Case Study Analysis: Fostering Dignity and Respect in Healthcare

This case study examines the ethical complexities surrounding assisted suicide, focusing on the practices of Dignitas Health, a non-profit organization providing physician-assisted suicide to individuals with terminal or severe illnesses. The analysis delves into ethical concepts such as autonomy, beneficence, justice, and the importance of honesty and transparency between healthcare providers and patients. The case study emphasizes the significance of effective communication and interpersonal skills in fostering patient understanding and supporting their decision-making processes, as well as the role of love, respect, and dignity in influencing patient choices. Furthermore, the study explores the 'BATHE' technique and other methods to improve communication and patient care. The case study also addresses the promotion of dignity through factors like symptom control, social support, and positive communication, including the application of dignity therapy to enhance patient well-being and quality of life. Overall, the study provides a comprehensive overview of ethical and practical considerations within the context of assisted suicide and end-of-life care.

Fostering Dignity and
Respect Case Study &
Reflection

Table of Contents
INTRODUCTION...........................................................................................................................3
Main Body.......................................................................................................................................3
Question 1...............................................................................................................................3
Question 2...............................................................................................................................4
Question 3...............................................................................................................................7
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9

INTRODUCTION
Dignitas Health is a non profit organisation which is rendering the Physician assisted
suicide to the individual who have the terminal illness or the severe mental and physical illness.
The Assisted suicide practice is the practice in which the physician helps in the patient death by
giving the necessary means (Dierickx. and Cohen, 2019). However this is illegal in many
countries but in some specific circumstances this is legal in some countries such as Austria,
Canada, Germany, Switzerland and few more. In this report which is based on the case study
there will elaboration of the several ethical ideas which needs to consider while handling the
situation such as discussed in the case study. Furthermore, the benefits of effective
communication skills and the interpersonal skills along with the love, respect and dignity
delivers the best outcome and may influence the individual to change their decision regarding the
assisted suicide practice. At last there will be reflection about the learning and the self
development.
Main Body
Question 1
The right for the death along with the dignity is completely linked with the ethics and the
morals. The assisted suicide is a problem where the person’s interest will not be completely
separated from the society (Lachenmeier, Kaplan and Caragacianu, 2019). There will be an
anxiety of getting discriminated in the assisted suicide, which could be result into the abuse and
the chances of killing person who does not want to die. The legal guidelines have facilitated
these procedures and assure that the evidence is of informed choices. These allow and facilitate
the dying process for the person who is suffering from the incurable diseases. As per the given
situation in the case study the ethical ideas which need to be considered while assisting the
suicide to the patients are given below:-
Autonomy:- This includes the rights for the eligible adults in order to take the decisions
which are informed to them completely and effectively related to their medical conditions and
care. The autonomy requires the informed consent or the agreement from the patient, prior to the
any procedures and the treatment (Rooney, Schuklenk and van de Vathorst, 2018). John Lenton
has the right to go for assisted suicide after acknowledging him with planned procedures and the
other multiple solutions available. After this John Lenton has the right of Death with Dignity

which will fulfil the legislation of the autonomy and he has freedom to take the decision and be
accountable for the taken decision. The autonomy right also ensure the healthcare worker in the
assisted suicide of the John Lenton that that the patient is disagreed and declined the other
alternative methods of the treatment. In order to achieve the autonomy the desires of the John
Lenton must be considered. The patients have the right of self government and the deserving
abilities to take their decision about their own well being (Kenny, 2020). As per the legislation,
John Lenton has the right to take the decision regarding his own life & death. It is the
responsibilities of the healthcare provider to leave the opinions and their partiality before giving
the quality care to the patient.
Beneficence:- This ethical concept enables the healthcare providers to treat the patient in
best of their capabilities which result in positive benefits (Kligerman and Divi, 2020). As per the
beneficence, ending the suffering of the John Lenton is considered as merciful as the John
Lenton is badly suffering from the Parkinson's. With the beneficence, the assisted suicide is
fostering the health of the John Lenton by removing the sufferings which he is experiencing till
the time. This concept ensures the considerations of the John Lenton situations and discovers
what will be best or worst for the patient. The Lack in the Beneficence will risk the safety of
John Lenton. As the John Lenton has denied to other methods of the treatments and willingly
want to be assisted for the suicide, then as per this concept of beneficence the healthcare provider
or the physician should treat John Lenton in best of their respective capabilities. As per the
legislation, John Lenton has the right to take the decision regarding his own life & death and
somehow he is also accountable for this decision. Both, the patient and the healthcare provider
have the power according to their position like John Lenton have the power to decide about his
life or death and the healthcare provider also have the power of control in the context of practice
as it can be influenced by the staff members or the or the systems included in the care which
shapes the caring environment (Baumrucker and et.al., 2022). The healthcare provider also have
the power of control in the context of evidence, which considers that the provided information
about the strategy involved is suitable or not suitable to be get implemented.
Justice:- This states that the Patient Must get the right and equal treatment. As per the
case study the patient named as John Lenton have Parkinson's diseases and wants to hasten the
death and avoided the other sustaining treatment and he only wants to die (Ricou and
Wainwright, 2018). As per the justice it can be depicted that John Lenton should be allowed for

