventually reach acceptance, thereby improving their quality of life. The essay is supported by a formal analysis and references relevant literature.

Death philosophy
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Formal Analysis
Do doctors and nurses have an obligation to care for the emotional needs of their patients?
“In this paper, I will argue that doctors and nurses have an obligation to care for the emotional
needs of their patients. To do this, I will first explain why Kubler wants us to believe in the
stages of dying. Next, I will argue on the five stages of dying inform of premises. Finally, I will
make the point that doctors have an obligation to care for the emotional needs of their patients
based on the stages of dying.
Premise 1
Premise 2
Premise 3
Premise 4
Premise 5
Conclusion- Dying is a difficult stage that people go through and thus the reason why they need
to be supported to meet their emotional needs.
Do doctors and nurses have an obligation to care for the emotional needs of their patients?
Kubler postulated the emotions that were suffered by terminally ill patients before their
death or those who lost their loved ones. This means that patients tend to undergo this stage due
to the challenge of facing death when they are not prepared. The role of the nurse is to ensure
that they prepare their patients in a way that makes them easily deal with the issues related to the
afterlife. Utilitarian’s take this as the role of the healthcare professional to maximize patient
utilities during the end of life care so that the dating can be made a better experience. Further,
Kantian ethics dwell so much on the duty ethics where the role of the nurse or doctor is to take

care of the patient. This means that they need to take care of the patients as they undergo the five
stages of dying properly1. This essay presents the argument on the role of doctors and nurses in
taking care of their patients at all stages of their hospital stay using the Kuber’s five stages of
dying.
The first premise is patients are in denial since they believe that the diagnosis may have
been done wrong or false which means that what they have been told is not true. Most patients
live in denial since they react negatively when they are diagnosed with a terminal disease which
makes patients develop different feelings towards death2. As people become overwhelmed by
disease, they lose their physical fighting ability and thus start putting in their psychological
defenses which increase manifold. The role of denial is to act as a buffer after unexpected
shocking news and thus doctors and nurses are supposed to give the patient time to recollect
themselves. In this case, nurses and doctors are supposed to assist the patient to overcome denial
so that they can move to the next stage of dying.
The second premise is patients experience anger which expressed through frustration as a
movement away from denial. The role of the healthcare team is to guide the patient through the
process by assisting them to let out their anger in nonviolent ways. This implies that the
caregiver needs to prepare the patient and assist them in expressing their anger in a way that
makes it easy for them to deal with the situation3. Expressing anger makes it easy for the patient
to deal with the situation appropriately. The nurse is supposed to place herself in the patient’s
1 Hoy WG. 2016. Bereavement groups and the role of social support: integrating theory, research,
and practice. New York: Routledge/Taylor and Francis.
2 Kübler-Ross, E., and D. Kessler. 2014. On grief & grieving : finding the meaning of grief through
the five stages of loss. New York: Scribner.
3 Maciejewski, P.K., B. Zhang, S.D. Block, and HG Prigerson. 2017. "An empirical examination of the stage
theory of grief." JAMA 297 (7): 716-723.

position by allowing them to express the grievances in a positive way that reflects the issues that
they face. The anger may be rational or irrational thus requiring a lot of tolerance.
In the third stage, bargaining is supposed to be based on the hope to avoid the cause of
grief. In this situation, the individual is faced with the reality that exists and thus the need to
develop a negotiation between the different options that exist. The role of doctors and nurses is
to assist the patient in undergoing the bargaining stage4. The duty obligation requires that the
nurse works with the patient through this process as they attempt to compromise and understand
the situations that exist. In the negotiation and compromise phase, the individual is supposed to
be assisted to understand the options that exist and how these options mean to live. For example,
terminally ill patients may be nearing death and thus be assisted to negotiate with their loved
ones or God if they are religious. Other types of patients need to be assisted to understand how
the condition has changed their life and how they need to adjust accordingly. If the patient
requires new competencies, then it is the role of the nurse and doctor to ensure that their
competencies are internalized in the best way possible.
The fourth stage is the depression process where individuals are faced with the reality of
the situation. This implies that the patient is overwhelmed with the situation and forced to
overcome it as a way of dealing with the situation that they are in. Patients in this stage exhibit
different types of characteristics which include becoming silent, refusing visitors and some spend
most of their time in a mournful and sullen mood5. This implies that the patient is faced with the
reality of the situation. The role of the nurse is to work closely with the patient in overcoming
4 Corr, Charles A. 2019. "The ‘five stages’ in coping with dying and bereavement: strengths,
weaknesses and some alternatives." Promoting the interdisciplinary study of death and dying 24
(4): p.410.
5 Hebert, Kathy, RN Harold Moore, and Joan Rooney. 2011. "The Nurse Advocate in End-of-Life
Care." The Ochsner Journal 11 (4): p. 327.

positive and negative depressive moods. Here the focus is to address the bad depression which is
focused on the past and look at good depression that is focused on the future that the patient is
going through.
The patient moves into the acceptance stage after realizing that the body can no longer
fight. In this case, the focus of the doctor of the nurse is to ensure that the patient is neither
depressed nor angry about the fate that they are facing. In most cases, this is supposed to be a
period of relief where the patient needs to have the best quality of life6. Whether it is recovery
and living with a condition or death, this stage is the beginning of the end of the struggle that the
patient has been through. The healthcare team needs to work closely with the patient and the
family members in assisting the patient to move through these stages.
In patients undergoing difficult stages of their illness and it is the role of doctors and
nurses to guide and support them in this process. From the five stages, it is evident that of not
assisted, the patient will remain in the denial stage forever which will affect their quality of life.
This implies that healthcare professionals have the obligation of working with the patient at each
stage so that they can assist them to move from the denial stage to the acceptance stage where
they realize that their condition cannot be changed and thus they have to face the new fate that is
brought by the condition that they are suffering from.
6 Ferguson, Rita. 2018. "Care coordination at end of life." Nursing 2020 48 (2): 11-13.

Bibliography
Corr, Charles A. 2019. "The ‘five stages’ in coping with dying and bereavement: strengths,
weaknesses and some alternatives." Promoting the interdisciplinary study of death and
dying 24 (4): 405-417.
Ferguson, Rita. 2018. "Care coordination at end of life." Nursing 2020 48 (2): 11-13.
Hebert, Kathy, RN Harold Moore, and Joan Rooney. 2011. "The Nurse Advocate in End-of-Life
Care." The Ochsner Journal 11 (4): 325–329.
Hoy WG. 2016. Bereavement groups and the role of social support: integrating theory,
research, and practice. New York: Routledge/Taylor and Francis.
Kübler-Ross, E., and D. Kessler. 2014. On grief & grieving : finding the meaning of grief
through the five stages of loss. New York: Scribner.
Maciejewski, P.K., B. Zhang, S.D. Block, and HG Prigerson. 2017. "An empirical examination
of the stage theory of grief." JAMA 297 (7): 716-723.