The boundaries of right to die with dignity are hard to determine. Keeping the terminal patient comfortable is the purpose of comfort care, however there could be a very thin line between what we consider terminal sedation and euthanasia. In theory, comfort care is quite different from euthanasia. Keeping the patient comfortable and letting the nature take its course is at the core of comfort measures (Gamliel, 2012). Yet, the line between keeping comfortable and facilitating death is often blurry. Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering (Gamliel, 2012). The purpose of this paper is to highlight the ethical issue of keeping comfortable vs. hastening death, and the ethical principles involved. Facilitating or hastening death is considered unethical or even illegal.
Comfort care or palliative care is when a terminal patient is placed in a quiet room, where no medical interventions are done except morphine. The patients are not placed on any monitors, no vital signs or given prescription medications. Only the presence of families, periodic turning, swabs for dampening the lips, and perhaps restful music is around the patient. Comfort care is meant to allow a dying person a peaceful end, thus, morphine drip is added for pain relief. Stephens (2012), states that it’s the same medications used to control pain and discomfort, could be used to “help” the patient to stop breathing. The concept of terminal sedation assumes death as an outcome of the intervention.
According to Gamliel (2012), euthanasia refers to actions or omissions that result in the death of a person who is already gravely ill. Techniques of active euthanasia range from gunfire to lethal injection, while passive euthanasia can be achieved by failing to treat pneumonia or by withholding or withdrawing ventilator support.
Working on a floor where patients are placed on comfort care regularly, the issue of hastening death always concerns me. An incident I recall is about a terminally ill patient, who had poor prognosis and was requesting to end her suffering. The patient’s family was hopeful that she would recuperate but not according to the doctors. One of my ethical principles was to advocate for the patient’s autonomy. According to Gastmans (2012), terminally ill patients are allowed to die in peace without being bothered by unnecessary medical interventions. I relayed the patient’s...