FNU Ethical Dilemma Discussion

1.  What signs might alert you to a potential professional boundary violation or crossing?

2.  Contrast the terms terminal sedation , rational suicide, and physician-assisted suicide.

3. Identify at least 3 moral dilemmas that occur during end-of life care and decision making.

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As a medical professor responsible for creating college assignments and evaluating student performance, I understand the importance of addressing various ethical issues and dilemmas that medical professionals encounter in their practice. In this answer, we will explore signs of potential professional boundary violations, contrast terms related to end-of-life care, and identify moral dilemmas encountered during end-of-life care and decision-making.


1. Signs that might alert you to a potential professional boundary violation or crossing include:

– Inappropriate physical contact or invasion of personal space: Medical professionals should maintain appropriate boundaries with their patients, and any physical contact that makes the patient uncomfortable or is beyond what is necessary for medical examination should be avoided.

– Dual relationships: Developing relationships with patients outside the professional setting, such as becoming friends or entering into romantic relationships, can blur professional boundaries and compromise patient care.

– Excessive self-disclosure: While it is important to establish rapport and trust with patients, revealing personal or intimate details about oneself can undermine the professional relationship and lead to boundary violations.

– Overstepping confidentiality: Inappropriately sharing patient information without a valid reason or without obtaining the patient’s consent can breach professional boundaries.

2. Terminal sedation, rational suicide, and physician-assisted suicide are distinct terms related to end-of-life care:

– Terminal sedation: It is a practice where a patient near the end of life is provided with sedative medication to alleviate suffering, even if it hastens their death. The primary intention is to relieve symptoms and improve quality of life, rather than directly causing death.

– Rational suicide: It refers to an individual with a terminal illness or unbearable suffering voluntarily choosing to end their own life. The decision is made by a competent individual who has the mental capacity to make such a choice.

– Physician-assisted suicide: This involves a medical professional providing a patient with the necessary means or information to enable them to self-administer a lethal dose of medication with the explicit intention of ending their life. This practice is legal in some jurisdictions.

3. Moral dilemmas in end-of-life care and decision-making:

– Withholding or withdrawing life-sustaining treatment: Deciding whether to continue or discontinue life-sustaining measures, such as mechanical ventilation or artificial nutrition and hydration, can pose ethical dilemmas for medical professionals, patients, and their families.

– Palliative sedation: Determining the appropriate use of sedation to alleviate intolerable symptoms while potentially hastening death can raise moral concerns. Striking a balance between relieving suffering and respecting the sanctity of life can be challenging.

– Cultural and religious considerations: End-of-life care decisions may clash with the religious or cultural beliefs and values of the patient and their family. Respecting autonomy while considering the impact of these factors can present moral challenges.

It is crucial for medical professionals to be aware of these ethical issues, continuously reflect on their own practice, and seek guidance from bioethics committees or appropriate resources to navigate these complex dilemmas in end-of-life care.

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