Ethics Advocacy: Addressing Ethical Issues like End-of-Life Care

Posted: February 15th, 2023

Ethics Advocacy: Addressing Ethical Issues like End-of-Life Care, Medical Aid in Dying, Reproductive Rights, Medical Research Ethics and Healthcare Rationing

Ethics advocacy is the process of promoting ethical principles and values in various domains of human activity, such as health care, law, politics, education, business, and environment. Ethics advocates aim to raise awareness of ethical issues, educate stakeholders about ethical standards and best practices, and influence decision-making and policy-making in favor of ethical outcomes. Ethics advocacy can be performed by individuals or organizations, such as professional associations, non-governmental organizations, religious groups, or media outlets.

One of the most challenging and controversial areas of ethics advocacy is health care, where many ethical issues arise due to the complexity and diversity of human needs, values, and preferences. Some of the major ethical issues in health care include end-of-life care, medical aid in dying, reproductive rights, medical research ethics, and health care rationing. These issues often involve conflicts between different moral principles, such as autonomy, beneficence, non-maleficence, justice, dignity, and respect. Moreover, these issues often have legal, social, cultural, religious, and political implications that affect the rights and responsibilities of various stakeholders, such as patients, families, health care providers, researchers, policymakers, and society at large.

This paper will provide an overview of each of these ethical issues in health care and discuss the role and challenges of ethics advocacy in addressing them.

End-of-Life Care

End-of-life care is the care provided to patients who are approaching the end of their lives due to terminal illness or old age. The goal of end-of-life care is to improve the quality of life of patients and their families by relieving pain and suffering, respecting their wishes and values, and providing emotional and spiritual support. End-of-life care can be provided in various settings, such as hospitals, hospices, nursing homes, or at home.

One of the main ethical issues in end-of-life care is the decision to withhold or withdraw life-sustaining treatment (LST), such as artificial ventilation, feeding tubes, dialysis, or cardiopulmonary resuscitation (CPR). LST can prolong life but may also prolong suffering or reduce the quality of life of patients who are unlikely to recover or benefit from it. Therefore, the decision to withhold or withdraw LST should be based on the patient’s best interests and preferences. However, this decision can be ethically and emotionally challenging for everyone involved. It may involve conflicts between the patient’s autonomy and the physician’s beneficence or non-maleficence; between the patient’s wishes and the family’s wishes; between different cultural or religious values; or between different legal or professional standards.

The role of ethics advocacy in end-of-life care is to promote ethical decision-making and communication among patients, families, health care providers, and other stakeholders. Ethics advocates can help patients and families understand their rights and options regarding end-of-life care; help health care providers respect the patient’s values and goals for care; help resolve conflicts or disagreements that may arise; and help ensure that all other medically appropriate care is provided, including palliative care and symptom management. Ethics advocates can also educate the public about end-of-life care issues and policies; advocate for legal reforms that protect the patient’s right to choose treatment; and support research and innovation that improve the quality of end-of-life care.

Some of the challenges that ethics advocates face in end-of-life care are:

– The lack of awareness or acceptance of end-of-life care among some patients,
families, health care providers, or communities
– The lack of advance directives or clear documentation of the patient’s
preferences regarding end-of-life care
– The lack of access or availability of quality end-of-life care services,
especially in rural or underserved areas
– The lack of training or education for health care providers on end-of-life
care ethics and communication skills
– The lack of resources or support for ethics advocates who deal with complex
and emotionally demanding cases

Medical Aid in Dying

Medical aid in dying (MAID) is the practice of providing a terminally ill patient with a prescription for a lethal medication that the patient can self-administer to end their life peacefully and at a time of their choosing. MAID is also known as physician-assisted dying (PAD), physician-assisted suicide (PAS), or euthanasia. MAID is different from palliative sedation (PS), which is the practice of administering sedatives to a terminally ill patient to relieve their suffering until they die naturally.

MAID is one of the most controversial ethical issues in health care, as it involves the intentional ending of a human life. MAID raises questions about the value and sanctity of life, the meaning and purpose of suffering, the role and responsibility of physicians, and the autonomy and dignity of patients. MAID also has legal, social, cultural, religious, and political implications, as it challenges the traditional norms and laws that prohibit suicide and homicide.

