Washington state to allow `dignity' deaths - page 5

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  1. by   Spidey's mom
    Quote from earle58
    this is one reason why the law requires the professional input from 2 physicians.
    to assure the life limit of the pt.

    leslie
    Two doctors are responsible for admitting hospice patients. The patient's own physician and the hospice doc. Of course sometimes the hospice doc IS the patient's own doc.

    Two docs cannot guarantee anything. Neither can a nurse.

    steph
  2. by   leslie :-D
    Quote from Spidey's mom
    Two doctors are responsible for admitting hospice patients. The patient's own physician and the hospice doc. Of course sometimes the hospice doc IS the patient's own doc.

    Two docs cannot guarantee anything. Neither can a nurse.

    steph
    under the "death with dignity" laws in washington and oregon, 2 doctors must agree that pt has less than 6 months to live:
    the attending physician and a consulting physician.
    pt does not have to be in hospice.
    we're not talking about end stage alzheimers, where there's gray areas.
    doctors would be hard pressed to give such a definitive prognosis, knowing this person was intending to take their life.
    so any doctor who says less than 6 months, they are saying so with certainty.

    leslie
  3. by   Spidey's mom
    Quote from earle58
    under the "death with dignity" laws in washington and oregon, 2 doctors must agree that pt has less than 6 months to live:
    the attending physician and a consulting physician.
    pt does not have to be in hospice.
    we're not talking about end stage alzheimers, where there's gray areas.
    doctors would be hard pressed to give such a definitive prognosis, knowing this person was intending to take their life.
    so any doctor who says less than 6 months, they are saying so with certainty.

    leslie
    I didn't mean to make it sound like I meant the patient has to be in hospice. I only mention hospice since that is my experience. In order to be admitted to hospice, you have to have docs say you have 6 months or less. Same criteria as Oregon for euthanasia.

    We don't have end-stage Alzheimers patients. Our hospital has an Alzheimer's unit where these patients are admitted. Usually not a hospice patient.

    Ours are lung cancer (a lot of lung cancer patients), ovarian cancer, ischemic bowel, post-stroke/rheumatoid arthritis. The last two were recently discharged - when they came onto hospice, they were both near death. But the bleeding in the bowel stopped and he regained his strength and started taking walks and eating well. The post-stroke had to be resuscitated - sent home with the expectation she would die soon. She is doing really well. Of course we've lost two lung cancer patients - one still here and we admitted another today. I read in my research today that our county has a very high rate of lung cancer.

    steph
  4. by   leslie :-D
    Quote from Spidey's mom
    I didn't mean to make it sound like I meant the patient has to be in hospice. I only mention hospice since that is my experience. In order to be admitted to hospice, you have to have docs say you have 6 months or less. Same criteria as Oregon for euthanasia.

    steph
    it's not the same criteria in oregon as it is for your hospice.

    a "consulting physician" is a doc who is qualified by specialty and/or experience, in making a professional diagnosis and prognosis re pt's disease.
    the approval process is long and drawn out.

    just because someone is in hospice, does not automatically qualify them for death w/dignity.
    when a pt outlives the 6 month cutoff, they are either discharged or recertified.
    no biggie.
    but the implications are HUGE in approving one for dignity deaths.

    you really need to read this statute to see all it entails.

    leslie
  5. by   Spidey's mom
    Quote from earle58
    it's not the same criteria in oregon as it is for your hospice.

    a "consulting physician" is a doc who is qualified by specialty and/or experience, in making a professional diagnosis and prognosis re pt's disease.
    the approval process is long and drawn out.

    just because someone is in hospice, does not automatically qualify them for death w/dignity.
    when a pt outlives the 6 month cutoff, they are either discharged or recertified.
    no biggie.
    but the implications are HUGE in approving one for dignity deaths.

    you really need to read this statute to see all it entails.

    leslie

    You don't think the patient's own physician, who has been following them throughout the disease process, is qualified to make a professional diagnosis? Or that a trained hospice doc is qualified?

    I am not saying hospice and euthanasia regs are the exact same.

