End-of-Life Care Struggles, Assisted Death, and HIV Status Disclosure

Health Issues
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Institution/ Affiliation
Struggle at end-of-life care
End-of-Life care presents significant challenges not only to the health care providers but also to patients and family members. It helps to improve the physical, psychological, spiritual and social life of patients suffering from life-threatening diseases. According to the World Health organisation (2020), nearly 40 million patients require end-of-life care. Unfortunately, only 14% of the patients who need these services receive it. Among the patients who need end of life of care are the elderly, who often experience pain, who are susceptible to loneliness, and face drug complications (Woo et al., 2006).
Unluckily, health professionals often lack the knowledge and skills essential in caring for patients at the end of life. For instance, some clinicians lack training and knowledge required in communicating the bad news to the patients and families as well to make informed decisions. Equally, they face distress on discussions about death while at the same time lack better compensation plans (Woo et al., 2006). As such, given the distinctive procedure of each individual’s death, the strategies used to control health professionals, families and patients are insufficient, thus making end life care complicated and psychologically puzzling process.
The challenges faced by patients at the end-of-life are sizeable and devastating. Ranging from depression, physical pain, loss of dignity, hopelessness, and a variety of intense emotions such as distress, fear, and sadness, are the critical challenges dying patients undergo. 90% end-of-life, patients experience physical pain that alters their behaviour (Woo et al., 2006). For instance, 90% of patients suffering from cancer-related pain respond to pain-relieving measures, and many fear that their suffering will progress unrelieved. On the other hand, 60% of patients at the end-of-life care experience psychological distress. For example, over 50% of patients with varying stages of cancer experience psychiatric disorders (Woo et al., 2006). Similarly, patients who have cancer and HIV infections are often prone to suicidal ideation due to hopelessness, confusion and enervation. Therefore, coping with these challenges complicates end-of-life care.
Difference between allowing patient to die and physician-assisted death
The ethical distinction of allowing and assisting a patient to die has been a controversial subject among health practitioners. Traditionally, the two actions are morally different due to the philosophies of human agency and causality. That is, traditionally, all forms euthanasia were considered immoral and were prohibited. However, today people do not understand the difference mainly because they have moved from the idea of fate from a traditional origination to modern design of causatives thus focusing on the moral assessment that focuses on the effects of an action (Petrillo et al., 2017). This explains why many countries have legalized euthanasia and the high number of patients undertaking the act.
Currently, physician-assisted death is prevalent at the end of life and have been legalized in some jurisdictions. Research shows that nearly 3% of all deaths are physician-assisted deaths in nations that have legalized the act (Petrillo et al., 2017). Unlike allowing patients to die from natural causes, physician-assisted deaths involve a deliberate action performed by a physician to end a life of a patient especially those suffering from end of life disease to relieve their persistent suffering (Petrillo et al., 2017). In physician-assisted death, the doctor is permitted by the law to end the life of a patient by a painless means as long as the patient and the family have consented.
On the other hand, allowing the patients involves caring for the individuals until they die of natural causes. Usually, this is pegged on the fact that assisting patients to die is ethically wrong and is equivalent to murder and even the terminally ill patients have the opportunity to regain their health. On the flipside, physician-assisted death focus to give patients a descent death free of physical pain, depression and psychological anguish.
Disclosure of HIV status by physicians to patients
The HIV/AIDS pandemic has stimulated controversial debates about a physician’s right to privacy and confidentiality and patient’s quality and safe care. Today, many people, including health professionals, have been infected with HIV/AIDS across the world. Globally, over 36.2 million adult and 1.8 million children have HIV/AIDs (World Health Organization, 2020). Among the number are doctors, nurses and other health care professionals who pose a risk of transmission to healthy patients. Informing and allowing the patients to know the status of the health worker can minimize the risk of spread of HIV/AIDS as patients can choose other health professionals or demand the infected workers to take precautions when treating them.
On the flip side, if patients knew the HIV status of some health professionals, most would end up declining services from a positive physician, thus adding a problem to the already understaffed health system. However, by law, physicians have the right to privacy and confidentiality, including in their workplace. Therefore, this poses a dilemma concerning which of the factor should prevail between safeguarding the workers' privacy and confidentiality or the real benefits of minimizing the risks to infecting healthy patients. Currently, health bodies do not have precise positions on the issue, thus leaving the decision to the discretion of health professional. Although it is the right for health care providers to privacy and confidentiality, they must disclose their status to pa...