Case Study Death and Dying Sample Paper

Introduction

From the case study provided, George is suffering from a degenerative disorder ASL- Amyotrophic Lateral Sclerosis in which he has only 3-4 years to live. George is fully aware of the debilitating state that he is going to be in when the disease fully settles in. For example, George risks losing his ability to speak, move, eat, and breathe. George fears the prospect of being fully dependent on other people to perform even basic chores like cleaning himself. He is contemplating voluntary euthanasia to cut his life short before his condition degenerates into a vegetative state.

Voluntary termination of a patient’s life through euthanasia is a very controversial issue. In particular, the Christian worldview on the termination of life holds strongly that no person has the right to terminate another person’s life or even one’s own life. While some people feel it is fine to relieve suffering patients from pain by terminating their lives, others feel that this is wrong based on moral and ethical principles.

Nurses are entitled to their beliefs, morals, and values which may be different from those of their patients. Giving care to patients who are close to the end of their lives is a difficult process, not just physically, but also emotionally and psychologically (Meller et al, 2018). Yet, nurses sometimes witness complicated scenarios where families of such patients must make difficult choices to end the lives of their loved ones.

Another ethical dilemma in health care ethics is the issue of physician initiatives. Physicians may sometimes be called upon to make difficult decisions to end a patient’s life through requests (Khalaf et al, 2017). This can be done using euthanasia or the physician-assisted suicide method. While there is a lack of consensus regarding how unethical or ethical these issues are, the dominant argument tends to hinge on an individual’s right to live. Some people feel it is unethical for physicians to end a patient’s life while others feel it is okay to relieve suffering patients of their pain by terminating their lives.

How George would interpret his suffering in light of the Christian Narrative

Christian worldview of chronic death is the response to a disparity that people display or exhibit when a significant loss occurs. Chronic death is a term used to describe the state of sadness that patients get into when dealing with pain from their health conditions. The Christian worldview of death provides an approach that can be used to understand the problem of chronic death. This approach encompasses parameters such as antecedents, external management methods, internal management methods, and trigger events. The importance of this theory is that it helps in analyzing responses from individuals who are experiencing disparate emotions arising from bereavement, chronic illness, and caregiving responsibilities. Christian worldview of death enables nurses and other caregivers to understand that death is a normal occurrence and that individuals experiencing such loss need access to positive coping strategies.

How would George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?

Christian worldview of death states that Christians must live a righteous life on earth with the hope of resurrecting during end times. In the past, death was associated with the grief in parents/caregivers of children suffering from chronic health issues. Today, the term has been expanded to mean normal response to grief associated with a painful loss such as death. Chronic sorrow is also known as living loss because it stays with the grieving person for an extended period of time (Buckley & Stricklin, 2017). In many cases, a medical crisis capable of magnifying the disparity between the existing reality and the life hoped for results in the possibility of a return of the sadness.

Confusion, anger, and frustration are some of the emotions exhibited by people who know their lives will be cut short by disease. The concept of death comes out clearly in bereavement and other types of significant losses even though people may sometimes question some responses of death by grieving people. For instance, when a bereaved person suddenly shows strong emotions of anger and behaves out of character, healthcare professionals may deem the behavior as unbecoming or inappropriate (Tofthagen, et al., 2017). Many healthcare professionals have no proper understanding of chronic death hence are not able to deal with it when it is exhibited by a grieving person.

In Chapter 4, the healthcare professionals in the scene are aware of the loss the angry man with the gun is going through, however, they do believe that his reaction is inappropriate. Offering counseling services to caregivers of patients early before any tragic event happens can help grieving people to quickly adjust to reality when the tragic event does occur (Funk, Peters, & Roger, 2017). For example, the reaction witnessed in the old man after the loss of his wife may not have been witnessed if he had received professional counseling early, especially when it became apparent that he may lose his wife.

