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 saw a great documentary about a woman dying from cancer who was going to use physian-assisted suicide. Her illness was progressing very quickly and she was given little time to live. In the documentary, she said knowing that she had the choice gave her a sense of control over a situation that was now controlling her. Knowing she had the power to choose her time to die gave her strength. The method used was giong to be a drink-concoction (?barbituates?); I believe she lived in Oregon, and the doctor who was prescribing this to her would be at her side when she chose her time to die.
In the documentary she took a turn for the worse, and her daughter begged her to wait to take the drink until the rest of the family came to be with her as she died. By the time the family arrived, she could no longer swallow and therefore, could not end her life when she would have wanted to. I believe she died a few hours after her family arrived.
Our society is always trying to "fix" our bodies and keep them going for as long as possible. We do open-heart surgeries on 80-90 year olds (yes, some may be healthy to survive surgery, but let's be honest - many are too ill to be having the surgery in the first place). I know cardiologists who will send patients practically coding out of the OR, only to die once they reach the ICU because they don't want to have anyone "die on their table".
I used to think that people who wanted to use physician-assisted suicide were "quitters". I imagined 40-year old people, just diagnosed with cancer, who wanted to kill themselves so they wouldn't have to suffer. I now think very differently. These people don't want death to define who they are; they want to define their own death as they continue to live.
Specializes in Community Health, Med-Surg, Home Health.
I also saw a documentary similar to this when I was a child. The woman decided to take pills every few hours, during that time, she spent time with each of her children and finally her husband. This process happened within about 24 hours. It was a very moving show...I still remember the name of the woman, and this was actually taped until she became unconscious. I was about 10 years old, and I NEVER forgot that show. What I admired, even then, that she took control over her whole situation...no physicians involved. I would not do it as a nurse, but, as another poster mentioned, it is alot to think about because the family or the client may do this to relieve the burden of caring for a sick person and may have clouded judgement.
. Animals are our possessions. They are not due, nor do they usually receive the level of care and dignity reserved for human beings. We would NEVER leave a human infant unattended for hours a day while at work, but think nothing of doing so with a puppy. We would never take our poorly-behaved or non-housebroken child to the Humane Society for adoption, but we do so with our pets, and those that can't be placed in homes may eventually have to be euthanized for no better reason than lack of space.
My sympathies to your pets, if you have any. There are a lot of people in the world that think treating animals the way you describe is inappropriate, and the majority would not be described as radical animal rights people by their friends.
Back to the subject, I support PAS, and would demand it in an advance directive for myself, if it was legal.
I personally think that the issue of PAS would not arise if patients had adequate access to palliative care. (Adequate pain medication, comfort measures etc.) That said I do believe that people should have the ability to make the choice to end their life if living in intractable pain or facing a lifetime of permanent disability as a result of injury. No easy answers but it does fall into the realm of personal choice.
why do you think there are hospice programs in the us? it allow patient themselves or family members to let go of their loved ones but without physical, psychological, and spiritual agony and allow patient to be as pain free as possible.
what??? there are many that die with pain because there is no combination of meds to make them comfortable for different reasons, without snowing them to an obtunded state. and if i were you i would not tell people who have a hard time with the loss of a loved one that there is no agony involved. i don't mean just the natural grief over the death, so don't even go there.
