Assisted Suicide - page 3

How should a nurse respond when a patient begs for a quick and easy death? What is a nurse's role, if any, in the assisted suicide process?... Read More

  1. by   Jay-Jay
    Hogan, your attitude is bordering on insulting to palliative care nurses. I have several certificates in palliative care, and am working towards becoming a nurse specialist in this area.

    Here is the teaching I have been given, time and time again: It is not the narcotic that kills an end-stage palliative patient, but the DISEASE!

    Yes, I have seen patients over-medicated with narcotics. That's another whole story. One instance recently: Doc applied 50 ug. Duragesic patch. Patient who had been walking/talking was now unresponsive, resp. 10. I called the doc, and got an order to reduce the dose to 25 ug. Next day, the patient was sitting up in bed, talking with family, and being assisted to the bathroom. She wasn't pain free, but pain was controlled at about a 2-3 out of 10. She lived for several more weeks.

    Second instance: elderly lady, with multiple health problems: diabetes, gangrene, CHF, DVT. Family has decided to let her pass rather than subjecting her to an amputation of her leg. She has been comatose, but is now awake, elevated pulse and RR, groaning in discomfort, BP elevated. She has had little or no intake of food or fluids for several days now. The doctor has left an order for titration of the pain pump, so I increase the dose by one step, and put in a phone call to the doctor on call to get Ativan to help with the respiratory distress. I also override the lockout on the pump, and give her an immediate bolus dose.

    Forty-five minutes later, she is still in distress. I increase the dose again. Finally, the doctor calls back with an order for Ativan, .5 mg. SL, and also a scopolamine patch to help dry secretions (so-called 'death rattle', patient is too weak to swallow saliva.) I also suction her and do mouth care.

    Half an hour later, she is starting to settle, and doze off. Her respirations are no longer laboured, and you can see that she has relaxed now that the pain is under control. She drifts off to sleep with her daughter sitting beside her, reading the Bible. Several hours later, she draws her last breath.

    Did I kill her? NO!! I HELPED HER TO DIE, in as pain-free and dignified a manner as possible. THERE IS A DIFFERENCE! I suggest you take some advanced courses in Palliative care, and find out what they are! If I had allowed Patient A to succumb due to her decreased respiratory rate (Duragesic HAS killed people in this way) THAT could have been considered assisted suicide, as that lady was not yet ready to go.

    I have absolutely NO idea where you got the idea that aggressive hospice is assisted suicide. That is one of the most ridiculous statements I have yet to come across on these boards. The goal of hospice is to assist a dying patient to pass in as pain-free and dignified a manner as possible. Assisted suicide is helping someone to VOLUNTARILY end their life, before the disease that is killing them has run its full course. If hospice nurses were allowed to do their jobs without interference from those who wrongly believe that giving adequate pain control is the same as murdering patients, THERE WOULD BE NO NEED FOR ASSISTED SUICIDE!!
    Last edit by Jay-Jay on Mar 26, '04
  2. by   gwenith
    Brilliant post Jane - thank-you - I learn something new every day and I do not regret it.
  3. by   leslie :-D
    have to agree jane, beautifully put. i truly hope there are certain angels that have read your post so one can understand the true meaning of dying in peace.
  4. by   Jay-Jay
    I think I got mistaken for an angel that night. The pt's daughter was so grateful to me that she called my manager, AND the CCAC case manager to tell them what a wonderful help and comfort I'd been.
  5. by   leslie :-D
    Quote from Jay-Jay
    I think I got mistaken for an angel that night. The pt's daughter was so grateful to me that she called my manager, AND the CCAC case manager to tell them what a wonderful help and comfort I'd been.
    no jane, it was no mistake. you clearly can relate to your pts' needs, wishes, fears and pain, and are proactive in ensuring that they and their tired, broken bodies can rest. not to be confused with the omnipotent, heroic angel of mercy, who takes it upon themself to put the pt. out of their misery with total disregard to what their actual desires are. God, some people just don't have a clue.
  6. by   Jay-Jay
    Thanks, Earle!

    I just found a link to a previous excellent discussion on this same topic. Check it out!

    http://allnurses.com/forums/showthread.php?t=1454
  7. by   NRSKarenRN
    Jane,

    What an eloquent example of NURSING ......post 27 shows!

    Don't think I could have expressed as well this statement:
    from Jay-Jay
    The goal of hospice is to assist a dying patient to pass in as pain-free and dignified a manner as possible. Assisted suicide is helping someone to VOLUNTARILY end their life, before the disease that is killing them has run its full course. If hospice nurses were allowed to do their jobs without interference from those who wrongly believe that giving adequate pain control is the same as murdering patients, THERE WOULD BE NO NEED FOR ASSISTED SUICIDE!!
    Agree with your sentiments 100%.

    Think I might to move to Canada so you can nurse me in my golden years.
  8. by   jkaee
    Wonderful post, Jane! You expressed so beautifully why I love working in LTC and with hospice patients. Knowing that I can help patients and families at the end is a wonderful, rewarding and humbling experience!

    Jennifer
  9. by   P_RN
    Jane what can I say? You have given the perfect description of Nursing. Thank you.
  10. by   hogan4736
    Where are my nurse cookie cutter and jello mold?


    sean
  11. by   leslie :-D
    Quote from hogan4736
    Where are my nurse cookie cutter and jello mold?


    sean
    you're a scary one hogan.
  12. by   Jay-Jay
    Sometime in the very near future, I may be called upon to put my palliative care knowledge to work a little closer to home.

    My husband has just been dx. with Ca. of the bladder. He's also had a heart attack and a stroke, and is recovering from pneumonia and two bowel obstructions (thank goodness, both resolved spontaneously).

    Now, excuse me while I slink off to have a really good cry. Don't think I'll be doing much moderating for the next little while.

    And Hogan? That post of yours I deleted was a deliberate dig at Agnus, so please don't cry "CENSORSHIP!"
    Last edit by Jay-Jay on Mar 26, '04
  13. by   leslie :-D
    you won't be alone jane, in spirit nor in prayer. God be with you.

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