the assisted death. Another reason for the assisted death could be the unbearable pain which is
far beyond the sufferings thus the assisted suicide will be the best response for this sufferings.
Moreover, John Lenton have right to mold his own destiny when life has became miserable &
worthless (Pierce, 2019). As the assisted suicide is a kind of intentional killing and many
countries had made this illegal and this has been a topic of debate from last few year, Ms Holmes
and John Lenton have taken the decision by considering the ethics for the justice and chosen
Switzerland for the assisted death as this is legal in Switzerland when the motive behind the
death is not selfish.
Honesty and Transparency between healthcare and patients:- This is an important
aspects which must be considered while assisting the suicide. John Lenton often wants to have an
open conversation regarding the options at that stage with the healthcare provider which he trust.
The healthcare provider must be transparent regarding the John Lenton willing for choosing the
assisted suicide (Briceño Morales, Enciso Chaves and Yepes Delgado, 2018). However, John
Lenton have the power to decide about his life but the healthcare provider included in it have the
responsibility to acknowledge the patient about the other available methods presents for the
unbearable pain which he is experiencing and foster him to change or think over his decision
(Brown, Whichello and Price, 2018).
Question 2
Good and effective communication is the facility to build the connection with the
patients. It ease the understanding process to recognise the patient’s wishes and supports the
decision making of the John Lenton. The effective communication, the exchanging of the
cognitions, opinions, information etc. done in order to understand the relevant information with
the clarity and actual purpose. The experience of the John Lenton gets fosters with the help of
effective communication and the complains regarding the provisions gets reduced. In context to
Healthcare provider, the effective communication enhances the job satisfaction and reduces the
stress (Brown, Agronin and Stein, 2020). The effective communication includes Written and oral
communication in which the physician can clearly and concisely speak without any
misinterpretation. The communication between the physician and the john Lenton facilitates the
specific ways for proper diagonals and the treatment options. With the help of effective
communication, the physician can reduce the fear and encourage the John Lenton to take the
other alternatives. With the help of effective communication John Lenton feels respected and

listen to the advices given by the physicians. As per the case study John Lenton is suffering from
the Parkinson's and was in severe pain, thus with effective communication he will gain
confidence to share needs and the symptoms for the relevant support and care from the
physicians.
With the help of communication skill and the “BATHE” techniques the physician
involved can support the John Lenton and develop a rapport. The “BATHE” technique includes:-
Background:- This include asking to the John Lenton about the Present situation like “What
going in his life?”.
Affect:- This include the asking to the John Lenton about the emotional concern to his health
like “How the Parkinson's is affecting the him?”
Trouble:- This include the asking to the John Lenton about the worries and the obstacles which
he is considering like “ what troubles him the most?”
Handling:- This include the asking to the John Lenton about the ways to deal with the problem
like “ How he has been handling the Parkinson's so far?”
Empathy:- This include the body language of listening and reflects back accordingly and
considers the John Lenton feelings. The physician must keep the communication confidential.
The interpersonal skill of the physicians is the ability is to obtain and understand the
concern of the patients so as to explain the problems in the healthcare and the engagement in the
healthcare decision making. With the help of interpersonal skill the physicians can improve the
quality of life of John Lenton and enhances the survival rate. The interpersonal skill involve the
Patience and the Awareness (Emich, 2018). The Patience have a crucial role in the several
aspects of the healthcare. Effective healthcare provide information in such a manner which calm
down the member of the family. This is really helpful when the outcome is undesired. The
building bondage or the relationship is also involved in the interpersonal skills. This focuses the
John Lenton emotions, conceptualisation and the experiences. The healthcare physicians can not
reduce these factors but help John Lenton in coping with this in life. The healthcare physician
with the interpersonal skills promote the morale and develops the better surrounding for the John
Lenton. These interpersonal skills also include the fostering positivity.
The fostering positivity in the healthcare surroundings profits everyone, this will make
John Lenton more comfortable which make him more adjustable in the ongoing medical
conditions. The Critical thinking is also involved in the interpersonal skills as it is mandatory for