    I'm just saying . ... we need to be careful because in my experience as a hospice nurse, the doc is not a fortune teller. He cannot say, for certain, that a person has less than 6 months to live. It is an educated guess even in the best of circumstances.

    steph
  6. by   leslie :-D
    Quote from spidey's mom
    you don't think the patient's own physician, who has been following them throughout the disease process, is qualified to make a professional diagnosis? or that a trained hospice doc is qualified?

    again, i have no idea what you're talking about.
    all i said is that the "death with dignity" law requires the pt's attending, followed by a consulting physician to confirm the attending's findings.
    if the pt's pcp is the attending, then yes, s/he would qualify.
    i did not set forth the criteria for the consulting physician.
    but if a hospice doc specializes in the disease, or has x amt of experience w/the disease, then yes, s/he would be qualified.
    but just by virtue of being a hospice doc?
    no, that would not qualify him to be a consulting physician.


    i am not saying hospice and euthanasia regs are the exact same.

    i'm just saying . ... we need to be careful because in my experience as a hospice nurse, the doc is not a fortune teller. he cannot say, for certain, that a person has less than 6 months to live. it is an educated guess even in the best of circumstances.

    steph
    yes.
    we need to be careful.
    and that is why a "consulting physician" is a mandate.

    honestly steph, you would gain much insight by reading the law.
    if you did so, i'm thinking you'd have a clearer handle on what it encompasses.

    leslie
  7. by   arelle68
    Quote from earle58
    this is one reason why the law requires the professional input from 2 physicians.
    to assure the life limit of the pt.

    leslie
    Quote from earle58
    under the "death with dignity" laws in washington and oregon, 2 doctors must agree that pt has less than 6 months to live:
    the attending physician and a consulting physician.
    pt does not have to be in hospice.
    we're not talking about end stage alzheimers, where there's gray areas.
    doctors would be hard pressed to give such a definitive prognosis, knowing this person was intending to take their life.
    so any doctor who says less than 6 months, they are saying so with certainty.

    leslie
    What we are saying is that doctors cannot tell the future, and are therefore NOT qualified to predict ANYTHING with "certainty".
  8. by   Spidey's mom
    Quote from earle58

    again, i have no idea what you're talking about.
    all i said is that the "death with dignity" law requires the pt's attending, followed by a consulting physician to confirm the attending's findings.
    if the pt's pcp is the attending, then yes, s/he would qualify.
    i did not set forth the criteria for the consulting physician.
    but if a hospice doc specializes in the disease, or has x amt of experience w/the disease, then yes, s/he would be qualified.
    but just by virtue of being a hospice doc?
    no, that would not qualify him to be a consulting physician.


    honestly steph, you would gain much insight by reading the law.
    if you did so, i'm thinking you'd have a clearer handle on what it encompasses.

    leslie
    leslie - the entire point is not to argue hospice vs the oregon "death with dignity" act. i think you are making this harder than it needs to be.

    you made a simple point about 6 months to live. i made a simple point that even in hospice, no one can tell for sure if a patient truly has 6 months to live.

    doctors can and are wrong.

    that is all.

    as to reading the act . . i have. it simply says:

    http://oregon.gov/dhs/ph/pas/ors.shtml

    127.805 s.2.01. who may initiate a written request for medication. (1) an adult who is capable, is a resident of oregon, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease . . . "

    (2) "attending physician" means the physician who has primary responsibility for the care of the patient and treatment of the patient's terminal disease.

    (4) "consulting physician" means a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding the patient's disease.



    i have patients who have an "attending physician" and a "consulting physician" . . . the cancer specialist, the family doc, the hospice doc.

    and sometimes they are wrong.

    and that is why we need to be careful.

    steph
  9. by   rkitty198
    My beautiful mother just died a week ago yesterday. She was not given an infinite timline, but that it would be "soon."
    She wanted the option and verbalized this with my sister; she wanted death with dignity, she lived in Oregon. Shortly after she was placed on hospice.

    I was against the death with digninty act, as it went against MY beliefs.

    After seeing the 17 agonizing hours of pain (despite Morphine), spraying foamy froth from her nose & mouth, the hours of endless seizures and the grimacing look she had on her face; my opinion of the death with dignity act changed.

