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Musculoskeletal, Metabolism, and Multisystem Complexities

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From a scholarly perspective, autonomy in reference to MAID is an ethical issue that is strongly supported by those who believed in assistance in dying. According to Spence, Blanke, Keating and Taylor (2017) supporters of the autonomy see the patient as an individual capable of making a valid decision without any form of influence from external parties. In line with the principles of autonomy, these decisions should be protected by the health care practitioners and implemented as desired by the patient. Proponents of the autonomy principles thus consider it as a significant health care value that should be adhered to by all the health care practitioners.

According to the article individuals who detract the principles of autonomy sees it as an act that is contrary to the health care value desired by a patient. These persons believe that autonomy bar the patient from receiving quality care and may be used as a way to escape the clinical responsibilities assigned to the health care practitioners (Spence, Blanke, Keating & Taylor, 2017). Also, issues on the possibility of the patient’s decision being influenced by their suffering have been presented questioning whether such decisions could be avoided through the provision of quality care. Opponents of autonomy argued that the medical practitioners and the concerned parties should influence the decisions made by the patients on MAID to ensure maximum care is provided. This argument has however, been refuted by Karnik & Kanekar (2016) who asserted that as much as the decision-making process to end life is complex and marred with many challenges, patients have a right to choose and communicate their end of the life treatment process.  Regardless of the decision made, nursing practitioners, and physicians, should uphold the ethics of autonomy and respect of persons and ensure their wants are honored. From the review of the scholarly literature it can be deduced that there are certain limitations of autonomy, however, the healthcare professionals should respect the autonomy of the patient, while exploring the possible limitations to ensure they offer maximum benefits to the patient without causing any harm.

Media Source

The article by Martin (2018) gives more insights into the ethical dilemmas concerning MAID as legalized in Canada. According to the author, the recommendations of the committee on eligibility, informed consent, access and safeguards are contrary to the principle of patient autonomy and respect for persons. Eligibility for MAID has been limited to people with publicly insured health care, barring others from accessing the same service irrespective of their end of life treatment desires. Also, informed consent from a competent adult is desired, to ensure the decisions made by the patients are out of their experiences, belief and values and not any other reason as supported by the principle of autonomy (Martin, 2018). This consent is also promoted to ensure the patient makes judicious choices based on the available alternatives to end of life treatment. It is reported that witnesses and organizations summoned by the committee argued that patients should seek approval from experts of legal authorities before becoming eligible for MAID. However, the committee recognized that the decision for MAID should be solely made by the patient after a discussion with the doctor to ensure the autonomy of the patient is protected.

The recommendations presented by the committee on MAID in Canada to a great extent upheld the principles of autonomy as indicated in the scholarly article by Spence, Blanke, Keating and Taylor (2017). As much as the eligibility criteria exclude some patients, the recommendations support the independent and autonomous engagement of the legible patients. It is reported in the media article, health care practitioners and facilities with religious orientations that are contrary to physician-assisted dying are not exempted from the service (Martin, 2018). Rather are commanded to provide effective referrals to enhance the access of the service to desiring patients. Also, nurses have been encouraged to offer MAID services in consultation with the doctors in rural areas, actions that will further improve the accessibility of the service to patients in different parts of the country.

Even though the Canadian take and recommendations on MAID have to a large extent taking into consideration the ethical issue of autonomy, access and eligibility, safeguard vulnerable patients still remains an issue of concern. Since pain and suffering are subjective nature, accurate identification of individuals ascertained to be suffering grievously and whose lives have become intolerable remains a major challenge. It is important that more stringent measures are put in place to safeguard the vulnerable patients.