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?
I am a cancer survivor and was treated well before zofran or 5HT drugs were available.
I have worked in Oncology/BMT, HIV or Hospice in nursing for the past 15 years. I worked with HIV patients, prior to nursing - the first IVs that I started were on friends dying of HIV - they often could not get HHC nurses to come at night to restart IVs, so the MDs taught caring laypersons to start them.
I have watched people die of GVHD, so bad that their intestines were shedding, skin was peeling off, and so swollen with edema, that their testicles and member were splitting open. I have had patients where tumors ate through major blood vessels (carotid or femoral) and been there as they bled out to death. I have dressed wounds from necrosing tumors that ate through the patient's nose and ate an hole into the brain. I have dressed a necrosing cancer wound (further damaged by radiation and then debrided) that ate through the patient's ribs - there was shards of bone sticking out into the wound and you could see pulsing from blood vessels.
I would say that I DO KNOW WHAT I AM TALKING ABOUT AND I STILL BELIEVE THAT PAS ARE WRONG!!!!!
Please don't assume that everyone that doesn't share your opinion, just doesn't have enough experience or is just "religious" - many of us do have the experience and no, religion does not form the basis of our beliefs.
Also, don't believe that we will deprive people of pain med. I have given quite a few "final" doses of morphine, even with low resps because the patient was in pain. I defend the right of people to be DNRs and have watched them be terminally weaned from the vent.
If the patient themselves takes an overdose of meds, that is their right. I am saddened by it but it is their option.
But I do not support Euthanasia and I do not support physician assisted suicide
I totally agree with you and this is been the point I was trying to make also thank you for putting it so nicely :)
My opposition to PAS is because, in reality, suicide [def: The act or an instance of intentionally killing oneself] cannot be 'assisted' and still remain a suicide. Once one assists a person to take their own life, the person can no longer be considered a suicide since they needed an accomplice that performed premeditated actions that directly lead to another's death. What I resent is the way society uses nice sounding phrases (euphemisms) to masquerade the truth. For instance, "the Patriot Act"-if you aren't for it, you aren't a patriot? "Euphemism is an expression intended by the speaker to be less offensive, disturbing, or troubling to the listener than the word or phrase it replaces, or in the case of doublespeak to make it less troublesome for the speaker. When a phrase is used as a euphemism, it often becomes a metaphor whose literal meaning is dropped" So, if a euphemism is needed for the act of facilitating a terminal pts death, I look at it as a cover-up for something that is offensive, disturbing or troubling.
Wonderful clarification of why I don't support PAS.
I did not read the entire list of responses, but i must make this point.
Every time we honor a DNR request we are essentially assisting in suicide.
Every time we disconnect tube feeds or IV fluids or with-hold treatment, we are assisting suicide.
It is not only the active act of doing something, but also the omission of care that directly contributes to the hastening of death.
Sorry disagree. We are preventing a natural death when we introduce equipment or substances to the body to prolong life (meds, vents, etc.). Sometimes this is good - when you can help the body though a crisis or regulate a chronic condition to allow a person more years of quality (as defined by the pt) living. When you cease life sustaining treatment you are withdrawing the Introduced equipment/substance that are keeping a person alive when their body wan't sustain itself; when you provide a way for a person to die you are actually introducing equipment/substances that will take away life where it can still sustain itself. By all means treat pain with anything and everything you can but don't treat a desire to die w/ lethal means.
For those of you who do not approve of PAS..it would appear that your response is driven, perhaps, by your religious beliefs. Or perhaps you have not been in nursing long enough to see the terrible carnage and suffering that humans can be subject to. Maybe you have never been in intractable pain, or been given a grim prognosis for your future or that of your family member. Let me tell you, chronic pain, or that of radiation and chemo will MAKE YOU CRAZY!!! Then the so-called experts will say you are not in your right mind, for considering offing yourself...at least with PAS there is a merciful, clean and peaceful way out..with dignity, because you are calling it. For those of you who believe such "suicide" is morally wrong, or that you'll go to hell...remember the good book says "God's ways are higher than our ways and his thoughts higher than ours" In essence, we cannot even begin to pretend to be God, nor can any pastor or priest, or put our moral judgement on it. Ladies and Gentlemen , my fellow nurses, re-read the ANA Code of Ethics for Nurses with Interpretive Statements. Yes, we all have our opinion, but PLEASE look at the other side of the coin, and perhaps spend some time visiting and ICU or hospice!
Didn't see anything in the ANA code about handing someone who intends to kill themselves the means to do so. And while it may be religeous convictions that cause many to reject PAS that does not make their views invalid. As I stated elsewhere just because my world view differs from yours does not mean I am obligated to leave my beliefs at home any more than an atheist is obligated to leave his belief, in the abscence of a diety, at home.
BTW, been a nurse 13 yr, in ICU for the last 5 and just watched my brother die of esophageal CA. I think I am qualified to opine on the subject and I still disagree w/ you.
