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?

[Brian, ASN, RN]

FYI, I just added a poll to this thread.

Please vote, all votes are anonymous.

[TazziRN, RN]

Ack! Brian, you should have added "Yes under certain conditions"!

[Molly55]

I support PAS. I have lived and worked in Oregon as hospice nurse. It was a requirement that the patient considering PAS be on hospice so I had the opportunity to work with three patients in the PAS program. Statistically there were 12 episodes of PAS in the state during 2001. Of the 12 people in the program all had terminal illnesses, one patient pursured PAS because of financial reasons (terminal illness bankrupting young family) and the other eleven were because of one reason alone...lack of control.

I was orginally against PAS when I started working with the patients but have since changed my mind. I now believe that people should have the choice of what they want to do with there lives and that includes how they want it to end. Just like physicans and nurses should have the choice to assist PAS patients or not. If people believe that there are moral and ethical consequencs to choices then it up to the individual to decide how to justify and live with, or with die with those choices. It is not up to society to decide for others. As health care professionals we can chose to particpate in PAS patients experiences or not. It is not mandatory that all of health care be pro PAS. But, the right to live or die in inherent to each human being and those decisions should be sacred to the individual. PAS should be available to those that desire to participate. Would I pursue PAS? I am not sure but when I think about ALS or some other horrible chronic terminal illness in relationship to me I think yes I would pursue PAS. There is nothing noble about suffering. Hospice can control pain and symptoms but we can not give you back your control. The individual must remain intact and sole authority on what is quality of life and how much is enough.

Just my opinion.

[sprocket]

Do you support physician assisted suicide?

I think that as nurses, we have a fundamental role in helping the dying die with dinity. If the person in question was at the very last days (or hours) of life, with no hope what so ever of recovery, then PAS should be considered. In the medical profession it is the mantra "do no harm", and i think by un-necessarily prolonging life where no recovery is possible, we are infact harming the person and not helping them.

However, how you determine which patients would be suitable and which not is a very grey and dodgy area!

[91C_ARMYLPN]

This is a very sensitive issue concerning PAS. I have read with interest both sides of this topic. I support PAS, however strict guidelines and laws need to be in place. Patients who are suffering from terminal illness or painful disease, should have the right to make this personal type of choice. Those patients who are incapable of making a decision, and yet they are suffering, this will be difficult to assess, but to be looked at per each individual patient on a case by case basis. As human beings we have the right to die with dignity, in a respectful manner, and pain free. To evaluate the patient's quality of life, the undue suffering, and so many other factors come into play here.

At the other end of the spectrum, this needs to be closely monitored:

greedy family members may push this issue so they can collect monies from insurance policies, others families may use this to do away with their medically fragile/disabled loved ones because they have been a "burden" for so many years, and they are tired of caring for them. So many horrible situations can occur if PAS is not watched over by the authorities who need to enforce these guidelines and laws. I hope we can meet in the middle of the road and have balance for the sake of the most important person here, and that is the patient.

[TazziRN, RN]

This is a very sensitive issue concerning PAS. I have read with interest both sides of this topic. I support PAS, however strict guidelines and laws need to be in place. Patients who are suffering from terminal illness or painful disease, should have the right to make this personal type of choice. Those patients who are incapable of making a decision, and yet they are suffering, this will be difficult to assess, but to be looked at per each individual patient on a case by case basis. As human beings we have the right to die with dignity, in a respectful manner, and pain free. To evaluate the patient's quality of life, the undue suffering, and so many other factor come into play here.

At the other end of the spectrum, this needs to be closely monitored:

greedy family members may push this issue so they can collect monies from insurance policies, others families may use this to do away with their medically fragile/disabled loved ones because they have been a "burden" for so many years, and they are tired of caring for them, so many horrible situations can happen if PAS is not watched over by the authority that makes enforces the guidelines and laws. I hope we can meet in the middle of the road and have balance for the sake of the most important person here, and that is the patient.

Well said, Charlie, VERY well said!

[nwamom]

I have read the posts and my heart goes out to all of you. However, we Christian caregivers have a greater responsibility than our own choices or that of our loved ones.

PAS in my OPINION is the easy way out. That way family doesn't have to deal with the patient, we professionals do not have to deal with the patient, the doctors do not have to deal with the patients. Just give the patients the means to end their life. What does that do to all of us? Death is part of life, pain comes in many forms (physical, spiritual, and mental), all of us, yes, are affected by terminal patients, but what greater people we are by knowing them and caring for them.

I have met many good people by caring for their family members. I have seen many happy deaths by not giving excessive medications to end or hasten death.

We all are going to be accountable and have to stand in judgement, no one will be there to hold our hand as we give an account as to why we helped a person end their life.

We professionals all better think.

[WakeUpRN]

i can't believe most nurses actually support physician assisted suicide. whatever happened to the phrase " primum non nocere" or "first do no harm?"

if a patient wants to die with dignity, then by all means, allow them to die. but don't let them die by your hand.

removing medical interventions such as life support machines and feeding tubes isn't suicide. if a person's body cannot live on it's own, then the term suicide doesn't apply.

but if some one is performing euthanasia to end another person's life when the body can live, that is perverse.

after this is legalized, what then? what happens after everyone's conscience is seared to this type of human euthanasia? what next?

are people going to start euthanizing their terminally ill children or dependants because some doctor tells them they are going to die? are people going to have this mentality- that since a person only has 2, 3, 6 or however many months to live that they might as well be put out of their suffering now? i personally know several people who were told they were going to die in months and instead lived years or are still living! (and are happy to be alive, i might add.)

throughout history all people have lived, suffered and died. it is the human condition. no one has a painless life. we are brought in this world through pain and we exit this world through pain.

