Those hospice nurses living in states where assisted suicide is illegal, how do your hospices handle patient and family admitting to assisted suicide plans with the means to do so?
Leaving OUT your own personal belief system, what are the legal ramifications for hospice knowing ahead of time and therefore becoming complicit in the act? If the legal system charges the spouse, can we be held liable? Are we not mandated reporters in this situation? Or do we handle it within the system of the ID team?
How do your hospices manage this patient?
I found the following from Oregon where assisted suicide is legal.
I hope the actual reason is more fundamental, that hospice workers in Oregon understand that facilitating assisted suicide is directly contrary to the hospice philosophy. Indeed, rather than facilitating doctor-prescribed death, hospice professionals are supposed to prevent the suicides of their patients by intervening to provide services or treatments the patient might be lacking, so that they no longer want to die immediately.I can personally attest to how seriously this obligation is taken by hospice administrators. I was trained as a hospice volunteer, and I was told in no uncertain terms that if I even suspected that a patient was suicidal, I was to immediately inform the multidisciplinary team so they could provide preventive mental health and other services—just as medicine would for any other suicidal person.This raises an important question: Why does hospice philosophy oppose assisted suicide? According to the late Dame Cecily Saunders—the creator of the modern hospice concept and one of the great medical humanitarians of the 20th Century—doctor-prescribed suicide denies the equal dignity of hospice patients. As she wrote in the 2002 book, The Case Against Assisted Suicide (chapter, “The Hospice Perspective”), hospice asserts on behalf of the dying patient his or her “common humanity and personal importance” to the moment of natural death.The great American hospice physician, Ira Byock, is similarly opposed to assisted suicide, writing in the Journal of Palliative Care, “The hospice focus is on life and the alleviation of suffering,” whereas “the goal of assisted suicide and euthanasia is death.” Moreover, if a hospice cooperated in doctor-prescribed death, it would abandon that patient to his or her worst fears—that they will die in agony, that they are a burden, that their lives truly are no longer worth living.Thus, when assisted suicide facilitators in Oregon brag that they have assisted the suicides of hospice patients, they are actually admitting that they interfered with the proper medical care of these patients. Indeed, boasting of helping hospice patients kill themselves is akin to patting themselves on the back for helping the patient die after denying them proper pain control—another crucial hospice medical service.This is the bottom line: Hemlock (if you will) and Hospice cannot occupy the same philosophical space. That is why I am very pleased that Oregon hospices are generally keeping assisted suicide at arm’s length. Legal or not, doctor-prescribed death has no place in proper end-of-life care.CBC Special consultant Wesley J. Smith is also a senior fellow in The Discovery Institute’s Center on Human Exceptionalism and a lawyer for the International Task Force on Euthanasia and Assisted Suicide.
Quote from SuesquatchRN
My beliefs about assisted suicide have become more nuanced since joining hospice. I now believe that the desire to die is the result of symptoms not being managed - most notably intractable NV and pain. Also, though, the only person who raised the issue with me had ample meds on hand had it been a real wish. I took it, instead, as a plea to get her comfortable.
I have never lived in a state in which as was legal so have no idea about how I would broach it then. But I would be uncomfortable, and would, as I did with the aforementioned patient, strike a bargain to give us x time to get the symptoms controlled and then we could discuss it again.
Thanks. I added the link about Oregon because I thought it interesting that even in a state where it is legal
, hospice should not be involved.
I agree that symptoms are not being managed - but those symptoms can be more than physical pain, nausea, vomiting. It can be emotional. Fear of the way they might die. Like suffocation.
That fear, in my opinion, needs to be managed as well.
My biggest question is, having knowledge ahead of time, are we liable?
Last edit by Spidey's mom on Dec 10, '11