Monday, June 3, 2019
What Theological Or Ethical Principles Religion Essay
What Theological Or Ethical Principles Religion EssayAs lenitive wish is specialized cheer c are for people who are approaching the extirpate of their stretch forths, it is related to many ethical issues and concerns. Its framework is based on the moral set and principles of the professionals involved, unhurrieds concerned, their families and society as a whole. alleviative anguish is a very sensitive issue and it is all important(p) that it is administered in an appropriate manner. The main objective is to achieve the best likely select of animateness, both for the person, and for their family. As such, palliative tending is more than the provision of medical relief from vexation and early(a)(a) distressing symptoms. It encompasses the psychological, social, emotional and eldritch aspects of residuum of life care.The palliative care philosophy affirms life and regards dying as a normal process. It neither aims to hasten nor postpone death. It endeavours to provide a team-based life system for the person, enabling them to live as fulfilled a life as possible for the time remaining and to help their family cope during their loved ones indisposition and prepare for their bereavement. Care fire be provided at home, in a hospital, an termd care facility or a palliative care unit. above all, palliative care respects the dignity of the person who is dying, carefully honouring their story, wishes and needs.A discussion about palliative care doesnt necessarily mean that death is imminent, in fact, its distant better to start thinking and talking about your palliative care options before you need them. Palliative care is sometimes required for a person whose death is very near a matter of hours or days while others will need care over a eight-day period of time, sometimes years. In this case their care needs will tend to be less intensive and more episodic. The need for palliative care does not depend on any particular medical diagnosis, mer ely the combination of many factors assessed through and through the judgement of the person, their family, the palliative care team and other medical professionals, including the persons GP. Families and carers may also receive assistance from palliative care services in order to help them cope with emotional and social problems weakened healers also need healing.To lenify is to cover with a cloak of care to offer protection and provide relief in the last chapter of life. A palliative approach is a type of palliative care and recognizes that death is inevitable for all of us. For me writing, I am reminded of a comment Professor John Swinton do in response to a question at the recent CAPS conferenceWherever we are in life, there is a storm coming preparation becomes about the solidity of our foundations.End of life questions of quality, planning and dignity are ethically and theologically grounded in solidifying our foundation. Clements (1990) wrote of this, explaining that as t he person moving through life finds their roles stripped from them, and if they have no spiritual foundation, they may be found naked at the core.Residential Aged Care Facilities are ofttimes the place where people spend the final chapter of their life people come into care because they are no longer able to look after themselves and well-nigh will have chronic malady alongside ageing. The focus of care in aged care facilities is to help people live well with their nausea and frailty during their time spent there. This focus on living well is the essence of the palliative approach to care. Our goal is al ways to assess and treat pain and other symptoms thoroughly, in familiar surroundings and in the company of the persons loved ones.Theres a Japanese proverb of which I am particularly fond, A sunset(a) can be just as beautiful as a sunrise. In my work Ive seen many beautiful sunsets in peoples lives. Sadly, Ive also witnessed some that arent so beautiful. With forward planning t hey may have been divergent. The sudden onset of illness has a way of turning our lives, and the lives of our family and friends, upside down at any age. shortly decisions can be very difficult to make thats why planning ahead is important. If we know what a persons choices and wishes are, were able to respect them if something should happen and theyre unable to declaim us themselves. Medical treatment to manage symptoms goes alongside comfort care and could include surgery or medications. The focus of a palliative approach is on living. That is why staff will want to set goals and to plan for how the person wants to live the rest of their life.The end-of-life stage is an extraordinarily profound and emotional time and a person does not have to be religious to have spiritual considerations. Spirituality is about how we make centre in our lives and intent connected to other things, people, communities and nature. Spiritual questions, beliefs and rituals are often central to peo ple when they are in the final chapter of their lives. Ensuring that staff are informed about each residents unique spiritual considerations will allow them to be properly respected and addressed. Helping the person to tell their story can help them find meaning, affirmation and reassurance.To effectively palliate would mean that family and staff communicate openly and with compassion with the person in care and with each other that pain control and comfort is achieved as faraway as possible that the resident has every opportunity to communicate with those who are important to them and that their physical, emotional, social, cultural and spiritual needs are addressed and as far as possible met. One size cloak of care does not fit all (Hudson, 