Earlier today there was a thread regarding Dr. Kevorkian's release from prison. Just as I was adding my thoughts, it got moved to the Current Events restricted area.
At that time, it seemed like there was 100% support for him. Honestly, I was surprised, especially since not everyone he killed was terminally ill. (I'm from Michigan, though, so maybe I know more about his history).
So I'm wondering, do nurses generally support the theory of physician assisted suicide?
If I may politely point out something (and I'm not trying to pick a fight, as I respect different points of view):
You say that it is committing murder if you knowingly withhold life-saving interventions, but you are against organ transplantation (which is a life-saving intervention)? Many people enjoy years of good health after being the recipient of organ donation.
Years ago when I was in school, we had a heart-transplant patient come to speak to my class, and he talked about when he meet the donor family. He said that one of the daughters went up to him and told him she was against her mother's decision to become an organ donor and when her mother passed away, she almost objected to the donation process. Then, the daughter turned to him and said "Can I put my head against your chest so I can listen to my mother's heart beating?" At the time, the man was going on 10+ years with his donated heart.
Why bother to care about the cost of organ donation when we are bankrupting medicare by coding terminal/DNR patients?
:yelclap: Right on macspuds!!!!!! I think that you hit the nail on the head! Death with dignity and being as pain free as possible is just plain humane.
Yikes. Well, I've seen enough suffering that I could never look down on someone's decision to end their own life when faced with a slow, painful death. I would not be able to actually give a fatal dose of medication -- but it doesn't sound like it would come to that. Ideally, the patient themselves, with full knowledge of the consequences, drinks the medication themselves with a doctor at hand for support and other symptom control. I really can't condemn that.
I think some of the things we do in the ICU to prolong death are grotesque and should be illegal! I actually refuse to do "noxious stimuli" to my 90+ year old head trauma/brain bleed patients who are having "EVERYTHING DONE" to save them. Yeah, I'm going to now pinch them to assess them -- OR NOT! There's a name for people who pinch dying old people! And I'm convinced I'm going to burn in hell for participating in "restraining" them so they don't extubate themselves. Or wait, am I actually "lifting up the sacredness of human life" by participating in the ICU plan of care? Silly me, I thought I was being an ogre....
For the past 2 mos., I have been watching my grandmother die from a very invasive, very quick form of cancer, to which we know no primary source. This 85 year old woman has gone from having Easter dinner for 14 people at her house, to a 108 lbs skeleton who is bedridden in 8 weeks. Because of the tumor growing in her lower spine, she is unable to control her legs and has intermittent, unexpected bowel and bladder incontinence. Because of the tumor growing around her superior vena cava, she has hypotensive episodes, difficulty swallowing and dyspnea.
As I help her and my family with her care, I often find myself brought to tears as I think of our dog. The family dog who was "PUT DOWN" when he had cancer in his hips, was no longer able to ambulate nor control bowel and bladder function. I would like to think that my grandmother is deserving of at least the same treatment given out of compassion to a family pet.
How can we say we help people die with dignity when we watch what they are reduced to in their final days? That is not dignity.
OK, I'll elaborate. If, as a nurse, you knowingly with-hold life-saving interventions, even though the family or patient requests it, you are technically committing murder. Let's look at it the other way. If the patient wanted these interventions (but was unable to say so) and the family said no, they would in fact be killing the patient. The only difference is that nobody arrests the nurses (for the most part)....if it went to trial, we'd all be hung out to dry.
This is an ethical dilemma for me. Every time I witness a person die and do nothing, it seems wrong, because the patient in the next bed gets full resusitative measures no matter what. And who's to keep another family member from disputing the DNR after the fact?
Personally, I think it should be a federally protected act to with-hold certain treatments in certain circumstances, but this country will never go there until drastic changes are made to our system of care.
BTW, I also vehemently disagree on using "spare parts" (organ transplants) to artificially keep people alive for a few years (in which the costs of care bankrupt all but the most financially well-off people). This is highly offensive to me.
I'm not a lawyer so someone might disagree with me but I believe that murder requires the act of stopping a life, while not preventing a death, such as allowing a person to drown while you hold a life saving ring, would be "depraved indifference to human life." Since nurses are not being indifferent, I don't think the law sees us as murderers or accomplices. Frankly, I see death as a beautiful process that so many have welcomed, keeping in mind of course that I only work with geriatric patients. I'd never stop someone from continuing on their journey based on anyone else's beliefs. If I worked with young people or children, I might have a different view.
