Hospice and Assisted Suicide - page 2

by Spidey's mom Guide

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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,... Read More


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    In Florida, unless it's changed since 2002, if a patient on hospice (or not) is a DNR they have to have a separate DNR for EMS - one of my parents was on hospice in Florida - this is how I know this. We had the DNR but had an additional one that was specifically for EMS that we were told to post where it could easily been seen by everyone - we did that.
    The sad thing about the death/dying, besides the obvious loss of a person we love, is in this country we do not want to discuss such matters....people will get on tv and talk about their abuses, affairs, money, you name it, but ask about death/dying/wills almost 100% will say "That's morbid" or " I don't want to talk about it" - trust me, its a conversation worth having.
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    It is each person's individual right to choose their own death. Period end of story. As such, suicide being illegal is an absurdity. All states must enact assisted suicide programs...it is only human. (Remember...separation of church and state...as these absurd laws are based on religious mumbo jumbo) That being said, I applaud the work of hospice organizations...My father and grandfather both died with hospice care and their deaths were as "peaceful" as they could be. To prolong someone's misery, on the other hand, based on lack of paperwork or family bickering as is often the case is cruelty...plain and simple. It is therefore each individuals responsibility...as has been noted...to "get their affairs in order" so as not to be at the mercy of the state/institution/religious zealot etc...Suicide "plans" as many people have them are a must in a society that refuses to honor this most important personal decision. One more thing...to say people that are suffering and at the end of their life that want to end their lives need mental health counseling, is one of the most disgusting and selfish ideas put forth...
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    I agree with malamud69. I have never worked hospice, so I'm just going off my personal beliefs. If you are in hospice, it is because you are near the end of your journey already. I understand why some, depending on a bunch of reasons, may not want to lay in bed just waiting...and waiting to die. If a person is in such a situation and chooses to end their life, I think having a legal system in place to help them along gently is much kinder then them having to shoot themselves. I remember a story back years ago when an older lady was at a place where it was legal. They had her family all come and I think it was even a pizza party, and when she was ready, she pushed a button on her IV and went out of this life peacefully. I have no other details of that, so for all I know it could've been an urban legend (snopes?) but doesn't that sound much better to go out calmly and surrounded by smiling family? It is no ones choice but the dying one's- and if they want to go, we should let them
    malamud69 likes this.
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    I was surprised to see this thread active today - it's been awhile.

    Thanks for the comments. As a hospice nurse I have to fight common misconceptions about what we do all the time. People don't come to hospice so we can help them die but for us to help them live fully in the time they have left. We help take care of their pain so they can take their grandson to the fair one last time and ride the carousel. We help them be able to continue a hobby they loved. We help them reconcile with family members who have become estranged. We help them live. Fully. Until the end.

    Hospice is set up to admit patients way before they are at death's door although some docs just can't give up on trying to cure their patients and wait for a hospice consult until a few days before. Of course we take patients whenever but it helps them much more if they are given some time. All over the country there is education regarding when and how to use hospice so docs won't wait so long.

    My particular question in this thread was related to the fact that a family talked about assisted suicide to hospice team members in a state where that is illegal, what are our legal responsibilites as a hospice? We are under the gun with just regular regulations. If we knowingly allow someone to have their spouse kill them, we would be accomplices.

    I said initially, leaving aside your own personal feelings about whether assisted suicide should be legal, help me answer some questions.

    We could debate all day about making it legal. It wouldn't change the fact that it is not legal here. I'm not talking about taking your own life under your own power. I'm talking about someone else doing it for you and a medical person knowing ahead of time and not doing anything about it. Legally -that's a mess to get into.

    From my first post: "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".

    It isn't disgusting and selfish to deal with the mental health of someone considering ending their life. If we can help them by alleviating their pain, they might just get that last visit to the fair with their grandson. That patient was in so much pain that of course he didn't want to live. But we helped him. He was able to live for 18 more months - with a pain pump. He saw the birth of a granddaughter. He got a ride on his Harley. He went out into the woods with friends to get firewood. He was driven to the top of a mountain to see the view. He cooked dinner for his wife. He was there for his son when son got out of jail. By intervening with mental health help and with medication for pain, he got to live out his life. He sent me a card with a photo of he and his grandson on that carousel and thanked me for making that possible. I'm going to always try to alleviate pain and depression before I hand someone the means to kill themselves.

    As a post script to the original story - the patient changed her mind. She lived for 3 more months and was surrounded by family most of that time. She was grateful she got to stick around.
    tewdles and SuesquatchRN like this.
  5. 1
    Here's a really good article by an AN member about hospice:

    Article: Hospice Misunderstood and Underutilized - Geriatrics / Aging / Elderly
    tewdles likes this.


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