End of life Care: Ethical Issues

Abstract

This chapter discusses the many ethical issues surrounding caring for patients with ALS and their families. These ethical issues include making decisions, especially regarding nutrition and respiratory support, and endof-life issues such as assisted dying or euthanasia. All of these areas need careful deliberation and consideration when caring for ALS patients as all are subject to ethical issues. In caring for ALS patients, it is necessary to discuss issues at an appropriate time, with sensitivity of the differing cultural values and attitudes in society, and with respect for different ethnic and cultural groupings and individual families. On the part of clinicians, they are bounded by clinical ethics wherein they are required to consider moral obligations of beneficence, non-malificence, autonomy, and justice. Ethical issues are not addressed by a lone person or group but rather it is a collective effort by the multidisciplinary team, the patients and the families wherein they would be able to come up with decisions that are acceptable to all.