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End-of-Life Issues: Ethical Issues

3.5 Contact Hours / 0.35 AOTA CEUs
Target Audience: Nurses, healthcare professionals, and interested individuals
Purpose/Goal: The outcome of this course is for the learner to describe key ethical considerations at the end of life and identify the tools necessary to make ethical decisions when providing care for patients at the end of their lives.
$34.93
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End-of-life care presents healthcare professionals with many ethical challenges and dilemmas. Advancements in medical sciences have created the possibility of reshaping the circumstances during death and can prolong lives. Understanding ethical theories and ethical principles can provide a foundation for decision making and for providing more compassionate, informed care.

Upon completion of the course, you will be able to do the following:

  • Describe the role of ethics in end-of-life care in health care today.
  • Define ethics.
  • Describe the key elements of the ethical theories of utilitarianism, deontology, Ross's ethics, natural law ethics, ethical egoism, and virtue ethics.
  • Describe the key ethical principles of autonomy, beneficence, nonmaleficence, veracity, confidentiality, justice, and fidelity.
  • Outline a method for analyzing ethical dilemmas.
  • State the relationship between culture and ethics.
  • Define brain death.
  • List key items from the Dying Patient's Bill of Rights.
  • Describe two types of advance directives and explain their purpose.
  • Define euthanasia and compare active versus passive euthanasia.
  • Compare involuntary active euthanasia with voluntary active euthanasia.
  • Describe assisted suicide and medical futility.
  • List important considerations relevant to do-not-resuscitate (DNR) orders.
  • Define terminal sedation and describe how and why it is utilized.
  • Define the double effect.
  • Describe considerations for the health care provider relevant to the voluntary refusal of hydration and nutrition.
  • Describe issues related to the removal of mechanical ventilation and organ donation.
  • Identify key issues related to end-of-life care of the neonatal and pediatric patient.

With the availability of increasingly sophisticated health care technology, end-of-life care presents unprecedented ethical challenges for individuals, families, health care professionals, and policy makers. The role of health care professionals and the use of these technologies are changing how death, dying, and end-of-life care are viewed and managed.

Almost all adults have had some experience with the death of a spouse, a parent, a grandparent, or a child. The experience is rarely easy. Most deaths are the result of chronic disease. Compassionate and effective coordination of care is essential because health care and science are not close enough yet to finding cures for the major chronic diseases. This slow progress toward finding a cure means that sick individuals are living longer with their chronic disease. The resulting financial costs are unprecedented (Callahan & Lawler, 2012).

According to Callahan and Lawler (2012), one of the unexpected consequences of the unlimited use of technology in health care is that technological advances have made it harder and harder to determine with any precision when a patient is actually dying. There is almost always something that can be done to give dying people a few more hours, or days, or even weeks before they actually die

Dying patients face many challenges that affect their physical, psychosocial, and spiritual integrity (Tulsky, 2005). The Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatment (SUPPORT) documented that many patients die a prolonged and painful death and that they receive expensive, unwanted, and invasive care during their last days. The emotional suffering of patients can be profound, and so, too, can the suffering of those who provide care for those patients at the end of their lives.

Yet, often, health care providers are ill-prepared to address the suffering experienced by dying patients and their families as they journey from serious illness to death (Tulsky, 2005). The SUPPORT study showed that many physicians behaved as though they were unaware their patients were dying and they rarely discussed prognosis and advance directives with their patients (Coll, Duffy, Micholovich, & Cohen, 2002). Many physicians do not know the extent of options for care at the end of life (Silveira, DiPiero, Gerrity, & Feudtner, 2000). As a result, end-of-life care has remains a high national priority (Steinhauser et al., 2000).

Complete the course post exam (CE Test) with a score of 80% or greater. Complete all fields of the course evaluation form. Certificate of Completion is provided once the course post exam is passed per criteria above.