As competent adults, we are supposedly allowed to self determine our own fates and end of life. So this should not really be an issue in practice, but for some reason people are afraid to let this behavior become a social norm. People need to be educated more about what life support really means and if they are told they have a chronic, or terminal illness by any standard let them choose the outcome. Someone said that this might allow them to really "live" during their final days. Isn't that what we all want? I see way too much being done that could be considered cruel when the ultimate outcome has been decided.
We're not talking about withdrawing support or refusing treatment. We are talking about PAS, giving someone the means to kill themseves
we're not talking about withdrawing support or refusing treatment. we are talking about pas, giving someone the means to kill themseves
exactly!!!!!!!!!! they don't seem to understand that for some reason--just because we disagree with the pas doesn't mean we would not treat them ,etc.i just refuse to be the means or stand behind suicide in all consciousness i just could not!!!
exactly!!!!!!!!!! they don't seem to understand that for some reason--just because we disagree with the pas doesn't mean we would not treat them ,etc.i just refuse to be the means or stand behind suicide in all consciousness i just could not!!!
i think most of us see your point. you disagree with pas and that doesn't mean you are anti-treatment.
also note fromt he flip side just because some of us believe in pas, doesn't mean we are anti-treatment.
We're not talking about withdrawing support or refusing treatment. We are talking about PAS, giving someone the means to kill themseves
True. And to quote the poster you are trying to correct. "As competent adults, we are supposedly allowed to self determine our own fates and end of life." Perhaps this poster is aware of the topic of the thread and it's understood they mean to include PAS as one of the means to determine our own fate. Maybe not. I can't speak for them, but that's how I read it.
I think most of us see your point. You disagree with PAS and that doesn't mean you are anti-treatment.
Also note fromt he flip side just because some of us believe in PAS, doesn't mean we are anti-treatment. You must allow others to agree with PAS.
Oh I have no problem with your opinion at all --I do realize everyone is entitled to their own opinion--I just felt like since I disagree with the PAS that everyone was not allowing me the same parogative--but no I have no problem with someone else disagreeing with me--I can agree to disagree but some people are just not happy unless you accept it their way and I am not here to change anyone else's opinion ---just to express mine thats all
My opposition to PAS is because, in reality, suicide [def: The act or an instance of intentionally killing oneself] cannot be 'assisted' and still remain a suicide. Once one assists a person to take their own life, the person can no longer be considered a suicide since they needed an accomplice that performed premeditated actions that directly lead to another's death. What I resent is the way society uses nice sounding phrases (euphemisms) to masquerade the truth. For instance, "the Patriot Act"-if you aren't for it, you aren't a patriot? "Euphemism is an expression intended by the speaker to be less offensive, disturbing, or troubling to the listener than the word or phrase it replaces, or in the case of doublespeak to make it less troublesome for the speaker. When a phrase is used as a euphemism, it often becomes a metaphor whose literal meaning is dropped" So, if a euphemism is needed for the act of facilitating a terminal pts death, I look at it as a cover-up for something that is offensive, disturbing or troubling.
Now, I am not saying that a person should suffer in any way. If a person needs what turns out to be a lethal dose of a narcotic in order to obtain pain relief, then, by all means, that person should obtain the pain relief. Since the goal/intent was to relieve the pain, the by-product of that attempt to relieve the pain was death. Now, if the goal is to cause death in order to relieve the pain, you would be attempting murder. IT'S ALL IN THE INTENT. If 100 mg of morphine is what a person will need to relieve their suffering, they should get it if they understand what the consequences could be. But, KCl IVP would only have one intended outcome... It actually takes more work and concern (following the principles of do no harm [as in the harm that pain/suffering brings about]) to intend to medicate with the goal of complete pain relief, than it does to 'assist' with suicide. Both ways may end the same; but, which way followed the holistic model of nursing more closely? It seems to be a more 'convenient excuse' to assist a person with an outright lethal dose of something, than to assist them in achieving total pain relief without the person (or their family) feeling possible last moment guilt because the intent was to die rather than acheive pain control.
So what do you call it, rather than suicide?
The intent of PAS isn't to conveniently kill someone just because it's easier to do. It's assitsting ther person with their own personal plan. It's their agenda, their choice, their decision, not the physicians.
One can still understand this point and consider it murder, and causing harm, that's o.k. But some people are missing this point. They are acting as if the medical establishment rather than deal with people wants to kill them instead.
Oh I have no problem with your opinion at all --I do realize everyone is entitled to their own opinion--I just felt like since I disagree with the PAS that everyone was not allowing me the same parogative--but no I have no problem with someone else disagreeing with me--I can agree to disagree but some people are just not happy unless you accept it their way and I am not here to change anyone else's opinion ---just to express mine thats all
True. Sometimes in the heat of debate people get carried away. I might be guilty as charged, as I continually add my two cents ad nauseaum. But isn't that a good debate - disagreeing and discussing it?
Eaglelady
201 Posts
I totally agree with you and this is been the point I was trying to make also thank you for putting it so nicely :)