The Critique of the Article “A Narrative Review of the Published Ethical Debate in Palliative Care Research…” by Sue Duke and Helen Bennett

Introduction

Palliative care usually refers to medical care which helps to reduce the symptoms of diseases for those patients who suffer incurable diseases rather than providing them with the treatment. The main aim of palliative care is to lessen the disease symptoms instead of stopping the illness to enhance the lives of the people who have life-threatening diseases. The reduction of disease symptoms ensures that the people who have life-threatening diseases continue to enjoy a good life regardless of their ill-health. According to Martzo & Sherman (2009), palliative care is concerned with improving one’s life together with his or her family by preventing as well as relieving the suffering. Palliative care thus plays an important role in helping those people who are going through life-threatening illnesses to mitigate the pain as well as saving them from the sorrow as a result of disease symptoms. Palliative care ensures that a person leads a normal life as if he or she has no serious conditions. It also allows the friends as well as relatives of the person who has critical conditions to take care of him or her as and when the need arises. For palliative care to be effective, it requires to be applied during the beginning periods of the illness and It is thus used together with another form of treatment to ensure that a patient lives longer (Martzo& Sherman, 2009).

Critique of the quantitative nursing research article

This section will focus on the critique of the literature that has been written about palliative care by Sue Duke and Bennett. Many authors have attempted to send light on the understanding of palliative care, its practical application, and the role it plays in improving the quality of life of patients suffering from chronic illnesses. Thus, I will assess the article by Sue Duke and Bennett in order to determine as to whether it is logical or there requires some areas for improvement. I, therefore, intend to critique the article in the following areas; to determine whether people with life-threatening diseases forms part of the vulnerable population, to determine whether it is morally appropriate to do research with people who are suffering from life-threatening illness and to determine as to whether people who are suffering from a life-threatening illness has the capacity to consent.

To determine whether people with life-threatening diseases forms part of the vulnerable population

With regards to the article by Sue Duke and Bennett, the persons who are suffering from life-threatening diseases such as cancer e.t.c. are considered to be special in that there should be no research that should be carried out on these people. This is due to the fact that the patients who are suffering from life-threatening illnesses are likely to be forced to be part and parcel of the research team in return for the care that is provided to him or them by the people behind the research process. The patients are thus not likely to gain following the research and this implies that they are likely to put the research design at risk or make the whole process to be impossible. These views are however not in agreement with several authors.

Most authors hold the view that people who are suffering from life-threatening diseases are indeed not vulnerable implying that ethical considerations can be used in the aim of protecting their needs. Also, the authors hold the view that when the people who are suffering from life-threatening illnesses are provided with a chance to share their stories concerning their illness, then this has the effect of restoring hope unto them. According to my opinion, the people who are suffering from a life-threatening illness should be included in the research as they are also willing to play a part in the research process (Forman, 2003).

To determine whether it is morally appropriate to research with people who are suffering from a life-threatening illness

The article by Sue Duke and Bennet states that the research of palliative care research that involves people with life-threatening diseases is morally inappropriate. This is because the research has some impact as far as the patients are concerned. The patient is thus much affected as compared to the persons who are carrying out the research. The risks, as well as benefits, thus should be assessed before involving people who are suffering from life-threatening diseases in research. If the necessary research is not deemed to be necessary, then it should not be carried out. Therefore, morally appropriate research is one that is intended to provide solutions to the needs of the community with regards to palliative care. This is indeed true and it is in agreement according to several authors.

Also, the article tries to define risk as well as the assessment of the risk. With regards to risk, the article by Sue Duke and Bennett, there is no need of exposing patients to harm or discomforts when treating them. The article continues to argue that there exist conflicts with regard to the goal of offering comfort and enhancing positive results. The article however does not provide a concrete solution on how the risk assessment should be carried out.

According to my opinion, this has the effect of undermining the comfort as well as the dignity of a patient. Therefore, the patient’s objectives should be realized if positive outcomes are to be derived and this will bring about satisfaction to the patients and the entire population at large. The dignity of a patient should be the first priority.

According to many authors, palliative care ought to be practiced in a reasonable way in order not to go against the rights of a patient who has a life-threatening illness. Thus it is important to make one feel valued at all times (Doyle. et.al. 2005).

To determine whether people who are suffering from a life-threatening illness have the capacity to consent

According to the article by Sue Duke and Bennett, consent forms a major role in determining whether a patient is vulnerable or not with regards to too hard. One is thus considered to be vulnerable if he or she cannot give his or her consent. This thus calls for the person to be protected so as to avoid others from taking this advantage for their own reasons. The mere act of giving consent is largely dependent on the information that is available so as to enable one to evaluate the risks as well as the benefits concerning the research. This is important since it helps one to make sound decisions. The article further argues that the illness, drugs, and the burden of the symptoms are the main factors that can manipulate one’s consent. The article however does not consider a person to be unique as far as his or her needs with regards to palliative care are concerned and therefore people are being impaired to participate in palliative care research against their will.

According to many authors, valid consent is largely dependent upon the parson’s free will i.e. the ability of a person to make decisions that are free from undue influence or any form of influence. However, according to the article by sue duke and Helen Bennett; free will can be manipulated as a result of the false information that is provided concerning the advantages that are associated with participation.

The article does not state whether it is sensible to determine whether one has the capacity to come up with informed decisions or not.

Many authors hold various views concerning palliative care. Autonomy is one of the values which are considered important with regards to palliative care by many authors. Other values that are highly regarded are the requirement to value one’s judgment among others. However, autonomy requires one to consider another as unique and so the need to treat each person differently forms the other.

According to my opinion, palliative care requires not to be given if the person is well prepared. As far as palliative care is concerned, there should be sufficient ensuring data supplied to people with life-threatening diseases in order to that is that adequate information is provided to the patients so as to facilitate them in making informed decisions.

According to many authors, palliative care is deemed to respect the free will of a person and no one should be forced to make decisions. The consent of the family members, as well as close friends, also requires to be sought. This article by Sue Duke and Bennett should ensure that palliative care requirements are met i.e. it should recognize that people who are suffering from life-threatening diseases have the capacity to consent just like any other normal person (Randall & Downie, 1996).

Conclusion

Palliative care plays a vital role in encouraging patients to stop worrying and focus on the good side of life. It thus gives people confidence not to lose hope as far as their life-threatening diseases are concerned. The article by sue duke and Helen Bennett has some elements which agree or differ from that of others. The literature concerning palliative care poses many ethical issues concerning the people who are suffering from life-threatening diseases and one of the issues that is raised is as to whether or not there is vulnerability as far as the participants are concerned. The literature is thus important as it helps to protect the moral principles and consent of a patient.

Reference List

Doyle, D.et.al. (2005). Oxford textbook of palliative medicine O xford textbook Series. London: Oxford University Press

Forman, W. (2003). Hospice and palliative care: concepts and practice Cancer Nursing Series.Sadbury: Jones & Bartlett Learning

Martzo, G. & Sherman, D. (2009). Palliative Care Nursing: Quality Care to the End of Life. Berlin: Springer Publishing Company.

Randall, D. &Downie, R. (1996). Palliative care ethics: a good companion. London: Oxford University Press.