  • American Board of Managed Care Nursing
    The American Board of Managed Care Nursing recognizes all of ALLEGRA Learning Solutions' ANCC accredited courses for continuing education credit for Certified Managed Care Nurses (CMCNs).
  • ANCC - American Nurses Credentialing Center
    ALLEGRA Learning Solutions, LLC is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.
  • AOTA - American Occupational Therapy Association
    ALLEGRA Learning Solutions, LLC, is an approved provider of continuing education for occupational therapists by the American Occupational Therapy Association. Approved Provider # 3166
  • ASWB - Association of Social Work Boards
    This course is approved by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program to be offered by ALLEGRA Learning Solutions, LLC as an individual course. Individual courses, not providers, are approved at the course level. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. ACE course approval period: 04/22/2021-04/22/2024. Social workers completing this course receive the specified distance learning continuing education credits.
  • California Board of Behavioral Sciences
    California Board of Behavioral Sciences Provider Number PCE 1564. Course meets the qualifications for the stated hours of continuing education credit for MFTs and/or LCSWs as required by the California Board of Behavioral Sciences.
  • California Board of Registered Nursing
    ALLEGRA Learning Solutions is approved by the California Board of Registered Nursing, Provider # CEP 14693 for the number of hours stated.
  • California Department of Health, Aid, and Technician Certification Section
    The California Department of Health, Aid, and Technician Certification Section accepts continuing education offered by CA-BRN approved providers.
  • District of Columbia Board of Nursing
    ALLEGRA Learning Solutions (CE Provider # 50-12076) submits all continuing education records to CE BROKER after successful completion.
  • Florida Board of Nursing
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Board of nursing (CE Provider # 50-12076). Courses are automatically submitted to CE Broker.
  • Florida Board of Nursing - Certified Nursing Assistants
    ALLEGRA Learning Solutions (CE Broker Provider # 50-12076) submits all continuing education records to CE Broker after successful completion.
  • Florida Board of Respiratory Care
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Board of Respiratory Care
  • Florida Council of Dietetics and Nutrition
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Council of Dietetitics and Nutrition
  • Florida Council of Licensed Midwifery
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Council of Licensed Midwifery
  • NAADAC - The National Association of Alcohol and Drug Abuse Counselors
    This course has been approved by ALLEGRA Learning Solutions, LLC, as a NAADAC Approved Education Provider, for educational credits. NAADAC Provider #813, ALLEGRA Learning Solutions, LLC is responsible for all aspects of their programming.
  • NCBTMB -National Certification Board for Therapeutic Massage & Bodywork
    ALLEGRA Learning Solutions, LLC is approved by the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) as a continuing education Approved Provider. Provider Number 451562-11.
  • Florida Board of Massage Therapists
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Board of Massage Therapists
AOTA CEUs:

0.35

Practice Level:

Intermediate

Content Focus:

Foundational Knowledge

Course Expires:

May 30, 2025

Instructor(s):
  • Cyndie Koopsen, RN, BSN, MBA, HNB-BC, RN-BC, HWNC-BC
  • Caroline Young, MPH
Jurisdictional Requirements:

Continuing education (CE) licensing requirements vary by jurisdiction, are not well defined, and may change. These CE requirements may vary in terms of the number of hours required to the types of courses that must be taken. ALLEGRA Learning Solutions, LLC recommends you contact your licensing board or accrediting organization for the latest continuing education requirements of your state or territory. Compliance with CE requirements is the responsibility of the individual health care provider. Health care providers must understand the CE requirements in their jurisdictions, and be sure they are up-to-date on any rule changes that affect their license. For further information, please see our Accreditation Information.

Accommodations for Disabilities:

Every effort will be made to accommodate your special needs. To request accommodations, please contact us.

Conflicts of Interest and Relevant Financial Relationships:

The authors/planning committee members have no conflicts of interests or relevant financial relationships to declare relevant to this activity.

Commercial Support:

No commercial support has been received for this activity.

Non-endorsement of products:

Accreditation refers to recognition of continuing nursing education only and does not imply ALLEGRA Learning Solutions, LLC approval or endorsement of any commercial product.

Off-label Use of Products:

None of the authors intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

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