[TazziRN, RN]

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PAS in my OPINION is the easy way out. That way family doesn't have to deal with the patient, we professionals do not have to deal with the patient, the doctors do not have to deal with the patients. Just give the patients the means to end their life. What does that do to all of us? Death is part of life, pain comes in many forms (physical, spiritual, and mental), all of us, yes, are affected by terminal patients, but what greater people we are by knowing them and caring for them.

PAS is not about the families or the professional care team, it's about the patient. This is about the pt who is afraid of having a painful death, about the pt who wants to say, "Okay, God, if I have to come Home now I will, but I want to choose the method of transportation."

What's wrong with that?

(The following quotes were made by a different poster than the one quoted above)

Throughout history all people have lived, suffered and died. It is the HUMAN CONDITION. No one has a painless life. We are brought in this world through pain and we exit this world through pain.

Throughout history people also suffered with or died of medical conditions for which there was no treatment. Through the passage of time and gain of knowledge that has changed, and will continue to change. With all the knowledge at our disposal, why should a pt with a terminal illness have to leave this world in pain if s/he doesn't want to?

Are people going to start euthanizing their terminally ill children or dependants because some doctor tells them they are going to die? Are people going to have this mentality- that since a person only has 2, 3, 6 or however many months to live that they might as well be put out of their suffering now?

PAS stands for physician-assisted suicide. It is not suicide if a parent or guardian makes the decision. This should not be an option for someone unable to decide for him/herself.

I personally know several people who were told they were going to die in months and instead lived years or are still living! (And are happy to be alive, I might add.)

This is not about people like those you describe. PAS is for people who have a terminal illness, have attempted treatment, and are at the point where they are told, "There is nothing more we can do" and they are either sent home or admitted to Hospice to die.

I happen to believe in PAS under very strict guidelines. I am not trying to change anyone's mind about accepting PAS, everyone is entitled to their own beliefs and willingness or unwillingness to allow something. The arguments quoted above, however, just don't work.

[Tweety, BSN, RN]

i can't believe most nurses actually support physician assisted suicide. whatever happened to the phrase " primum non nocere" or "first do no harm?"

if a patient wants to die with dignity, then by all means, allow them to die. but don't let them die by your hand.

removing medical interventions such as life support machines and feeding tubes isn't suicide. if a person's body cannot live on it's own, then the term suicide doesn't apply.

but if some one is performing euthanasia to end another person's life when the body can live, that is perverse.

you, everyone in this forum, and myself are entitled to be respected for our opinions. i disagree with much of what you have to say....with respect for your right to your opinion. :)

after this is legalized, what then? what happens after everyone's conscience is seared to this type of human euthanasia? what next?

are people going to start euthanizing their terminally ill children or dependants because some doctor tells them they are going to die? are people going to have this mentality- that since a person only has 2, 3, 6 or however many months to live that they might as well be put out of their suffering now? i personally know several people who were told they were going to die in months and instead lived years or are still living! (and are happy to be alive, i might add.)

throughout history all people have lived, suffered and died. it is the human condition. no one has a painless life. we are brought in this world through pain and we exit this world through pain.

i whole heartedly agree with your right to hold and express your opinion, while i respectfully disagree. :)

assisting a patient in a gentle and desired end to me seems less harmful than some of the interventions we put patients through: ventilators, feeding tubes, dehabilitating chemotherapy, leaving elderly curled up in balls unresponsive with tube feedings, fighting to the bitter end, to the same end. sometimes in our quest to "do no harm" we do the opposite.

even our hospice care leaves much to be desired, but that's the right direction, and i think the choice for most people, no pas.

what happens next? we should look to oregon. are they killing innocent terminal children and indiscriminantly ethanizing people just because they have a diagnosis of terminal illness?

the current medical establishment, doctors and nurses alike, completely disagrees with your contention that death needs to be painful.

[Molly55]

the only state in the union that allows PAS is Orgeon. That law states the person must be a/oX4 under go psychological exams and be ok'd by two other physicans agreeing the patient is terminal. The patient must then ingest the medication by THEMSELVES. It cannot be given IV, thru gastric tubes or any other method. It is not by anyones hand. It is by the patients hand alone. They must be able to take the medication out of the physicans hand and ingest it orally. It is the patients decision not the families and the patient must go through the all of the testing etc before the medication is ordered by the physican. If the patient cannot take the medication BY THEMSELVES they can not participate in PAS period. Nurses are precluded by law from assisting in anyway. We can there if the patient wants there and we agree to be there but only as a friend. The work is betweent the physican and patient only. The family does get to intervene. The physican cannot administer the medication, they can only order it and be there at ingestion to render aid if the medication causes adverse effects (vomiting etc) This is not giving someone a shot or an IV to kill them. This is patient driven only. There is a mythology that nurses or doctors will be asked to decide who dies then go render the fatal dose. This is not the law. And this is not the law the states are comteplating.

[TazziRN, RN]

Thank you, Molly.

How can anyone say that this is euthanasia??