the healthcare professionals to consider the information with the critical mindset specially when
they think something is wrong happened. After ensuring the data accuracy, the healthcare
professionals can develop positive relationship with the John Lenton and decline the chances of
the miscommunication & facilitates the rectification of the problems. With the help of effectual
language and the communication play a vital role in the dignity, compassion and the respectful
care. Importance is furnished in the practical ways of the healthcare professionals who utilizes
the communication skills and take the accountability of the physical surrounding so as sustain the
emotional factors for the caring of John Lenton.
The dignity can be fostered by increasing some factors such as controlling the symptoms,
encouraging the social support and the maintaining the positive tone while providing the care,
listening the issue actively and passing the information properly and also by showing the respect,
companionship and the empathy. The dignity of the John Lenton can be promoted by fostering
the life reviews (Stevens, Price and Walker, 2021). In context to the formal sense, this considers
the dignity therapy which is a psychotherapeutic method discovered by the Chochinov. This
dignity therapy concentrates over the conversation over the dignity task like settling the
relationship, preparation of the documents for the loved ones and also sharing some words for
the loved ones. It has been reported that, after this John Lenton will be highly satisfied which
will benefits him and his family too by excessively increasing the sense of meaning and purpose.
It has been found that those who gone under the dignity therapy has improved their quality of life
and change their families view and reduce the depression and sadness. This dignity therapy
includes the defining roles in vocations or hobbies, hopes and dreams, lessons learned in life,
autobiographical information, unfinished business, accomplishments, character traits, love and
guidance for others. The dignity is subjectively experienced and every patient has their unique
requirements and it is important for the healthcare physicians to go for an open approach to gets
assessed the needs and the requirement of the every patients accordingly.
All the above mentioned skills which are effective communication skills, interpersonal
skills, encouraging the positivity in the healthcare surroundings and treating the patient with the
respect and dignity skills promotes the morale and develops the better surrounding for the John
Lenton. This skills will deliver the best care results for the John Lenton and may convience him
to change or think again on his decision over the assisted suicide.

Question 3
In this discussion I am using the Driscoll Model of Reflection. In this I am consciously
looking thinking about my experiences, taken actions, feelings and their responses. This
reflection is done while asking myself about what I did, How I did it and what I learnt from this.
It is stated by the Nicol and Dosser (2016) that the reflection can be used at any stage of an
incident or any situations and it mandatory to understand about what reflection is and how
successfully it can be excited (Misra, 2021). With the practice of reflection the skills and the
knowledge can be developed and helps us to maintain this development throughout the whole
life. Throughout this reflection I will be discussing about the understanding of the dignity and
respect.
What?
I am reflecting on the case study of fostering the dignity and the respect. It has been
analysed from the case study that the John Lenton is suffering from the Parkinson’s disease and
several months before his death, John Lenton expresses his desires to travel to the Switzerland.
So her daughter along with her son took John Lenton to Dignitas facility in the Switzerland as
the dignity and the respect of the patient is maintained properly. Unlike UK, the assisted suicide
is legal in Switzerland. I think that it was a mixed feeling as the letting the loved one to die is
painful but John Lenton has never have to face those discomfort or pain from now onwards.
So What?
It has been analysed from the case study that Ms Holmes along with her son who is
However ready to be prisoned is feeling relaxed as the Crown Prosecution Service (CPS) has
declared that no one will charged with any legalallity will not get prisioned as this suicide is not
in public interest. Now Ms holmes want to change the laws formulated for the Assisted suicide
as she discovered many others people are there as of her father who wishes the same.
Now What?
In context to this case study I have put my own values aside as every one have
contrasting values. This case study has facilitated my understanding about the dignity and respect
and enhances my learning and self development. By the help of case study I get a chance to
know about the several ethical ideas which should be focused during these circumstances and
how some skills like communication skill, interpersonal skill, the support, love and affection
helps to maintain the dignity and respect the patient (Zegarac and Burgund Isakov, 2019).