How George would contemplates life with ALS. How would the Christian worldview inform his view about the value of his life as a person

In Practice, knowledge or the understanding of chronic sorrow aid health practitioners in creating effective coping mechanisms for themselves and grieving clients/customers. Having a good background and understanding of the concept can help such professionals to learn and inculcate in their systems an effective and therapeutic communication that they can use to help grieving people deal with their pain (Jinks, 2018).

For example, in the clip provided, all the healthcare professionals in the scene are some of the best physicians at the hospital and can handle even the most complicated medical operations; however, none of them seem to understand how to deal with the issue of chronic death in grieving persons. Having effective and therapeutic communication skills would have helped to diffuse the tension witnessed in this scene. However, what comes out is a picture of confusion, anger, and frustration which should not have been the case especially with the professionals in the room.

An understanding of chronic sorrow can help to improve the quality of care given by community health nurses. Community health nurses interact closely with patients under their care which means they occasionally witness scenes of death and anger. Their understanding of the theory of death can help them to prepare their grieving customers/clients/patients to deal with the associated emotions. Further, as Oates and Maani-Fogelman (2019) observe, such experienced nurses can prepare their patients and patient relatives on how to effectively cope with tragic events such as death when it occurs. An understanding of the theory by this group of professionals is essential in a healthcare environment because it enables the practitioners to lessen and contain irrational behavior in grieving persons by offering guidance and counseling adequately early before any tragic event occurs.

In terms of research, extensive literature is available on parents or caregivers dealing with children with physical disabilities or children with mental retardation problems. Contemporary researchers have sought to widen the scope of chronic death to include persons who are bereaved from the death of close relatives, friends, and family. One of the outstanding studies that has contributed widely to the understanding of the theory is the research done by Damrosch and Perry in 1989. The duo conducted a small study that compared parents in families with children with Down’s syndrome (Coughlin, & Sethares, 2017). The study evaluated the parents on pertinent issues such as exhibiting chronic death, patterns of adjustment, and coping mechanisms. The findings from the study revealed valuable results especially on coping which has led to better understanding of the theory of death.

What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia?

From the Christian worldview, and given the kind of values upheld in Christianity, the focus should be on whether opting for euthanasia is the best decision for George. Further, these values should include the appreciation of suffering as part of an individual’s life on earth, which is also a reflection of Jesus’ suffering. Just as the Bible teaches that Jesus; suffering was God’s desire, so should we be able to interpret George’s suffering as God’s plan for him. Furthermore, it is important to understand that Christian teachings define suffering as God’s tool of bringing humanity closer to him. He can therefore use this time to evaluate God’s desires for him and to work on getting closer to God. That said, much research work concerning the justification for euthanasia reveals a positive relationship between parameters such as the optimistic definition of circumstances, maintaining family integration, social support, and positive self-esteem with positive outcomes. These elements should help inform the decision of whether a patient should opt for euthanasia.

What options would be morally justified in the Christian worldview for George and why?

George’s understanding and knowledge of chronic pain is critical as it prepares him to cope with the inevitable. Instead of deep feelings of sadness, and anger, the knowledge of chronic sorrow can help George to adopt positive strategies of dealing with the condition and continuing with treatment therapy. In terms of a Christian worldview, the only option George has is to accept his condition and continue having faith in God that all will be well. However, for George, death is inevitable and as a Christian, he should be ready to wait until natural death does occur. The use of Euthanasia as a method of mercy killing is expressly abolished in the Bible under the doctrine ‘thou shall not kill’. This doctrine refers to the killing of other people or killing oneself.

Christian worldview of chronic death can help nurses and doctors to identify the symptoms of death and deal with it early. Symptoms of grief often start before death occurs and continues after it has occurred. In the video scene provided, it is apparent that the angry man whose wife has just died had been experiencing pain and death even before his wife died. Having knowledge of death by nurses and doctors at the hospital would have helped to avert the current crisis. The knowledge would have helped them to provide therapy and other coping strategies to the man way before he was bereaved.

Based on your worldview, what decision would you make if you were in George’s situation?

