The topic of end-of-life issues in healthcare is usually considered a sensitive subject. Death is inevitable, and this reality is recognized by different cultures across the globe. As such, people should have the right to choose how they want to die, especially when all hope of survival is lost. At the end stages of life, patients and their authorized family members must make crucial decisions on whether to be on life support or not. These decisions are influenced by a range of factors, including policy considerations, ethical issues, and the patient's wishes.

Fundamentally, every patient has the right to accept or refuse treatment. This right becomes more relevant as the patient approaches the end of life, where there may not be any life-saving alternatives. Dying patients reserve the right to choose their end-of-life treatment, including deciding how they wish to die. However, most Americans die in hospitals or nursing homes due to the complications involved in providing life-sustaining procedures at home.

The severity of a patient's condition affects their mental state, which may render them incompetent or unable to provide informed consent. For those who are competent, they are required to provide written consent outlining their end-of-life wishes. Some patients prefer palliative care and staying on life-sustaining procedures, while others may refuse treatment to preserve their dignity.

End-of-life issues have previously sparked ethical debates, such as the case of Dr. Jack Kevorkian, who helped a patient with Alzheimer's disease die. While the patient had consented to the procedure, the doctor was still charged with felony for assisted suicide. Such instances raise ethical dilemmas and leave us questioning the morality of letting someone die while in chronic pain.

In conclusion, end-of-life issues in healthcare are complex and demand careful consideration. Patients and their families should be empowered to make critical decisions regarding their end-of-life care. Additionally, medical practitioners and policymakers must engage in ongoing discussions on policy considerations and ethical guidelines to ensure that patients' rights are respected.

When a patient is unable to make decisions for themselves due to incompetence, the responsibility of giving consent usually lies with the designated or authorized person. However, not every family member or friend is equipped to make such a choice. In cases of minors, the legal guardians make the decision on behalf of the child. For adults, the person in their legal care - usually their spouse, child, or parent, can make the decision.

Deciding whether or not to let a loved one go is an arduous task. It's human nature to want to keep our loved ones alive, but in some cases, they may be in a coma that they will not recover from. Some people hold onto these situations for years, even decades, without truly accepting the reality of the situation. Eventually, acceptance of the inevitable or the burden of hospital bills will determine if they should be allowed to pass peacefully.

Despite its difficulty, this decision must ultimately be made. It is a critical responsibility that requires careful consideration from all parties involved, including caregivers and medical professionals.

References:

Thorns A. (2010). Ethical and legal issues in end-of-life care. Clinical medicine (London, England), 10(3), 282–285. https://doi.org/10.7861/clinmedicine.10-3-282

Karnik, S., & Kanekar, A. (2016). Ethical Issues Surrounding End-of-Life Care: A Narrative Review. Healthcare (Basel, Switzerland), 4(2), 24. https://doi.org/10.3390/healthcare4020024

Babgi, A. (2009). Legal Issues in End-of-life Care: Perspectives from Saudi Arabia and United States. American Journal of Hospice and Palliative Medicine®, 26(2), 119–127. https://doi.org/10.1177/1049909108330031

Chiarella, M. (2008). Practical legal issues in end-of-life care. Australian Nursing and Midwifery Journal, 15(8), 21.

Yadav, K. N., Gabler, N. B., Cooney, E., Kent, S., Kim, J., Herbst, N., ... & Courtright, K. R. (2017). Approximately one in three US adults completes any type of advance directive for end-of-life care. Health Affairs, 36(7), 1244-1251.

Pozgar, G. D. (2020). End-of-Life Dilemmas. In Legal and ethical issues for Health Professionals (pp. 98–127). Jones & Bartlett Publishers.