2012). When these elements are neglected the cloak becomes an empty cover up, exit the resident exposed rather than protected. When the cloak does not fit it is uncomfortable to wear (Hudson 2012) but the vulnerable population of people in their fourth age may wear it anyway for fear of seeming ungrateful. An appropriate cloak of care moldiness have a spiritual lining, and provide opportunities to reveal hugger-mugger hurt forgive, reconcile and find peace in breathing out through tasks of ego-reflection and self-transcendence. Spiritual and pastoral care in this context aims for wholeness and spiritual growth.Palliative care should not palliate death itself denying the stark objective(a)ity of death and dying with false platitudes and consolation can mask existential pain and real needs and further, make these taboo. From a Christian theology, death is recognized as inevitable and necessary. Ageing is an inescapable process that in part defines human humankind and experience. From the moment we are born we age. Ageing only ends when we die. Experience of human life tells us that ageing and death are linked. The curse of Adam in Genesis 3 introduces this finitude to our lives.Our role as pastoral carers is one of empowerment, relationship and human straw man. Care of people who are woeful means providing real spiritual care, where a closeness or intimacy is developed between the person who is suffering and the carer. This is often quite alien for health professionals, who, through the goal of residential aged care accreditation, are subscript to activity theory and a doing role that emphasizes action rather than being with (MacKinlay, 2006). This involves not a moxie of competence, but a sense of humility in the awareness of our own in ability to fix anything, beyond being with that person at their point of need.The photograph of being present to ageing and death constitutes a simple and costly demand to stay. Not to under domiciliate or explain just to stay Or else to expire in terrible wilderness, lonely silence (Caldwell 1960). In MacKinlays (2006) observation that care of people who are suffering means to walk the journey of suffering with them, to be present with them and auth entic in caring (p. 167) I am reminded of Jesus telling his disciples to watch and pray (Matthew 2636-46)to bear witness. We cannot cure the biblical worst enemy of the fatal sting but we CAN care sincerely respecting that the cloak is not ours to fashion and that the chapter will always have an end (Hudson, 2012). Jesus, in becoming human and by his death and resurrection, defeats death and gives resurrection hope of a body free from ageing, decline and frailty, providing hope to all people, especially those in the fourth age.Terminal illnesses do not inhibit people the way they used to a person burdened with such an illness can live a long and reasonably well life. Consequently terminal disease is tangled in an ethics web concerning limited health resources, contributing to accompaniment and community tensions. These tensions intrinsically present ethical issue in the equity of service provision.Stemming from this is the sensitive nature of transitioning to palliative care, an d further to end-of-life care. End of life can be defined as that part of life where a person is living with, and impaired by, an eventually fatal condition, even if the prognosis is ambiguous, or unknown. The ball Health Organisation defines palliative care as an approach that improves the quality of life of separates and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and management of pain and other needs, physical, psychological and spiritual.There is further tension surrounding communication and generational knowledge. As with Jefferys Mrs Davis there can be enormous gaps in generational perspective which may compromise informed decisions. The onus for decision making in a palliative care team lies with the resident themselves so, ethically, whose responsibility is it to be sure that a decision is well-informed? And further, who can be unbias ed in providing information so as not to manipulate a decision? Contradictory beliefs, conflicting principles, and competing duties between the parties involved in end-of-life care can pluck the cloak.Beauchamps primary principles of health care include non-maleficence, confidentiality, autonomy, truth telling, informed consent, and justice. Empathy underpins each of the principles above, and in this lies the difficulty. We cannot understand (Okon, 2006 cited by Hudson 2012), we cannot try the cloak on for size but sometimes just looking as though you could understand (Saunders, 1987 cited by Hudson, 2012) makes a world of difference and goes some way to thwart loneliness. In end-of-life care, our presence as pastoral carers is strengthened in enabling spiritual growth through the sharing of connectedness and ritual.A palliative approach is built on an understanding of the uniqueness of individuals life histories and personalities, and implies commitment to an individuals developm ental tasks of ageing and coming to peace. To be able to reach such goals as personal satisfaction, the individual must have means of expressing themselves. Our role in the care of older people is to support and alter each individuals sense of meaning and self-expression to affirm each individual as a person of great value, and loved by God.Aged care is a delicate balancing act in that functional decline, infirmities and diseases are often inherent in ageing. Because of the nature of chronic illness in the fourth age, a caring response in the face of incurable illness is respect, and commitment to personal autonomy and integrity. That is, our role in promoting overall comfort and wellbeing