I just wanna share this story which makes me confused.
I'm on my third week working on RSL as an AIN.
We have this 70 yr old residence who has been diagnosed for having metastatic cancer that has spread from her left breast to her spinal column and ribs. She kept comfortable with medication and nursing care. She also has dementia that cause her to suffer a confused state of mind requiring the nursing staff to restrain her hands to prevent her hitting the staff.
She is very thin , bony and her skin over her coccyx began to break down from pressure of her bopdy against the mattress. We tried to coax her and turning every two hrs, but she cried out from pain so much that we wonder if we really helping her with this nursing intervension routine.
Her oral intake has fallen below life sustaining level. The doctor discusses artificially hydrating and feeding. Her family are divided on what to do and agonise between prolonging her life, maintaining comfort, and introducing extraneous intervention.
Do you have any idea of what ethical principles involved here, ethical dilemmas that the we as staff were facing, and what certain rights and responsibilities the clients has?
does the family has the right to choose what they want such as euthanasia or its only the doctor have the right to decide?
Lethal doses of barbiturates are usually what's prescribed (Seconal is one of the drugs). It is legal in Oregon, and the people there are supportive of it, but Bush is looking to make it illegal.
The newer drug used is Fentanyl patches. They are placed more frequently.
You do not see Seconal ordered too much anymore. It doens't help with the pain at the time either. It is strictly for sleep.
The state of Oregon has an assisted suicide law. I'm not sure what the exact details are, but I think that it allows physicians to prescribe lethal amounts of medications? Please, someone correct me if I'm wrong.
The Oregon law requires that the patient request the drugs and be able to take them orally without assistance. A patient such as described by the OP (dementia, etc) would not be eligible.
What a sad situation. I hope you are not equating a decision not to do artificial hydration and nutrition with euthanasia. In a case like this, as said before, this woman is dying a long slow painful death of CANCER. Artificial hydration and nutrition will only prolong it as well as adding lung congestion, possible pneumonia, and third spacing to her list of symptoms. She needs generous doses of pain control meds so that she can tolerate turning. Lying in one position is an agony of itself.
The newer drug used is Fentanyl patches. They are placed more frequently.
You do not see Seconal ordered too much anymore. It doens't help with the pain at the time either. It is strictly for sleep.
I think the poster meant that lethal doses of barbituates are what is commonly prescribed to provide assisted suicide. I don't think she intended to imply that Seconal provides pain relief.
It's so easy to misinterpret in this medium, and I don't mean to speak for fab4fan, but it's important not to get the wrong idea about this controversial issue.
Thanks for all the info on the Oregon Assisted Suicide law. I didn't know that the patient must be able to administer the dose by themselves. 2099847giok0x.khfsdd This issue is so charged and controversial. I agree with those who said that cancer is what will kill this woman, and pain control is the number one priority.
I agree with you, though the medication helps for a minute relief. Its really hard to see her in that situation. She forget almost about everything and when shes been attack by a severe pain all she ask is she wants rest.
suzanne4, RN
26,410 Posts
The newer drug used is Fentanyl patches. They are placed more frequently.
You do not see Seconal ordered too much anymore. It doens't help with the pain at the time either. It is strictly for sleep.