As to the family disputing the DNR, it's a legal document that the courts recognize. I don't think the family would win, but that certainly doesn't mean they wouldn't try.
As to the comment about the rich and the transplants, I had a co-worker whose husband needed a lung transplant. She said the first question she was asked was "How's your credit?" She felt badly about that, but was glad she had excellent credit, owned two homes and had a healthy bank account. Unfortunately, her husband died unexpectedly a few days later, before the transplant.
I think the best thing we can do is make sure all of our own papers are in order so that when our time comes, the caregivers will know what to do and hopefully follow our wishes. I don't want anyone to kill me, just let me go.
Specializes in LTC, assisted living, med-surg, psych.
I have always opposed physician-assisted suicide. This is both an ethical and spiritual issue for me........I just don't believe we human beings have the right to decide when it's time for another human being to leave this earth.
That said, I do NOT oppose giving patients in pain enough medication to ease their suffering, even if it speeds up the dying process somewhat. I've seen as little as 5 mg of morphine suffice to relieve dyspnea to a point where respirations stopped completely. Maybe it hastened death by only five minutes, but those were five minutes that the patient wasn't gasping for breath, terrified, agitated, and in mortal agony. And it certainly wasn't given to cause death. But there's an enormous difference, IMO, between giving a drug that shortens a dying person's downhill trajectory and giving a deliberate overdose.
Now, I would never sit in judgment of any person who wishes to avail him/herself of PAS in my state (Oregon is, so far, the only state to have made this legal, although there are similar pieces of legislation being debated in statehouses elsewhere in the country). I am not the one living inside a pain-wracked body or facing a lengthy, agonizing deterioration.......how could I possibly put myself in that person's place? However, I would not assist with the process in any way, nor be in attendance when the patient takes the overdose.
Is God for or against Assisted Suicide? Check out His textbook for the answer.
Dr. Kevorkian does not believe God exists.
I believe the fifth vital sign, pain and pain control, should be top of the list when caring for the terminally ill.
I believe the terminally ill person should be allowed to let nature take it's course. I do NOT believe that people's dying process should be prolonged by extraordinary measures, which all us nurses know about.
I linked the two topics (assisted suicide and organ transplants) because, to me, these are two things that I have moral difficulty with.
Although I fundamentally agree that it is to no-one's advantage to keep people alive who are no longer productive citizens or, for that matter, don't know they even exist. That being said, I struggle with the fact that when the decision is made to withdraw/with-hold care, I feel I am actively involved in "euthanasia by omission". Let's face it, folks, nurses are put behind bars more and more easily nowadays. It isonly a matter of time before someone locks one of us up for murder by following Dr's orders on withdrawing care.
As for the transplant issue, I just feel it's wrong to put another person't organs into another body. Divvying up the corpse for spare parts, like the zombies fighting over the entrails on Night Of The Living Dead. Just my humble beliefs.
I suppose the question is how you would define PAS(Shades of Bill Clinton). If it is to take a baby off a vent who has a syndrome or genetic disorder that is incompatable with life, then I support it. If it is to give a choice between giving a painfully struggling cancer patient a dose of morphrine knowing it could be his last, then I support it. But to assist someone who is active, mobile but afraid of pain from a disease, no I don't support it. Labs and doc get it wrong sometimes. There was the man in Britian recently who was told he had a year to live and sold everything he had and lived it up. Nine months later, the doctors said oops we got it wrong. Of course he's trying to sue. And in the US a lab that came back with the dx of breast cancer for this one woman. She had both breast removed and guess what no cancer found in either breast. What if these two had taken the easy route and did PAS?
And what about God? I think that we learn more in our trials than in the easy times. What would He be saying to us in this time of struggle? So I guess I have mixed feeling and views on PAS. How clear is that?
Where in the hell do they get off asking you THAT?
kmoonshine, RN
346 Posts
If I may politely point out something (and I'm not trying to pick a fight, as I respect different points of view):
You say that it is committing murder if you knowingly withhold life-saving interventions, but you are against organ transplantation (which is a life-saving intervention)? Many people enjoy years of good health after being the recipient of organ donation.
Years ago when I was in school, we had a heart-transplant patient come to speak to my class, and he talked about when he meet the donor family. He said that one of the daughters went up to him and told him she was against her mother's decision to become an organ donor and when her mother passed away, she almost objected to the donation process. Then, the daughter turned to him and said "Can I put my head against your chest so I can listen to my mother's heart beating?" At the time, the man was going on 10+ years with his donated heart.
Why bother to care about the cost of organ donation when we are bankrupting medicare by coding terminal/DNR patients?