    My sisters 20 and 26 had to see our mother like this and it broke my heart. I have been a nurse for a 2.5 years now and have seen and helped many patients transition from the physical to the spiritual and still had not seen anyone suffer like my mother, even with my relationship to her aside.

    I am very able to place myself in others shoes and I cannot imagine taking the rights away of someone just because of MY beliefs.

    I probably would not have wanted her to do it, until after I saw how miserable she was and how my sisters and I have been traumatized by the way she died. (I would not ever say that I would want her to end her life because of how my sisters and I would have to suffer) because if she wanted to die in whichever way, we would support her. The hospice team was amazing, caring and just the most loving people I have ever met and tried as best they could to prevent her suffering.
    However, who am I to take the rights away from someone. Her death went in a rather fast manner and her wishes were not legalized on paper, which is why hospice was the choice for her.

    My uncle chose the death with dignity after years of battling rectal ca. He had the family with him, he was at peace and went in that manner.

    The lines of this issue are blurred and I dont think that any rationale would justify one opinion over the other. However, I do think that we are patient advocates with our own belief systems and should be given the choice to participate or not. The lines become more blurred when the issue arises to whom is allowed this right. I have not read the legalities yet, but I dont think it would be right to allow someone to pursue this option if they are mentally incapacitated.

    Again & again because of my religious beliefs I cannot justify this, yet because of my religious beliefs I cannot judge this either.

    I just wanted to share my story with you all.
    Last edit by rkitty198 on Mar 7, '09 : Reason: Add rationale.
  10. by   leslie :-D
    i'm really sorry about your mom, rkitty.
    thankfully, she went quickly and is free from all suffering now.

    as a nurse, it is imperative to remember it should always be about the pt and their beliefs.
    not everyone gets that.

    please take the time you need to strengthen and heal yourself.
    mom's ok now.:icon_hug:

    leslie
  11. by   Spidey's mom
    Quote from rkitty198
    My beautiful mother just died a week ago yesterday. She was not given an infinite timline, but that it would be "soon."
    She wanted the option and verbalized this with my sister; she wanted death with dignity, she lived in Oregon. Shortly after she was placed on hospice.

    I was against the death with digninty act, as it went against MY beliefs.

    After seeing the 17 agonizing hours of pain (despite Morphine), spraying foamy froth from her nose & mouth, the hours of endless seizures and the grimacing look she had on her face; my opinion of the death with dignity act changed.

    My sisters 20 and 26 had to see our mother like this and it broke my heart. I have been a nurse for a 2.5 years now and have seen and helped many patients transition from the physical to the spiritual and still had not seen anyone suffer like my mother, even with my relationship to her aside.

    I am very able to place myself in others shoes and I cannot imagine taking the rights away of someone just because of MY beliefs.

    I probably would not have wanted her to do it, until after I saw how miserable she was and how my sisters and I have been traumatized by the way she died. (I would not ever say that I would want her to end her life because of how my sisters and I would have to suffer) because if she wanted to die in whichever way, we would support her. The hospice team was amazing, caring and just the most loving people I have ever met and tried as best they could to prevent her suffering.
    However, who am I to take the rights away from someone. Her death went in a rather fast manner and her wishes were not legalized on paper, which is why hospice was the choice for her.

    My uncle chose the death with dignity after years of battling rectal ca. He had the family with him, he was at peace and went in that manner.

    The lines of this issue are blurred and I dont think that any rationale would justify one opinion over the other. However, I do think that we are patient advocates with our own belief systems and should be given the choice to participate or not. The lines become more blurred when the issue arises to whom is allowed this right. I have not read the legalities yet, but I dont think it would be right to allow someone to pursue this option if they are mentally incapacitated.

    Again & again because of my religious beliefs I cannot justify this, yet because of my religious beliefs I cannot judge this either.

    I just wanted to share my story with you all.

    Thank you very much for sharing your story.

    :icon_hug:



    steph
  12. by   arelle68
    I'm so sorry about your mom, rkitty. I'll be praying for you and your family.

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