Dying with Dignity? Can't Everyone Die with Dignity?

Recent news has focused on the news that a terminally ill patient ended her own life rather than let an aggressive brain tumor end it for her. Many praise this as a death with dignity but as nurses, let's make sure everyone dies with dignity by providing end of life care. Hospice and palliative care offer death with dignity every day for patients. Nurses Announcements Archive Article

Dying with Dignity? Can't Everyone Die with Dignity?

There is huge support for the recent case in the news about Brittany Maynard who recently took her own life rather than letting cancer take it from her in its own time. While many people believe that what Brittany did was a good and decent thing, a question remains: If the only way to die with dignity is to take your own life, what does it mean if you don't?

As a hospice nurse, I believe all of my patients die with dignity. They die with dignity because they are human persons, with the dignity and worth all human persons deserve. I certainly can speak for the fact that they suffer, that they decline, that they need help and support of others, but that does not exclude the fact that they have dignity. Nor does it diminish their honor that they choose to let nature take its course rather than letting a pharmaceutical cocktail end it for them.

It is my hope that no one believes that there is nothing to live for if you have a terminal disease. I hope all my patients know that. Life isn't always about being a perfect person, without sickness or debility. Steven Hawkings is an excellent example of this, although severely debilitated, and having a terminal illness, he continues to contribute greatly to knowledge, to science, and to many people who care deeply for him as a person.

Being sick or being terminal doesn't have to mean you have no quality of life. Not knowing what Brittany Maynard was told about her condition, I can only hope that she was given the choice to continue life with hospice or palliative care. Such care can give patients quality of life they did not know they could achieve with a terminal or severe illness.

Further, although a person may feel they don't want to live with sickness or debility, what they really may be feeling is that there is no hope, which is never true for anyone. They also may not understand or be informed that the things they fear may not happen at all. Often, health professionals opt to be totally honest with patients and let them know "worst case scenario" and while honesty is generally the best policy, sometimes too much information does a disservice to a vulnerable person. All of us know what happens when we look up diseases or illness on the internet: we learn things we never wanted to know or we learn things that aren't even close to accurate. Someone who has just learned they are terminally ill is someone who needs information but they also need support and at the end of life, one of the best supports is knowing that there is help no matter how dismal things seem.

With hospice or palliative care, many patients realize that their symptoms can be controlled and managed and they can go on living and enjoying each day. It is beyond doubt that most people given a terminal diagnosis fear not only death, but being a burden on others. With supportive care from hospice many of these concerns are ameliorated but a patient doesn't know that if no one tells them.

So before we start to think that the only way to die with dignity is to end a life, let's make sure we offer our patients every option for end of life care we can. Hospice and palliative care can make so much difference and give hope to those who may feel that they have no choices left. Let's make sure that every patient dies with the dignity of end of life care, given by health workers who believe that no one death is less dignified than others.

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JaneGilletteRogers

About JaneGilletteRogers

Jane Rogers is a hospice case manager with experience in gerontology and a Master's Degree in Bioethics. Certified in gerontology and hospice and palliative care.

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Specializes in hospice.

THANK YOU so much for writing this! It's everything I've been thinking and you expressed it so well.

:up:

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My dearest friend has been a hospice nurse for 20 years. This has been her response to the phrase "death with dignity" as well. Thank you for your article.

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Specializes in Gerontology, Med surg, Home Health.

Perhaps everyone has a different definition of dignity. If I have a disease that robs me of my ability to feed myself and maintain continence, to ME, that is not dignified. Everyone should be able to choose for themselves how they go.

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Great post. I often wonder if we adequately assess and treat for depression in those with terminal illnesses; suicidal ideation should be a red flag no matter what other co-morbidities exist.

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Specializes in Correctional, QA, Geriatrics.

I, too, believe that the definition of a death with dignity is determined by the patient. The person that inspired this article wasn't afraid of unbearable pain or being alone. She was experiencing uncontrollable seizures, had lost most of her ability to do the things she loved because of the complications from her cancer and, for her, the quality of life required that she maintain that one last shred of control: dying when she was ready and she was still able to make the decision instead of waiting for her higher functions to be totally gone.

Hospice is a wonderful thing but each death, like each life is unique. Not all of us wish to remain alive at all costs or unaware of our surroundings when our time to die comes.

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Specializes in Med Surg, Specialty.
If the only way to die with dignity is to take your own life, what does it mean if you don’t

So before we start to think that the only way to die with dignity is to end a life

Death with dignity simply means the patient has choices, including the choice on how/when to die from a terminal illness. It does not mean that people who are incontinent or immobile or choose not to die sooner or anything else are undignified.

edit: OP, who have you come across stating a person must end their life to be dignified? In the decade I've been on this board, I've never seen that view expressed here among nurses.

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Specializes in hospice.
It does not mean that people who are incontinent or immobile or choose not to die sooner or anything else are undignified.

Oh really? Someone should tell that to the numerous commentators out there applauding her decision as the right one because sticking around any longer would have been dumb, useless, burdensome to her family, expensive...... Yes I actually heard that on the radio yesterday and have heard similar sentiments repeatedly. We're careening toward the day when "assisted suicide" euthanasia will be presented as an obligation to the terminally ill and disabled. Look what that mother just did to her autistic daughter in England.

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Specializes in Med Surg, Specialty.

Your own self-dignity can not be determined by some random person on the radio trying to get ratings. A core tenant of nursing is to advocate for patient autonomy, even if their choice is not one you personally would make.

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Specializes in Med Surg, Specialty.
Look what that mother just did to her autistic daughter in England.

It would probably be good idea to start a new thread on that case. That case is about a mother who withdrew the feeding tube on a child (Nancy Fitzmaurice).

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We're careening toward the day when "assisted suicide" euthanasia will be presented as an obligation to the terminally ill and disabled.
Your vague fear of some imagined mandatory death decree does not negate an individual's right to determine their own fate on their own terms. I think your argument is appalling. If you don't care for assisted suicide, a term that you encased in quotation marks in order to marginalize its meaning, don't have one. Wait for the sky to open up and take you when "higher powers" determine you're ready. Not to be rude, but I really just don't care what you do. Please show the same courtesy due me.
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As a hospice nurse, I too was concerned about the definition of "death with dignity" and made mention of this case in another thread. So, I tread lightly here.

However, our goal for all hospice patients is death with dignity. Peaceful and pain free. The term "death with dignity" is being ascribed to assisted suicide because you don't have to live with incontinence, seizures, pain, etc.

That irks many of us who work in palliative and hospice care.

Just to be clear, I'm not getting into whether I believe in euthanasia . . just agreeing with the OP that the term "death with dignity" negates natural death as something awful to be avoided.

No one wants to die. Death is a terrible thing. But we've made it seem unnatural in the last 50 years or so. People used to die at home surrounded by family. Now it is unfortunately death in the ICU attached to vents and lots of IV drugs and chest compressions breaking ribs. Of course people like us, medical folks, see that and are appalled.

Hospice has a long way to go in educating folks about what we actually do. I had a family member ask me why we should put our mom on hospice. "Don't you guys just go in and kill them with morphine?".

Uh, no.

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