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 for it. As long as it is the patient's wish. I also believe in DNR and withdrawing of care with morphine gtts @ 20mg/hr as it applies to the appropriate circumstances. Many of us work with suffering and hopeless cases in which the prognosis is inevitable. And we do give our beloved animals more consideration that spares them from suffering. Technology is wonderous and I embrace it. But not when it interupts a person of their natural dignity to die and prolong the inevitable that includes pain and suffering. For an elective surgery such as a bariatric procedure, a patient must undergo a psych eval. Why can't a similar process exist for a terminally ill pt?
I am for it. As long as it is the patient's wish. I also believe in DNR and withdrawing of care with morphine gtts @ 20mg/hr as it applies to the appropriate circumstances. Many of us work with suffering and hopeless cases in which the prognosis is inevitable. And we do give our beloved animals more consideration that spares them from suffering. Technology is wonderous and I embrace it. But not when it interupts a person of their natural dignity to die and prolong the inevitable that includes pain and suffering. For an elective surgery such as a bariatric procedure, a patient must undergo a psych eval. Why can't a similar process exist for a terminally ill pt?
I know this has already been said but withdrawing tx that artificially prolongs life and providing comfort measures is not the same as giving someone who would otherwise live weeks, months or even years a substance to immediately end their lives.
Specializes in Hospice, Palliative Care, Gero, dementia.
I know this has already been said but withdrawing tx that artificially prolongs life and providing comfort measures is not the same as giving someone who would otherwise live weeks, months or even years a substance to immediately end their lives.
In the one place where it is legal to write a prescription for physician aided death (new term in the field for PAS), a person has to have decision-making capacity and have a life expectancy of six months or less. Admittedly, these kinds of prognosis is far from exact, especially if you are talking things like COPD or HF, but the vast majority of people using it have cancer, where the prognostication is fairly decent. So no one who is likely to live "years" is going to get a prescription, and I doubt many physicians are likely to write one for someone who it looks like has many months.
Under the proper conditions (medical reason, etc.) and very strict guidelines, yes I do.
Yes this. If a person knows they are going to die especially from some long debilitating disease. Or something like cancer, treatment has stopped and they have been given clearance to enter hospice, DNR why not?
Seriously if that's who those people want to die, why not? It not my place to say they need to spend months or years suffering from some long agonizing death.
a question for you all: for your end-of-life patients, does the doctor write a very "inprecise" prescription for morphine (or something similiar)? We have a few physicians that will write a range for morphine, and we're supposed to titrate as we see fit. i KNOW that if i gave any of them the higher end of the dose, they would die. i always use the lowest dose and it always seems to work for pain relief/comfort. sometimes it makes me wonder if the physicians aren't trying to participate in PAS, but in a legal way...
Specializes in LTC, rehab, Adolescent trach/vent,.
I think physician assisted suicide is just the first step in getting society to believe it is acceptable to kill terminally ill people. Once that is routinely established, it is a short hop to exterminating people with birth defects, mental retardation etc... does this remind anyone of Nazi Germany?
Specializes in Hospice, Palliative Care, Gero, dementia.
a question for you all: for your end-of-life patients, does the doctor write a very "inprecise" prescription for morphine (or something similiar)? We have a few physicians that will write a range for morphine, and we're supposed to titrate as we see fit. i KNOW that if i gave any of them the higher end of the dose, they would die. i always use the lowest dose and it always seems to work for pain relief/comfort. sometimes it makes me wonder if the physicians aren't trying to participate in PAS, but in a legal way...
Actually, you don't know that the higher end of the dose will kill someone. I have had patients on pumps at rates that were hundreds of mg/hr and they were still up and scooting around in an electric wheelchair. People do develop tolerance, and may need an amount of analgesia that would seriously compromise another person.
It also sounds like you are describing dosing ranges not titration. Titration mean increasing until control is achieved--recognizing that it may not be a stable thing as the dx process continues and/or tolerance develops. Most providers don't even do titration correctly. Having an order that reads "you can increase by X amount every Y hours" is not appropriate -- increases should be percentage to quote the EPERC fast fact:
moderate to severe pain increase by 50-100%, irrespective of starting dose
mild-moderate pain increase by 25-50%, irrespective of starting dose.
The fast facts cover quite a range of EOL issues, and I recommend this as a source for anyone dealing with patients who are dying. You can even download them into a PDA if you use one and have them handy.
Specializes in Hospice, Palliative Care, Gero, dementia.
I think physician assisted suicide is just the first step in getting society to believe it is acceptable to kill terminally ill people. Once that is routinely established, it is a short hop to exterminating people with birth defects, mental retardation etc... does this remind anyone of Nazi Germany?
Well, PAS has been routinely established in Oregon for ten years and the rate of useage has held steady at about 1/10 of 1 percent of all deaths (0.1%) -- or 49 people in 2007. You have to be a competent decision maker as evaluated by two physicians (plus a psych consult if deemed necessary), as well as other safeguards.
Not saying it's perfect, but it's been shown to be a fairly well written law
I think physician assisted suicide is just the first step in getting society to believe it is acceptable to kill terminally ill people. Once that is routinely established, it is a short hop to exterminating people with birth defects, mental retardation etc... does this remind anyone of Nazi Germany?
NO, people should make their own choices. I would rather have people slip away comfortably than drink Drano because no one gives them that choice.
.thumb.jpg.755b83f43c9f3860c778e2fcb2022ecb.jpg){kind=small}
leslie :-D
11,191 Posts
"malice aforethought", as characterized by deliberation/premeditation.
because of its deliberate intent, the courts deem that as malicious.
others disagree.
leslie