Assisted Suicide

[snoopy29]

The BBC ran a thought provoking programme on assisted suicide last night. It centred on the mother of a 31year old daughter who was chronically sick with ME. The mother helped her daughter take an opiate overdose and she died. After she died the mother was charged with assisting her murder. In the UK the current position is that it is not illegal to attempt to or to take your own life but it is illegal to assist someone. There are lots of grey areas and a number of UK citizens have travelled to a clinic in Switzerland called Dignitas in order to end their lives.

The Mother's case raised concern because although her daughter was chronically sick she did not have a terminal illness. She did go to trial and was found not guilty. The daughter had made it expressly clear that she wanted to die.

The goverment has now drawn up a set of guidelines which give the CPS more flexibility in whether they charge a relative or not. It takes into account patient wishes, type and outcome of illness, and whether anyone will financially gain by there death.

For me the whole area is an ethical nightmare. As nurses our registration says that we do everything in our power to treat and maintain life but we also have a duty to ensure dignity at death.

Without SAFE guidelines there are so many grey areas one: man with motor neurone disease said that currently he will have no choice but to end his life earlier than he would like because he will need to make that decision whilst he still has use of his hands in order to not involve his family.

Anyway my interest is what happens in other countries and also what are the thoughts of other nurses on this matter. I can honestly say I don't know what to think - on the one hand I think life is precious and we should do everything to preserve it but on the other if it was my terminally ill relative in pain and suffering I might feel differently.

Really interested in thoughts views and experiences. :)

[Da_Milk_of_Amnesia, MSN]

That is not a fact... that is your value judgment.

While you are totally correct in what your pointing out, don't misunderstand me I was stating arguments against it. I am totally pro-PAS. I was just stating 2 of the many arguments against it and then providing why the 'slippery slope' argument holds no water.

[tewdles, RN]

Originally Posted by EMTRN6785

Along with the fact that killing another human,

even assisting

is wrong.

"That is not a fact... that is your value judgment. "

In many states, Michigan for one, assisting in the suicide of a patient is wrong in the eyes of the law...not only a value judgment. This was clearly demonstrated in the conviction and imprisonment of Jack Kevorkian.

[Up2nogood RN, RN]

bubbly,

there is no one that assists the person per se. The person requesting PAS (physician assisted suicide) is merely given the means to do so. The patient themselves must administer the fatal dose of medication in order to go thru with it. The only true assistance that the person gets is in getting the medication that is it. The act is up to them. There is a study that was conducted out in oregon and it had statistic on people who sought out PAS, those who got the perscriptions and those who actually did the deed.

"Between 1997 and 2001, there have been 141 lethal prescriptions written in Oregon. Of the 141 written, only 91 patients have filled these prescriptions to end their lives. This is hardly enough evidence to prove the presence of a 'slippery slope' "

My neighbor chose death with dignity and administered himself. His family was not even aware until after the fact as they weren't close and he didn't want them to intervene. I don't think that I as a health care provider have any right to persuade a patient to live in horrible pain and suffer just because their family is selfish and does not want them to go. Even with the modern drugs people still die in pain. Not to say that all do but I've seen my share of patients lingering for years on CADD pumps with PCA's and orals on top of that still in debilitating pain and unable to even move.

Not saying I would assist with anything like this but if the patient meets criteria they should have the option available to them.

[Pepper The Cat, BSN, RN]

The poster who commented that our culture is afraid of death was correct.

We give our pets a better death than we do our loved ones.

Have you ever seen a dog on a vent? Or a feeding tube in a cat? Of course not. Let's say my cat stops eating. If I were to take him to the vet and have a feeding tube put in, I'd be called cruelby practically everyone. Let's say my Mother stops eating and I have a feeding tube put in - will people still call me cruel? Some might but others won't.

[Music in My Heart]

While you are totally correct in what your pointing out, don't misunderstand me I was stating arguments against it. I am totally pro-PAS. I was just stating 2 of the many arguments against it and then providing why the 'slippery slope' argument holds no water.

I did understand your point after reading your posts... I'm just a stickler for language and the phrase "the fact is" is one which is greatly misused and abused.

[Music in My Heart]

Originally Posted by EMTRN6785

Along with the fact that killing another human,

even assisting

is wrong.

"That is not a fact... that is your value judgment. "

In many states, Michigan for one, assisting in the suicide of a patient is wrong in the eyes of the law...not only a value judgment. This was clearly demonstrated in the conviction and imprisonment of Jack Kevorkian.

