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. :)

[Silverdragon102, BSN]

Interesting and thought provocative subject and one both my husband and myself have discussed several times and each time we both have said the same and that has been let it be a decision that is suitable to the situation. If we are able to make the decision we will respect the decision and if not able to make the decision but the other one can, if the outcome is poor leading to poor quality of life then let it be peaceful and painless release as long as everything had been discussed medically and future outcomes looked at properly. There is no way I want to stay on this earth if I am going to be in a unconscious state for a long time etc.

[ShayRN]

There are some cultures in our country who believe that their loved ones must suffer to atone for their sins to get to heaven. Then there are others who are convinced that the .25ml of Morphine I gave their loved ones 3 hours ago is what killed them and I am the murderer. As for me? If I ever get diagnosed with ALS, I may move to Oregon. I consider that a fate worse than death.

[Zookeeper3]

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?

thank you for feeling my pain for my patients, you are wonderful.thank you, if only family loved them enough to let them go.....

[Zookeeper3]

interesting and thought provocative subject and one both my husband and myself have discussed several times and each time we both have said the same and that has been let it be a decision that is suitable to the situation. if we are able to make the decision we will respect the decision and if not able to make the decision but the other one can, if the outcome is poor leading to poor quality of life then let it be peaceful and painless release as long as everything had been discussed medically and future outcomes looked at properly. there is no way i want to stay on this earth if i am going to be in a unconscious state for a long time etc.

unfortunately, in the icu setting, the doctor will tell you or your husband, this may be temporary, and you love each other and don't want to let go, so you proceed with intubation, maybe pressers if needed. now someone is on life support and we can't continue like this, so get a trach and peg and all may go well in the next 30 days....

now, it's that simple, that's how it happens and your stuck with facing with draw of care and watch your loved one gasp for breath and finally die... or linger on.. trached and vented, against their wishes.... hoping that change will occur., you can see how hcpoa and poa trach and peg and vent... it's easier for the doc's to say.. you never know... than wondering if you'll sue , safer for them to do it all, and the patient suffers, terribly. the doc's give false hope, and you take it because you want to believe it. then it's too late.

better to have... "we've done all we can do, we've given it our all and we need to stop". that is a statement that needs to be said, so many times over and you'll all disagree with me but i say then, we can do nothing more but provide a comfortable death, please alaow us to give your loved one comfort to die......

there in itself is the difference of what is said and what we do, we torture, code and violate our patients for our family and it is inhumane to those we care for.

i don't disagree with what you've posted, but what you've posted never, ever plays out with what i've seen. as soon as you can't state your needs, you're trached, peged and long term death. sorrry to be so blunt, but this is what i do.

[ShayRN]

I have had family members tell me when they refused for their 90 year old loved ones to have a trach placed, the docs actually said "why are you trying to starve your mom?" What the heck is wrong with saying NO! My 90 year old loved one had a long and wonderful life. I love them and it is time to say goodbye now. I have also had this conversation with my husband, I am sure we all have that deal with horrible lives every day. He understands and agrees, but the qualifies it with, but if there is a CHANCE.... I tell him NO! Even if there is a chances, I will not be ME. I want to be ME. If I cannot, let me die, period.

[Silverdragon102, BSN]

unfortunately, in the icu setting, the doctor will tell you or your husband, this may be temporary, and you love each other and don't want to let go, so you proceed with intubation, maybe pressers if needed. now someone is on life support and we can't continue like this, so get a trach and peg and all may go well in the next 30 days....

now, it's that simple, that's how it happens and your stuck with facing with draw of care and watch your loved one gasp for breath and finally die... or linger on.. trached and vented, against their wishes.... hoping that change will occur., you can see how hcpoa and poa trach and peg and vent... it's easier for the doc's to say.. you never know... than wondering if you'll sue , safer for them to do it all, and the patient suffers, terribly. the doc's give false hope, and you take it because you want to believe it. then it's too late.

better to have... "we've done all we can do, we've given it our all and we need to stop". that is a statement that needs to be said, so many times over and you'll all disagree with me but i say then, we can do nothing more but provide a comfortable death, please alaow us to give your loved one comfort to die......

there in itself is the difference of what is said and what we do, we torture, code and violate our patients for our family and it is inhumane to those we care for.

i don't disagree with what you've posted, but what you've posted never, ever plays out with what i've seen. as soon as you can't state your needs, you're trached, peged and long term death. sorrry to be so blunt, but this is what i do.

i guess this is how things change in the different countries. in the uk i have seen families heavily involved and even doctors have said to the family enough is enough. i know each situation is different and if there is hope then i know either my husband or myself will make the appropriate call but i do think sometimes it is hard to make that call but that is when we should step in as nurses and make sure that enough relevant information is given to the family to make an informed consent.

sometimes i wonder if a society that is too quick to sue causes something like this because people are afraid to say something because the fear of sue is in the background (this is just a thought of mine and not intended to derail this thread)

[Music in My Heart]

unfortunately, in the icu setting, the doctor will tell you or your husband, this may be temporary, and you love each other and don't want to let go, so you proceed with intubation, maybe pressers if needed. now someone is on life support and we can't continue like this, so get a trach and peg and all may go well in the next 30 days....

now, it's that simple, that's how it happens and your stuck with facing with draw of care and watch your loved one gasp for breath and finally die... or linger on.. trached and vented, against their wishes.... hoping that change will occur., you can see how hcpoa and poa trach and peg and vent... it's easier for the doc's to say.. you never know... than wondering if you'll sue , safer for them to do it all, and the patient suffers, terribly. the doc's give false hope, and you take it because you want to believe it. then it's too late.

better to have... "we've done all we can do, we've given it our all and we need to stop". that is a statement that needs to be said, so many times over and you'll all disagree with me but i say then, we can do nothing more but provide a comfortable death, please alaow us to give your loved one comfort to die......

there in itself is the difference of what is said and what we do, we torture, code and violate our patients for our family and it is inhumane to those we care for.

i don't disagree with what you've posted, but what you've posted never, ever plays out with what i've seen. as soon as you can't state your needs, you're trached, peged and long term death. sorrry to be so blunt, but this is what i do.

i never hear anybody mention it but the reality is that the docs also get paid to continue to treat these patients... the billing stops once they die. it's hard for me to believe that that consideration is never part of their reluctance to address eol care vs. icu interventions.

[Up2nogood RN, RN]

I took care of a wonderful lady a few weeks ago who ultimately ended up with ESRF and said no to any further tx. Her family respected her wishes and she passed within a few days. I felt quite touched to have received a card from a family member thanking me for being so caring for her mother on her last night on earth. In a perfect world it would always be this simple.

Even though we have the Death With Dignity Act here it has hardly been utilized. I think it's just not an acceptable option along with all the hoops one has to jump through for many of our terminally ill. I'm glad though that the option is there.

[tewdles, RN]

I never hear anybody mention it but the reality is that the docs also get PAID to continue to treat these patients... the billing stops once they die. It's hard for me to believe that that consideration is never part of their reluctance to address EOL care vs. ICU interventions.

I soooo hope that this a tiny fraction of any medical practice. Of course there are bad apples in every cart, so...