The Right to Die with Dignity- MD assisted suicide

[SL2014]

With the recent ruling in New Mexico to allow physician assisted suicide for the mentally competent terminally ill, it made me wonder current views on physician assisted suicide. I found a topic on this from 2007, but a lot changes in 7 years.

I personally believe that every person has the fundamental right to choose if they want to die. As a nurse I would refuse to administer the medication but that is because I don't want to be responsible. As a future NP I would also refuse to prescribe it (for one because I think that's way out of an NP's scope) because I would not want the moral liability.

As far as suicide being a sin: What is a "sin" is determined by each individual person, and is between them and G-d. No one should be forced to suffer.

I wish there was a way to make it available to the incompetent also, patients who are in a persistent vegetative state or severely debilitated... I think PAS is much more humane than pulling someone's G-Tube and letting them starve to death... But that's just me.

What do you think?

[srercg]

1 in 3 is high - but you have to remember that most hospitals report miscarriages and stillbirths and elective abortions - they all fall under the heading of "abortion" prior to 21 weeks - so if a woman miscarries in her 14th week - its an abortion. if a pregnancy ends in stillbirth in week 17 - its an abortion when it is reported to state and fed. Extremists don't care where the numbers come from - they just report the number of abortions.

That being said - dying with dignity I 100% agree with. I have told my kids that if I ever have a stroke or something that leaves me as a person that has to be fed, bathed, clothed, without ability to communicate - I'm just strapped into a chair for 10 hours a day and then put back in bed - let me die in peace. I would want the option to end it or someone to make that choice for me. LTC facilities like the income from it -but that in my opinion is just wrong at that point. Better not do it to me. My mother was like that too.

Euthanasia - I think every situation is different. IF you are an individual who KNOWS their condition is irreversible, won't get any better, WILL get worse, and will put a strain on your family for weeks, months - I think they should be able to make that choice. If my husband, and children are going to have to go through prolonged agony of watching me get worse, watching me have episodes, and the kids miss out on normal lives because of "mom" - etc etc. . I think its better to get it over quickly - and let them make their adjustments, and move on. They're going to cry - they're going to be sad - but let them do it, and be done - not drag it all out.

And - looking at this I may have euthanasia and dying with dignity reversed there - but same applies

Now, if we are talking about a healthy individual who just wants to commit suicide - of course not. No way. Get them counseling.

And, then there's the in between - the person who COULD have a 20% chance of beating something - the COULD live - but they've been through 4-7 years of fighting, and it comes back, and they fight and it comes back - THAT is the tough call. BUT I ultimately think THE PATIENT should be able to choose.

[srercg]

Also, if you have ever worked in LTC - even those who can get around, and communicate - I would very often hear from a resident that they wished the could just die and get it over with, or end it. It was a nice facility, great care - they were just frustrated with their never-ending ailments, and having to take all the pills, and getting up and every day is the same - they stop wanting to participate in activities (some never want to) - and of course our response is to give them "mood enhancers" and counseling etc. BUT, that doesn't really answer THEIR needs. Some are very aware that they are no longer LIVING their life - they are simply getting up each day and going through the motions - and watching tv all day - they don't want to keep doing it. I don't blame them. We try as care givers to get them to see what possibilities that DO have - take them to functions, outings , get entertainment in the door to break up their day - do their nails, and such - but they KNOW - its not the same. They don't want to have to keep doing that anymore. I wouldn't want to either - to me it would be wasting soooooo much money. And quite frankly - with more and more people living to the point where they need facility care - it is going to be draining the health care system - medicare, Medicaid - for all those people - I mean - hate to say it - because that is money facilities need -but if you're thinking about the PATIENTS - its not always the right thing to do.

I really think that one day we will evolve to the point where there will be an "age" or "opt out" option for people once they reach a certain age, and they will be able to schedule their own deaths. They'll be able to face it, make peace with it- include their families in the planning - save a lot of money -(for their family) and get to do it on their OWN terms.

I think the biggest adversary of that happening will be those who lobby against it - mainly LTC organizations.

[db2xs]

I work with a young nurse who supports AS. Then they pushed the dose of Morphine they thought ended the life of their DNR pts life. The anguish on that nurse's face was painful to see. Apparently there is a difference between theory and reality.

Believing in something is different than being allowed to do it. I believe in physician-assisted suicide, but if someone were to accuse me of killing a patient, then of course I'd be freaked out. Our licenses are constantly hanging on a limb and our managers are not shy to remind us.

If this young nurse took an ELNEC course, then she would have better understanding of the morphine situation and not have been as freaked out. If you know this young woman, please recommend the course to her, thank you.

[TNnursejane, BSN, RN]

My father committed suicide at 87 y/o. In doing the typical nurse thing of researching my dad's history, I decided that if a person really wants to take their own life, they will. They don't need anyone's permission either. There were no cues that my dad was suicidal. He was always a big joker so things that he said after my mom's death 2 years prior to his death, he laughed about. Even the psychiatrist in the rehab facility he was a resident of didn't pick up on his intentions.

