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Ethical Decision-Making




Decision-making at the end of life necessarily occurs within an ethical framework. Dying and death occur in a context of personal values and beliefs about suffering, the meaning of death and the place of an individual within family and society. Questions can arise regarding such matters as the use of morphine, physician-assisted suicide and terminal sedation. Caring for these people requires a sensitive appreciation of the ethical, legal and moral perspectives of the patient, the family and the clinical team. This requires an understanding of the context of suffering within which palliative care is often provided.


Contents include

  • Introduction
  • The ethical context of suffering
  • Clinical Pragmatism
  • The use of sedation
    • The ethical problem
    • Case study
    • Discussion of the case study
    • Principles from the case study
      • Thorough assessment of the clinical situation
      • Findings of assessment discussed openly and frankly
      • A clear goal identified
      • A time period for review established
      • Novice practitioners' ongoing support and mentoring
      • Sedation use in emergency situations predicted and planned
    • The principle of 'double effect'
  • Requests to hasten death
    • The ethical problem
    • Case study
    • Discussion of the case study
    • Principles from the case study
    • Symptom management
  • Differing desires for end-of-life care
    • The ethical problem
    • Case study
    • Discussion of the case study
    • Principles from the case study
  • Conclusion
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Author / Editor Biographies

Palliative Care
Professor Margaret O’Connor is the inaugural Professor of Nursing at Swinburne University in Melbourne. Prior to this she was the Vivian Bullwinkel Chair in Palliative Care Nursing at Monash University, where she established and led a successful Palliative Care Research Team. Margaret’s research has been widely published, concentrating on models of palliative care , issues of culture and the end of life needs of particular population groups. From 2006 to 2011 Margaret served as the President of Palliative Care Australia and in 2005 she was made a member of the Order of Australia for h...
MN, BAppSc (Advanced Nursing), RN, MRCN.
Professor Sanchia Aranda is Chief Executive Officer of the Cancer Council Australia. Her research focuses on the development and testing of interventions to address the supportive and palliative care needs of people with cancer.

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