Ethical aspects of the end of life

Abstract

The care for seriously ill patients requires good professional training and life wisdom preceded by a deep moral-ethical reflection. Ethical rules are extremely important in palliative care because of specific problems which arise at the end of human life. Taking care of the subjectivity of the patient, his dignity, proper communication and telling the truth are essential elements of the palliative care. Respect for the autonomy includes the patient’s right to take deliberate decisions, information of the diagnosis, prognosis and the treatment. From the ethical point of view, the term of futile therapy is a difficult problem. The consequence of identification of such therapy should be a decision to refrain from any ineffective or aimless procedures which prolong dying and may cause excessive suffering. A serious ethical dilemma is applying the principle of double consequence which is used in palliative sedation. It is an element of the therapy and its role is to palliate suffering. The principle of doing good is linked to issues of the value and comfort of life. The most important thing in palliative care is pursuance to assure the patient the highest quality of the terminal period. Palliative care respects life, therefore it links the aspects of medical psychological, social, and spiritual support. However, it treats dying as a natural process and accepts the inevitability of death. The fight against death at any price is not a doctor’s duty. Medical staff that takes care of the seriously ill is often obliged to solve many moral dilemmas. The point of ethics in the medicine of the end of life is to maintain humanistic aspect of medical art.