AWS AND ETHICS ON END-OF-LIFE CARE: ROLES AND CHALLENGES OF PALLATIVE NURSES

Abstract

A terminally ill patient is a patient who is mortally injured or has an uncurable disease even and will die if he or she has specialized treatment. This patient is inevitably facing death within a few hours or months. This type of patient also includes brain-dead patients whose brain has permanently lost the ability to perceive and communicate.

               Treatment for the terminally ill patients is aimed at minimizing physical pain while spiritual beliefs, traditions and needs of patients and relatives are also met. As a result, palliative care is applied for the terminally ill patient to ensure that the patients and their relatives have a good quality of life during the last period of the patient. Moreover, nursing care for terminally ill patients must be holistic nursing care so the nurse must have medical knowledge about the body and mind of patients who are near death. In addition, they also need to understand the society, traditions, and beliefs of the patients and their relatives about death. What is more, the aim of this article is to study an element of the holistic nursing care on terminally ill patients which are the ethics of nurses and relevant laws of such patients during palliative care. 

            The study has found that nurses must deal with five ethical dilemmas about terminally ill patients and their relatives which are telling the truth, self-awareness of the patients about near-death state, confidentiality of the patient, cessation of treatment and making choices about treatment of similar condition patients while having a shortage of resources. In addition, there are four related legal issues: firstly, cessation of treatment (which is not considered as neglect of the patient under Article 307 of the Thai Penal Code). Next, helping the patients to pass away peacefully and not facing a murder offence. Thirdly, the will of the terminally ill patients. Finally, a letter of intention on not receiving treatment during the end-of-life period.