Ethical Issues at the End of Life

Abstract

This chapter explores the ethical, legal and professional issues that healthcare professionals face when caring for individuals at the end of life. Contemporary guidance will be drawn upon along with an evolving case study and legal judgments to illustrate and discuss the issues raised. Beginning with an exploration of the concept of the good death and the role of palliative care in facilitating a good death, the process of advance care planning and making advanced decisions is discussed. This is followed by a consideration of the withdrawal of treatment and draws on English and Irish cases to illustrate the legal and ethical aspects of futile treatment. The classification of artificially administered nutrition and hydration and the controversy surrounding the use of the Liverpool Care Pathway are also considered. The final sections of the chapter consider the difficult subject of assisted dying, suicide and physician assisted suicide. The discussion is informed by cases in the English and Irish Courts and the attempts to change legislation in the UK. Euthanasia, arguably the most controversial aspect of assisted dying, is examined. Insight from countries such as The Netherlands, where active voluntary euthanasia is lawful, informs the debate.