There are many patients who, because they are not allowed the choice to die with dignity, choose to end their own lives in a way that they feel spares their family, friends, etc. They just lose the will to live and will themselves to die. My own mother went into the hospital, and after years of being homebound, dependent on others, was told she has a pseudo bowel obstruction, and needed rectal and ng tubes. She just said she could not tolerate them. They promised morphine, and all kinds of things saying she would not feel them, but she said NO. They told her that she would die, she made the final decision the next day. She told her cargiver, who had been with her for years, " guess my time is up. I have had a long good life." She was tired, she was dependent and just did not want to go on. NOR did she want to die at home alone. So she finally let them put in a central line, but that was it. Kept saying she wasn't in pain, slipped in and out of consciuous when the bowel began to leak the TPN they insisted on,and finally just slipped away 4 days later. This was her way. Others need the support of family and friends. MOST want to do it in a way that spares guilt to those they leave behind. Chronic pain, is the one area that concerns me more than most. It is so undertreated, and their lives could be improved with the right combo of drugs and physcian treatment. but unfortunately, most drs are afraid to prescribe the meds needed to give them their lives back. So that they can live a life that does more than drain their remaining strength. Many will argue that research is always finding new cures for those who feel they have an incurable condition. How many times do neonatologists recommend to the family that they let the baby go? I've seen life saving surgery not even attempted on elderly patients with other medical conditions that might prove to be a problem. They say keep them comfortable.Then again, I have had patients who sign DNR orders, family agrees, they start to slip away, and the family screams to me DO SOMETHING
why do you think there are hospice programs in the us? it allow patient themselves or family members to let go of their loved ones but without physical, psychological, and spiritual agony and allow patient to be as pain free as possible.
exactly...
for those that don't agree w/ pas, how do you distinguish that from hospice (except from pas, the death is within minutes)...
i saw it over and over in the snf where i worked...
pt x has been hanging on for weeks, even, at times, lucid and ambulatory. family decides (finally) to place said pt on hospice, and 2 days later he dies (peacefully and without pain)...
he did not die of the disease process, it was from the q 1hour sublingual morphine...
my last job, in a busy, urban, catholic er; pts would come in w/ a head bleed, unconscious; family makes pt a dnr. er doc orders a morphine gtt, and lets the family titrate...if that's not pas, then i don't know what is...i thanked god every day for that agressive treatment of an otherwise, slow, horrible, death.
My purely personal preference is to lucidly experience my own death. If my mentation is going, I don't want to be kept hanging on until I can't cognitively process the experience, nor if in pain do I want more pain meds than will put the distractor of pain in the background. So I might need a physician's assistance to let me be fully present at the time of my death. Yet in taking advantage of medical expertise to time my death for my final developmental benefit, much as we might use tocolytics or pitocin to time a birth for the developmental benefit of a baby, in no way could I view the cause of death being anything but the disease process that brought me to that point. The point is, we can't own our births, but we can own our death experiences. Shall others decide for us?
I do, given strict medical and psychological guidelines...I think a terminally ill person should have the right to decide when and how they die...and at great risk of sounding tacky, I afford the 'good death' to my beloved pets, and if someone terminally ill wants that same 'good death', that's up to that person, not me.
:yeahthat: :yeahthat: :yeahthat: :yeahthat: I think the patient has the right to choose or if it truely is the end of life and the patient is in pain, medicate no matter what.
I am all for a "death with dignity". That means different things to different people, so I believe PAS should be an option available to the terminally ill. Death is not always a bad thing....
kmoonshine, RN
346 Posts
Under the right circumstances, yes.
I saw a great documentary about a woman dying from cancer who was going to use physian-assisted suicide. Her illness was progressing very quickly and she was given little time to live. In the documentary, she said knowing that she had the choice gave her a sense of control over a situation that was now controlling her. Knowing she had the power to choose her time to die gave her strength. The method used was giong to be a drink-concoction (?barbituates?); I believe she lived in Oregon, and the doctor who was prescribing this to her would be at her side when she chose her time to die.
In the documentary she took a turn for the worse, and her daughter begged her to wait to take the drink until the rest of the family came to be with her as she died. By the time the family arrived, she could no longer swallow and therefore, could not end her life when she would have wanted to. I believe she died a few hours after her family arrived.
Our society is always trying to "fix" our bodies and keep them going for as long as possible. We do open-heart surgeries on 80-90 year olds (yes, some may be healthy to survive surgery, but let's be honest - many are too ill to be having the surgery in the first place). I know cardiologists who will send patients practically coding out of the OR, only to die once they reach the ICU because they don't want to have anyone "die on their table".
I used to think that people who wanted to use physician-assisted suicide were "quitters". I imagined 40-year old people, just diagnosed with cancer, who wanted to kill themselves so they wouldn't have to suffer. I now think very differently. These people don't want death to define who they are; they want to define their own death as they continue to live.