As a Christian, the phenomenon of mercy killing is not an option. If I were in George’s shoes, I would continue taking medication, especially medication for pain so that I am not in much pain. After controlling the pain, I would patiently wait for the day that my natural death occurs. I believe my loved ones would willingly take care of me until death occurs. It is incumbent on the relatives of a sick person to care for their loved one until their demise. In my culture, it is allowed for family members to hire professional caregivers to help them in taking care of sick relatives. This can ease the pressure of taking care of a sick person.

Cooperation with active suicide and euthanasia is one of the issues covered in chapter seven of the book. Termination of the lives of patients using euthanasia is a very controversial issue. While some people feel it is fine to relieve suffering patients from pain by terminating their lives, others feel that this is wrong based on moral and ethical principles. Nurses are entitled to their beliefs, morals, and values which may be different from those of their patients.

Giving care to patients who are close to the end of their lives is a difficult process, not just physically, but also emotionally and psychologically (Zheng, Lee, & Bloomer, 2017). Nurses may sometimes witness complicated scenarios where families of such patients must make difficult choices to end the lives of their loved ones. There is a lack of consensus regarding how unethical or ethical these issues are. Some people feel it is unethical for physicians to end a patient’s life while others feel it is okay to relieve suffering patients of their pain by terminating their lives.

Conclusion

When people face imminent death, the situation causes immense emotional and psychological trauma. George is aware that in 3-4 years, his life will be cut short by ASL- Amyotrophic Lateral Sclerosis. Being a degenerative disease, George is afraid of the debilitating state he will be in three years’ time and contemplates voluntary suicide through euthanasia. the Christian worldview on the termination of life holds strongly that no person has the right to terminate another person’s life or even one’s own life. While some people feel it is fine to relieve suffering patients from pain by terminating their lives, others feel that this is wrong based on moral and ethical principles. The contentions notwithstanding, if I were in George’s shoes I would choose to persevere the pain till the end of time as opposed to choosing euthanasia.

References

Buckley, C. J. L., & Stricklin, S. M. (2017). When Sorrow Never Stops. Journal of Christian Nursing, 33(1), 22-29. 10.1097/cnj.0000000000000231.
Coughlin, M., & Sethares, K. (2017). Chronic Sorrow in Parents of Children with a Chronic Illness or Disability: An Integrative Literature Review. Journal Of Pediatric Nursing, 37, 108-116. https://doi.org/10.1016/j.pedn.2017.06.011
Funk, L. M., Peters, S., & Roger, K. S. (2017). The Emotional Labor of Personal Grief in Palliative Care: Balancing Caring and Professional Identities. Qualitative Health Research, 27(14), 2211–2221. doi: https://doi.org/10.1177/1049732317729139
Jinks, A. M. (2018). Conclusions drawn from the literature review and the research questions. Caring for Patients, Caring for Student Nurses, 42–45. doi: 10.4324/9780429459610-4
Khalaf, I. A., Al-Dweik, G., Abu-Snieneh, H., Al-Daken, L., Musallam, R. M., Baniyounis, M., Masadeh, A. (2017). Nurses’ Experiences of Grief Following Patient Death: A Qualitative Approach. Journal of Holistic Nursing, 36(3), 228–240. doi: 10.1177/0898010117720341
Meller, N., Parker, D., Hatcher, D., & Sheehan, A. (2019). Grief experiences of nurses after the death of an adult patient in an acute hospital setting: An integrative review of literature. Collegian, 26(2), 302–310. doi: 10.1016/j.colegn.2018.07.011
Oates, J. R., & Maani-Fogelman, P. A. (2019). Nursing Grief and Loss. In StatPearls. StatPearls Publishing.
Tofthagen, C., Kip, K., Witt, A., & Mcmillan, S. (2017). Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses. Clinical Journal of Oncology Nursing, 21(3), 331–337. doi: 10.1188/17.cjon.331-337
Zheng, R., Lee, S. F., & Bloomer, M. J. (2017). How nurses cope with patient death: A systematic review and qualitative meta-synthesis. Journal of Clinical Nursing, 27(1-2). doi: 10.1111/jocn.13975