I don't equate "wrong" with "illegal." The former is (IMO) a moral judgment; the latter is legal.

Not all things that are morally wrong are illegal; neither are all things that are illegal morally wrong.

[Music in My Heart]

The sad thing about the present system is that it forces people to step out of the game earlier than they might need to simply in order to preserve their right to self-determination.

[CeilingCat, ASN, RN]

Originally Posted by EMTRN6785

Along with the fact that killing another human,

even assisting

is wrong.

"That is not a fact... that is your value judgment. "

In many states, Michigan for one, assisting in the suicide of a patient is wrong in the eyes of the law...not only a value judgment. This was clearly demonstrated in the conviction and imprisonment of Jack Kevorkian.

It was made illegal because some people had that value judgement first. It can be just as easily made legal.

[proudnurseRN]

Raise your hand if you want to be kept alive, even though multiple doctors have said you are terminal, you can't move, you can't speak, you may or may not know who your relatives are, you're crapping yourself continuously and you hurt all the time.

Anyone?

I know there are exceptions and some people do want to be kept alive no matter what the measures, but the fact is that most people do not want to live like that. I'd go as far to say the vast majority.

So, it's always seemed odd to me that we (as in the medical profession) seems to do the exact opposite of what most people would want. I understand it's because of lawsuits, but if we could bring back grandma for 3 minutes and ask her if letting her go was what she wanted... 99% of the time the answer would be yes.

[leslie :-D]

Raise your hand if you want to be kept alive, even though multiple doctors have said you are terminal, you can't move, you can't speak, you may or may not know who your relatives are, you're crapping yourself continuously and you hurt all the time.

Anyone?

I know there are exceptions and some people do want to be kept alive no matter what the measures, but the fact is that most people do not want to live like that. I'd go as far to say the vast majority.

So, it's always seemed odd to me that we (as in the medical profession) seems to do the exact opposite of what most people would want. I understand it's because of lawsuits, but if we could bring back grandma for 3 minutes and ask her if letting her go was what she wanted... 99% of the time the answer would be yes.

i would have to say, it's also because of families who can't/won't let go.

often, it is also poa's who KNOW the patient's wishes, but disregard them because of guilt or an inability to be THE one who authorizes dc'ing txs.

and yes, there are too many doctors who fear lawsuits...

as well as those who refuse to believe they are not God, and will continue working on these near-dead pts, regardless of futility, cost, and suffering.

the bottom line is it should be the pt's right to choose how they die, but because of ubiquitous anxiety and fears, it is often the pt whose wishes are tragically ignored and dishonored.

when will folks realize that dying isn't about them, but about that of the pt??

a novel concept gone awry.

leslie

[Zookeeper3]

Just recently we trached and pegged a 101 year old. The primary doc had to surgeon shop because so many had refused to trach and peg this person.

At some point it has to ok to tell family, there is nothing more we can do and NO, we are not prolonging their death!

In a society that allows family to trach and peg an 101 year old out of fear of civil suits... and allows the POA, or health care POA to oppose the patient wishes..... how can we even begin to be a patient advocate again and assist in their death? Ahhh to have our priorities straight:devil:

[tewdles, RN]

Just recently we trached and pegged a 101 year old. The primary doc had to surgeon shop because so many had refused to trach and peg this person.

At some point it has to ok to tell family, there is nothing more we can do and NO, we are not prolonging their death!

In a society that allows family to trach and peg an 101 year old out of fear of civil suits... and allows the POA, or health care POA to oppose the patient wishes..... how can we even begin to be a patient advocate again and assist in their death? Ahhh to have our priorities straight:devil:

Actually, there is more that they can do...they just need to stop shopping false hope for immortality and cure of currently incurable disease. The odds are that the 101 yearl old will never fully recover from that surgery. Odds are that the quality of life will be gone in the post operative spectacle of care. Odds are that the 101 year old will suffer through pain and loss of dignity until they die, without the assistance of a palliative or hospice team to ease their burden. Odds are that the family will not have a sense of peace about the death of their elder. So sad...

and yes, evidence that we are no where near ready (in general) in health care today to practice assisted suicide on a national level. Heck, we can't even accept the inevitability of death to the point that we don't torture the very elderly on a regular basis. But we are eager to help people kill themselves when maybe they could be happier with a medical plan of care which focuses on comfort and quality of life?