Do nurses support physician assisted suicide?

[NightOwl0624]

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?

[Blee O'Myacin, BSN, RN]

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.

The family titrated a drip? Seriously? Is that legal? We "titrate to comfort" in our ICU when we have a patient on comfort measures, but I would never, ever let a family member dicate, let alone touch one of "my" drips. Wow... And I am all for comfort measures, even if means shortening a person's final hours on earth if it means easing their suffering.

Did you see a problem with Pt. X passing away after being placed on hospice and finally receiving the pain meds that he needed? Just because he was ambulatory and lucid does not mean that he wasn't suffering. Sometimes, simply having the family "allow" the patient to be placed in hospice care or on comfort care is all it takes to let them go.

As for PAS, I'm all for it under strictly laid out circumstances. However, I think it should be just that. Physician assisted. Not physician ordered and nurse assisted. The attending physician should be administering the drug and staying with the patient until death occurs.

Blee

[Roy Fokker, BSN, RN]

My humble opinion:

There is little dignity in death.

But there can be dignity in how one gets to face ones own mortality.

Life is like a meandering river, and it must ultimately reach it's destination... and be lost in - the sea. As someone else already mentioned: we get to choose in all aspects of our life, why can't we choose how we face our own demise?

For moral and philosophical reasons, I support assisted suicide.

- Roy

[Jolie, BSN]

wow, as an rvt i take great offense to your post. it is tasteless and has no basis in reality for the vast number of veterinary practices out there. animals are due and for many they do recieve the same level of care i have infact seen where they recieve better care than many humans. being on both sides of the fence i can say this. unfortunately you are correct on one of your assertions. we do euthanize pets when their needs outstrip our budgets, quote from atl john above

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. quote from canoehead above

a previous poster asked those of us opposed to assisted suicide to explain our rationale, which i did. i did not intend to offend animal lovers or professional animal care-givers, all of whom i have great respect for. but nothing that i stated is untrue. i did not address the quality of medical care offered to animals. i addressed the legal status of animals and how it differs from that of human beings. animals are regarded as posessions in our society. they do not enjoy the legal protections that human beings enjoy, which is the reason why animal euthanasia is legal and human euthanasia is not (other than in oregon). that is the point i was trying to make, not that i agree with such treatment of animals, simply that it exists and does not result in legal charges against pet owners or veterinarians, because it is legal and accepted in our society, as the next poster, an animal care worker, clearly describes.

i work in an animal er, there are owners who decide to euthanize their pets because they really do care for them and do want them to suffer. there are also "other" types.

people euthanize their pets because the pets become a burden to care for when they get sick. i've heard things like, "oh, i just can't give him pills. he hates them. i love my cat and i don't want to do this, but there's just no way it would work."

i can see the same thing happening with people. i can see people feeling pressured to chose euthanasia because their illness is draining their loved ones, physically, financially or emotionally.

in an ideal world, euthanasia would make sense, but our world is not ideal. there are people who kill their husbands/wives/children and more than a few crooked doctors out there.

suicide is something that should be done alone, or not at all, imho. i agree with the person who said we should focus more on not prolonging suffering with futile treatments. quote from turtlesoup above

[buddiage]

http://www.ana.org/readroom/position/ethics/etsuic.htm

This is the ANA stance.

[LilPeanut, MSN, RN, NP]

Personally, I support it, within reason. I don't think a terminally ill person should be forced to try and shoot themselves in the head or fall to their death if they want to end their life.

If a person is mentally competent and decides they want to end their life, I think they should have access to ways to do it effectively and painlessly.

[nj1grlcrus]

The problem is that when you reach the point of life in which suicide would be preferrable to continuing to live, you no longer have the ability to end your own life, a scary catch-22 that I often think about when caring for patients with a laundry list of diagnoses, and a medication list as long as your arm, in pain, with no quality of life. I shudder to think how much it would cost my family, monetarily as well as emotionally to keep me alive, that's the real problem, at least for me.

[ann945n, RN]

No one escapes death, the terminally ill who are suffering a great deal should have the right to decide when they want to leave this earth and in what condition and in what amount of pain and suffering. I support it when guidelines are in place.

[hogan4736, BSN, RN]

The family titrated a drip? Seriously? Is that legal? We "titrate to comfort" in our ICU when we have a patient on comfort measures, but I would never, ever let a family member dicate, let alone touch one of "my" drips. Wow... And I am all for comfort measures, even if means shortening a person's final hours on earth if it means easing their suffering.

Did you see a problem with Pt. X passing away after being placed on hospice and finally receiving the pain meds that he needed? Just because he was ambulatory and lucid does not mean that he wasn't suffering. Sometimes, simply having the family "allow" the patient to be placed in hospice care or on comfort care is all it takes to let them go.

As for PAS, I'm all for it under strictly laid out circumstances. However, I think it should be just that. Physician assisted. Not physician ordered and nurse assisted. The attending physician should be administering the drug and staying with the patient until death occurs.

Blee

I asked family if they wanted more morphine, if they said yes, I did it...A common occurrence in the ED...

And no, I had no problem w/ pt X receiving the pain meds...I just want to call a spade a spade...Hospice tries to spin the death as the disease process...That's an insulting take on the truth...The morphine directly led to pt X's death...

I'm just asking for honesty...

I'm for PAS, WITH adequate truth, and consent...And I personally have no problem giving the meds...Being "for" it, and having the doc give the meds, does not constitute true support of the process IMHO...

[teeituptom, BSN, RN]

I most certainly support it, I have seen many candidates for it.

[Ruby Vee, BSN]

so i'm wondering, do nurses generally support the theory of physician assisted suicide?

if a person wants to commit suicide, that's their right. but i don't think they should be asking someone else to take that stain on their soul. if you want to commit suicide, then do so. but just don't ask me to participate.

on the other hand, withdrawal of care is not physician-assisted suicide. it's just the cessation of extraordinary care, and i have no problem with that.

[GilaRRT]

This is quite a polarized topic. My opposition to PAS is indeed related to my moral and perhaps religious views. I do not think I as a health care provider should knowingly administer or help somebody self administer a substance that will cause their death. I am in a profession that supports life and I took a pledge where I swore to God and everybody else that I would not knowingly administer a harmful drug. I do understand people will interpret this differently; however, I hope that inspite of disagreement you will at least respect my stance.

[Sabby_NC]

I work in Hospice and quite often am the last one to give the patient pain medication before they die.

PAS is another kettle of fish though. How can you decide when the time is right?

No one knows what tomorrow will bring. Even terminally ill people have good days mixed with the horrid days.

I do not wish to be the person to decide when that patient has had enough and their time is now!

So in answer to your question I do not agree with PAS myself.