Futhermore, when I have to face the same circumstances then initially i will try to change the
decision of the patient by the help of these above skills followed by the assisted suicide along
with the consideration of all the legalities.
The self development plan is formulated below:
Goal Action Evidence for the
Achievement
Targeted Time
Learning of the ethics I will read the books
related to the
Jurisprudence,
science, several moral
and political ethical
books
The achievement will
be identified by my
self and by the peer
evaluation.
Three months
To develop the
interpersonal skills
For this I will practice
active listening,
empathy and develop
a positive outlook and
also talk politely.
My ability to interact
and building the good
relationship with the
others reflects my
developed
interpersonal skills
One month.
CONCLUSION
From the above discussion based on the case study, it can be concluded that, the assisted
suicide practice is the practice in which the physician helps in the patient death by giving the
necessary means. However this is illegal in many countries but in some specific circumstances
this is legal in some countries. This report describes the several ethical ideas in details which
need to be considered by accessing the situation which includes the assistant suicide. Along with
this, there is description about the benefits of effective communication skills and the
interpersonal skills along with the love, respect and dignity delivers the best outcome and may
influence the individual to change their decision regarding the assisted suicide practice. And At
the end of this report there is reflection has presented with the help of Driscoll Model of
Reflection.

REFERENCES
Books and Journals
Baumrucker, S.J and et.al., 2022. Ethics Roundtable: Autonomy and Delusion. American Journal
of Hospice and Palliative Medicine®, 39(1), pp.131-139.
Briceño Morales, X., Enciso Chaves, L.V. and Yepes Delgado, C.E., 2018. Neither medicine nor
health care staff members are violent by nature: Obstetric violence from an
interactionist perspective. Qualitative health research, 28(8), pp.1308-1319.
Brown, E.L., Agronin, M.E. and Stein, J.R., 2020. Interventions to enhance empathy and person-
centered care for individuals with dementia: a systematic review. Research in
gerontological nursing, 13(3), pp.158-168.
Brown, S., Whichello, R. and Price, S., 2018. The impact of resiliency on nurse burnout: An
integrative literature review. Medsurg Nursing, 27(6), p.349.
Dierickx, S. and Cohen, J., 2019. Medical assistance in dying: research directions. BMJ
Supportive & Palliative Care, 9(4), pp.370-372.
Emich, C., 2018, October. Conceptualizing collaboration in nursing. In Nursing forum (Vol. 53,
No. 4, pp. 567-573).
Kenny, S.N.P., 2020. Challenges to Dignity From Medically Assisted Death: Lessons From
Canada. In Finding Dignity at the End of Life (pp. 129-143). Routledge.
Kligerman, M.P. and Divi, V., 2020. Physician-Assisted Suicide for Patients with Head and
Neck Cancer. Otolaryngology–Head and Neck Surgery, 163(4), pp.759-762.
Lachenmeier, F., Kaplan, K.J. and Caragacianu, D., 2019. Doctor assisted suicide: An analysis of
public opinion of Michigan adults. In Right to Die Versus Sacredness of Life (pp. 61-
88). Routledge.
Misra, P.K., 2021. Types of Learning. In Learning and Teaching for Teachers (pp. 37-57).
Springer, Singapore.
Pierce, R., 2019. AI in Healthcare: Solutions, Challenges, and Dilemmas in Medical Decision-
Making. AI in Healthcare: Solutions, Challenges, and Dilemmas in Medical Decision-
Making In Cynthia Cook (ed.) Voices in Medical Sociology.
Ricou, M. and Wainwright, T., 2018. The psychology of euthanasia. European Psychologist.
Rooney, W., Schuklenk, U. and van de Vathorst, S., 2018. Are concerns about irremediableness,
vulnerability, or competence sufficient to justify excluding all psychiatric patients from
medical aid in dying?. Health Care Analysis, 26(4), pp.326-343.
Shale, D. and Parapanos, L., The Role of the Medical Examiner Officer. In The Medical
Examiner Service (pp. 55-65). CRC Press.
Stevens, E., Price, E. and Walker, L., 2021. Dressings and dignity in community nursing. British
Journal of Community Nursing, 26(11), pp.526-531.
Zegarac, N. and Burgund Isakov, A., 2019. Using a real case scenario in teaching social work
with children and families in different practice settings. Social Work Education, 38(3),
pp.406-421.