Do nurses support physician assisted suicide?

leemacaz · Jul 23, 2008

One of the criteria that seems to come up again and again is "quality of life"...this is different for each person..as to when life is no longer "life".

Can pain be taken care of by meds...can the person give up whatever they have to..and find something they can enjoy....No matter how hard the hospice or other caretakers try...can they really overcome lonliness...separation from neighbors, friends, family....

I do not know about assisted suicide.....but what is that drug induced coma where all other nutrition and water withheld? It makes the patient comfortable (or so they say)...and allows them to die of more natural causes...

I do not know about anyone else, but I would bless anyone who found a way to lesssen any physical or emotional or mental suffering I had...just not sure I could ask them to kill me.. I don't know if I could place that on someone else....

I respect the nurse who said she could manage pain at lower doses...but I would hope she would up mine..to the upper limit if the lower did not provide relief to a degree acceptable by me...that is not killing me...after all..the tolerance of drugs (morphine) varies from person to person anyway I think.

marachne · Jul 23, 2008

I do not know about assisted suicide.....but what is that drug induced coma where all other nutrition and water withheld? It makes the patient comfortable (or so they say)...and allows them to die of more natural causes...
I do not know about anyone else, but I would bless anyone who found a way to lesssen any physical or emotional or mental suffering I had...just not sure I could ask them to kill me.. I don't know if I could place that on someone else....
I respect the nurse who said she could manage pain at lower doses...but I would hope she would up mine..to the upper limit if the lower did not provide relief to a degree acceptable by me...that is not killing me...after all..the tolerance of drugs (morphine) varies from person to person anyway I think.

You're referring to palliative sedation or terminal sedation. It's done with several different medications, depending on the setting. The medication selected for use is usually a benzodiazepine or barbiturate. Midazolam is the most commonly used drug, i've seen propofol used, but usually only in a ICU setting. Lorazipam, increased opiods, haldol, thorazine, phenobarbitol, ketamine...the main thing is that if sedating drugs are used that appropriate analgesia is on board, and that all other physical care is continued. There is no good data on the efficacy of different meds

Also, there is the possibility of temporary sedation -- for example if someone has intractable nausea, they might be sedated for a while to allow the GI system to settle down.

The suffering has to be unbearable and intractable. Often an ethical consult is done. Some institutions (the VA for instance) do no allow it for emotional suffering, only physical suffering.

And the rule of "double effect" has been looked at -- the intent is to relieve suffering, not hasten death, so even if that is the outcome, it's not the intent. (and sometimes people will still be on fluids...)

The other thing about "managing pain at lower doses" something that we are often not well trained to assess is hyperanalgesia. Sometimes the opioid has created a hyper excitability state and to actually get relief, dose needs to be dropped (and usually medication changed too). So giving more, more, more is not always the best care

pbsct · Sep 10, 2008

I do. I work on a very busy stem cell transplant floor and have seen some of the most disturbing, drawn-out deaths anyone could imagine. My most recent patient had GVHD of the skin that was literally causing her skin to rot away. She was made a DNRCCA, but her airway was inflamed so she ended up on a vent, sedated, and unable to tell us how much pain she was really in. Her pressure stayed in the 70s for 4 days, on 50 of morphine/hr, plus 8 of ativan/hr. Every time we moved her (we changed sheets/pads once daily, due to the smell from the skin rotting) she would clench her fists and stiffen up. So we'd go up by 5 on her morphine, but no real change. It was also pure torture for her family, who knew of and respected her wishes but couldn't do anything but sit there watching this horror for days and days, literally begging the poor woman to just let go.

I was in favor of PAS before this, but now I'm even more sure that it could be a blessing.

Do nurses support physician assisted suicide?

Do you support physician assisted suicide?