The role of ethics advocacy in MAID is to promote ethical debate and dialogue among patients, families, health care providers, researchers, policymakers, and society at large. Ethics advocates can help patients and families understand their rights and options regarding MAID; help health care providers respect the patient’s values and goals for care; help resolve conflicts or disagreements that may arise; and help ensure that MAID is performed in accordance with ethical standards and best practices. Ethics advocates can also educate the public about MAID issues and policies; advocate for legal reforms that protect the patient’s right to choose MAID; and support research and innovation that improve the quality of MAID.

Some of the challenges that ethics advocates face in MAID are:

– The lack of consensus or clarity on the definition, criteria, and procedures
of MAID among different jurisdictions, organizations, or professions
– The lack of access or availability of MAID services, especially in rural or
underserved areas
– The lack of training or education for health care providers on MAID ethics
and communication skills
– The lack of resources or support for ethics advocates who deal with complex
and emotionally demanding cases
– The risk of stigma or discrimination for patients, families, health care
providers, or ethics advocates who are involved in MAID

Reproductive Rights

Reproductive rights are the rights of individuals or couples to decide freely and responsibly whether, when, how, and with whom to have children; to access safe and effective methods of contraception, abortion, infertility treatment, and assisted reproductive technologies (ART); to receive quality reproductive health care and education; and to be free from coercion, discrimination, or violence in relation to their reproductive choices. Reproductive rights are also known as sexual rights or reproductive justice.

Reproductive rights are essential for the health, well-being, equality, and empowerment of individuals and communities. However, reproductive rights are often violated or restricted by various factors, such as poverty, inequality, ignorance, prejudice, stigma, violence, oppression, exploitation, or corruption. Some of the major ethical issues in reproductive rights include abortion,
sterilization, contraception, infertility treatment, ART,
surrogacy,
genetic screening,
sex selection,
and prenatal diagnosis.

The role of ethics advocacy in reproductive rights is to promote ethical awareness and respect for reproductive rights among individuals,
couples,
health care providers,
researchers,
policymakers,
and society at large. Ethics advocates can help individuals and couples understand their rights and options regarding reproductive choices; help health care providers respect the patient’s values and goals for care; help resolve conflicts or disagreements that may arise; and help ensure that reproductive health services are provided in accordance with ethical standards and best practices. Ethics advocates can also educate the public about reproductive rights issues and policies; advocate for legal reforms that protect the patient’s right to choose reproductive options; and support research and innovation that improve the quality of reproductive health services.

Some of the challenges that ethics advocates face in reproductive rights are:

– The lack of awareness or acceptance of reproductive rights among some individuals,
couples,
health care providers,
or communities
– The lack of access or availability of quality reproductive health services,
especially in rural or underserved areas
– The lack of training or education for health care providers on reproductive
rights ethics and communication skills
– The lack of resources or support for ethics advocates who deal with complex
and emotionally demanding cases
– The risk of stigma or discrimination for individuals,
couples,
health care providers,
or ethics advocates who are involved in reproductive choices

Medical Research Ethics

Medical research ethics is the branch of ethics that deals with the moral principles and values that guide the conduct of biomedical research involving human participants or animal subjects. Medical research ethics aims to protect the rights,
welfare,
and dignity of research participants or subjects;
to ensure the scientific validity,
integrity,
and quality of research;
and to balance the potential benefits and risks of research for individuals,
communities,
and society.

Some of the major ethical issues in medical research ethics include informed consent,
confidentiality,
privacy,
vulnerability,
exploitation,
coercion,
compensation,
conflict of interest,
plagiarism,
fabrication,
falsification,
misconduct,
dual use research,
and publication bias.

The role of ethics advocacy in medical research ethics is to promote ethical awareness and adherence to ethical standards and best practices among researchers,
sponsors,
reviewers,
editors,
policymakers,
and society at large. Ethics advocates can help researchers understand their rights and responsibilities regarding ethical conduct of research;
help sponsors respect the values and goals of research;
help