through positively reinforcing and enabling those with such prognoses, to live to their best quality of life. The goal of palliative care is to provide comfort and care when cure is no longer possible. This paradigm shift entails a shift in the comment of autonomy. People at the end stage of lif e are not playing by the same rules as you or I who would oblige patient autonomy and nod to expert medical opinion. Health professionals in this context need to be enablers not decision makers.Gradual functional decline and loss of control in autonomy are inevitable with age. Loss of control is painful and scary. Perhaps this kind of persona is paralleled only in infancy expiration our elders feeling a sense of childhood being forced upon them (Jeffery, 2001). Unfortunately admission to aged care often does not help these older adults to feel less like children. The danger and ethical dilemma here is the assumption of impaired autonomy in that decisions are made and autonomy declared befuddled even when this is unnecessary, because it is a simpler, easier course of action we know what is good for you (Jeffery, 2001). The basis of this kind of paternalism is beneficence its motivation is to act in a persons best gratify so that no one gets harmed making harm or burden the reas on for intervention.Some loss of autonomy is inevitable in later life and steps have to be taken to act in the incompetent persons best interest, sometimes with their wishes recorded in living wills or advance care plans. Often autonomy presupposes someone, who acts in accordance with such a pre-conceived plan, and who is rational and independent but autonomy may be better understood in terms of identity and self expression of values (Jeffery, 2001).A written advance care plan is about ensuring peace of mind. Effective advance care planning can avoid an unwanted transfer to a hospital. But even such counteractions as advance care planning can be problematic as these are based on todays situation and forecasted futures i.e. these cannot take into account tomorrows medical breakthrough. This being the case, there arise new ethical dilemmas e.g. do we have a even out as people acting in someones best interests to tweak what they have proclaimed to want for themselves? Would they have wanted what they state they wanted were they deciding now?When autonomy is understood as a property of action or a aptitude of persons (Reich, 1995) impaired autonomy, becomes a dispiritedly limiting self fulfilling prophecy in that it diminishes the opportunities of those who lack certain abilities or capacities (Caplan, 1992). Autonomy needs to be seen as a way of valuing the human person, respecting them and recognizing their right to make decisions as the master of themselves.Personhood is not compromised or incapacitated by end stage life we are who we remember one another to be an essential aspect of being human is to care and be cared for interdependence is a non-accidental feature of the human condition. Being human, we are bearers of the image of God (Gen 126). This image demonstrates our capacity for relationship with God, and with the rest of humanity (Green, 197). This capacity for relationship does not diminish as we age.If autonomy is taken as valuing ones uniquene ss and the capacity to give gifts, it is a search for meaning in life authenticity. That is as Jeffery writes authentic choice is the autonomy of action that requires meaningful choices to be offered and identified with which equates to ones values and essentially what they stand for. If this is how we understand autonomy then this sheds new light on impaired autonomy. In effect we lose the ability to stand for what we stand for. In this case, autonomy becomes less about incompetence and more about advocacy in helping the person to reconnect their essential values to their choices and allowing them to give meaning to their life. By honouring this form of authentic control rather than a control via acquiescent consent or accept it or leave it culture we enable fulfillment and empowerment of the persons dignity.Being a resident in a nursing home may conjure conceptions of a twisted and limited self, and is unwholesome of autonomy. This is partly because the environment is thick wi th congruity and thin with community (Jeffery 2001) and partly because decision making is made nearly obsolete. The desire to control is moderated by the self-fulfillment of the possibility of not being able to process all the relevant information as the person psychologically shrinks, so too does their autonomy and self faith. Further, someone faced with a life shock can find their autonomy impaired in that they find themselves in a dramatically different world where previous life plans have no meaning and even stable values disappear (Jeffery 2001). In such settings autonomy becomes about the ability to make meaningful choices. An older person may not be able to carry out what they decide, but they are able to recognize commitments and to be themselves (Jeffery, 2001).As partners in end-of-life care, aged care staff must take into account such ethical dilemmas as autonomy and intergenerational tension in the way physical care is given by focusing on presence, meaningful experienc e, journeying together, listening, connecting, creating openings, and engaging in reciprocal sharing.Affirmative relationships support residents, enabling them to answer to their spiritual needs. Barriers to appropriate palliative care include lack of time, personal, cultural or institutional factors, and professional educational needs.By addressing these, we may make an important contribution to the improvement of patient care towards the end of life.
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