Now saying all of that, I feel like what my dad did was a very selfish act but he went out the way he wanted to. I believe in heaven and hell and believe that I'll see my dad in heaven one day. PAS is just another way of committing suicide with permission from whomever. It's a much more controlled setting. That's all.

[Nurse SMS, MSN, RN]

Controlled and with less suffering. We put our pets to sleep humanely but force relatives to suffer on and on in spite of their own desires and in spite of what is ethical at times.

I am am a very big proponent of PAS. To me it goes hand in hand with being a patient advocate and nursing according to the patient's will, not my own. Whether or not I would choose the same is not the point. I have no business legislating my morals onto others. It is the freedom to choose for themselves that matters.

[beachynurse, ASN, BSN]

On 1/16/2014 at 7:51 AM, subee said:

HBO did a documentary "How to Die in Oregon." Maybe it's still around. Highly recommend .

I watched it and thought it was extremely well done. I am an advocate of the right to die, and feel that we have the freedom to choose how we live, why can't we have the freedom to choose how we die? I believe that as health care providers, we not only want to help others back to health, we also want to relieve people's suffering as well. While I may not be comfortable taking part in the actual act, I see no reason why the patient can't do what needs to be done as in the documentary. Just remember, we are all different, and have different beliefs and values, it's ok to disagree.

[Persephone Paige, ADN]

On 1/15/2014 at 10:07 PM, SL2014 said:

Wow... That is not the response I would have given. I assume you have never seen a failed suicide attempt in the ICU before? I have seen many and they are very, very ugly. I'd say ONE person out of the 20-25 I've seen turned out okay (as in still functional). Every other one either died after being mechanically supported for weeks (prolonging their suffering and the suffering of their family) or ended up with SEVERE brain damage or disabilities. I'd especially never tell someone "just take all of your pills"... It's very common for that type of attempted suicide to fail... I've also seen failed self inflicted gun shot wounds and hangings fail, so awful.... So incredibly awful. An effective alternative should be available to those who wish to die... Definitely for the terminally ill.

This has been my experience as well. Horrible.... especially if they have family who are caring, yet in denial. These poor people linger, for so long. And one 'blink' in answer to a question and it's pull out all the stops, again. Don't get me wrong, I've seen plenty of evidence that a patient may well still be 'in there,' but they will never be the same. Families will ask, 'what would you do?' I don't ever weigh in, I just say 'what would they want?' Which is obvious, they tried to kill themselves. But, I'm powerless.

I am a little on the fence about involving someone else. In that case, why not make solid dependable information available and let patient self - administer? It's a little unfair to say you are against suicide while asking another to do it for you, I think. At least with guidance they know they won't wake up gorked out from it. As to the vegetative state, I still think turning off the feeding tube is the only way to avoid being accused of homicide.

This debate is disconcerting for me. But, I believe it needs to be better everywhere, for everyone.

[Here.I.Stand, BSN, RN]

I’m all for autonomy — so long as the physician has the autonomy to refuse said assistance.

I’m also all for opting for comfort care.

But euthanizing someone who isn’t able to make the decision is NOT physician assisted SUIcide. “Sui” being the reflexive pronoun, genetive case meaning “of oneself.”

[NRSKarenRN, BSN, RN]

Bill requires second oppion re diagnosis

CNN March 25, 2019

New Jersey is about to legalize medically assisted suicide for the terminally ill

Quote

Terminally ill adults in New Jersey will soon be able to ask for medical help to end their lives.

Gov. Phil Murphy said he plans to sign a bill legalizing assisted suicide which passed the state legislature on Monday. The bill allows adults with a prognosis of six months or less to live to get a prescription for life-ending medication.

[subee, MSN, CRNA]

On 3/8/2019 at 2:23 PM, Here.I.Stand said:

I’m all for autonomy — so long as the physician has the autonomy to refuse said assistance.

I’m also all for opting for comfort care.

But euthanizing someone who isn’t able to make the decision is NOT physician assisted SUIcide. “Sui” being the reflexive pronoun, genetive case meaning “of oneself.”

Who is euthanizing patients who aren't capable of self-determination?

Where is this happening? Assisted suicide requires a lot of hoops for the patient to jump through and no physician is forced to participate.

[offlabel]

Allowable for all terminally ill and vegetative (decision can be made by family or patient if the patient is competent).

This is the reason why institutionalized suicide is a horrible idea, because the definitions get fudged and morph into something else. Someone in a "vegetative" state by definition cannot participate in so called PAS. That persons death would come about by direct euthanasia which is in an entirely different category but which has been allowed to be considered in the same way because of the natural progression of the concept.

This progression will not stop here as the Netherlands is a prime example of PAS under the guise of compassion progressing to involuntary euthanasia. This paper in a medical oncology journal was written 8 years ago and the problems have only progressed since then.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070710/

Institutionalizing the intentional ending of human life by the medical/nursing establishment is a fearful development in our history.

[offlabel]

38 minutes ago, subee said:

Where is this happening? Assisted suicide requires a lot of hoops for the patient to jump through and no physician is forced to participate.

Not yet. It's only a matter of time. Once allowable objections to participation in termination of pregnancies are now considered invalid in many western countries and even residency programs in the United States.