Euthanasia is a very touchy subject, especially within the medical field. As a healthcare advocate, it is our job as professionals to better the lives of our patients. What happens when there is nothing more you can do?
I understand, being a Home Health Aide that works a lot with Hospice, that comfort care is important. But truly, when a suffering patient looks to you to ease the pain what do you do? Should you apologize and say their is nothing more I can do?
I can hardly say no more treats to my cat when he gives puppy dog eyes, much less a patient dying alone of cancer. In my opinion, for what it is worth, Euthanasia is most certainly not murder and should never be referred to as such.
If Euthanasia was legal, but very strict in regulations and rules, it would be very beneficial to many terminally ill patients. This may be the only healthcare decision a patient makes within their life, and they should be allowed to make such a decision when conditions permit. We all have choices in this world, what gives you or I the right to take such choices away from someone in such a situation.
What is your opinion? Do you agree or disagree? Do you have a story, personal or not that pertains to this topic?
This isn't about clubbing seals who weren't able to complete an advance directive.
This is more like, I think homosexuality is a sin so therefore what happens between two consenting adults is my business and I will vote down their personal rights based on my personal religious beliefs.
This is people stating they think euthanasia or PAS is wrong based on their personal beliefs that ending a life is wrong regardless of how much suffering and zero chance of any type of improvement. It doesn't matter that someone's, who is completely unrelated to them, limbs are black and they're agonal and that they had completed an advanced directive stating their wishes to end their suffering. It's keep them comfortable if you can but ending their life painlessly a few hours early is just wrong. Period. And it's their moral imperative to block personal rights.
But there is no convincing otherwise, self righteousness runs deep.
I'm thinking as a hospice nurse about your patient with the blackened limbs and the agonal breathing. There are ways we can give comfort care for your patient to die a peaceful and pain free death.
I really think we need to do more education about how we can handle the terrible deaths I do see or hear about in ICU's or other parts of the hospital where end-of-life palliative or hospice care is not practiced. I grant you that people are dying terrible deaths due to ignorance regarding what could happen as an alternative. Family members don't want to let go and physicians don't want to give up. We should do a much better job of education.
And honestly I didn't mean to imply that this is about clubbing seals . ..I was trying to give an example not related exactly to human beings to make it easier to understand where some of us are coming from. Maybe not the best example I guess but is not an example of self-righteousness.
I'm thinking as a hospice nurse about your patient with the blackened limbs and the agonal breathing. There are ways we can give comfort care for your patient to die a peaceful and pain free death.
I really think we need to do more education about how we can handle the terrible deaths I do see or hear about in ICU's or other parts of the hospital where end-of-life palliative or hospice care is not practiced. I grant you that people are dying terrible deaths due to ignorance regarding what could happen as an alternative. Family members don't want to let go and physicians don't want to give up. We should do a much better job of education.
And honestly I didn't mean to imply that this is about clubbing seals . ..I was trying to give an example not related exactly to human beings to make it easier to understand where some of us are coming from. Maybe not the best example I guess but is not an example of self-righteousness.
Just sharing thoughts and ideas.
i'm sorry, I was combining a lot of different thoughts, not directed to anyone specifically even though I did use your seal example.
And I'm not arguing that hospice care doesn't maintain comfort or that the majority would even want euthanasia or PAS, but for those rare few who might, I think it's their right to choose, and not ours to take away. And the burden would be on them or their family to find a willing legal participant.
In as much as an individual's life is their own, so should and must be their death. If the state wants to control ones death as it seems to want to, what is it based on, science or religious persuasion? The state wants to control women's bodies insofar as it cares to control abortion. They're saying it is for societies good and to avoid abuse. I don't believe this is the role of government. Their role is to create a level playing field for ppl to make decisions which affect their lives. We don't choose to come into existence but we are told time and time again, it's your life. Fail or succeed on your own. So when it comes to end of life decisions, where is our choice in how we go out! Suffering seems to be a needless requirement in this society. I wonder where this comes from?
I was thinking more about this. It may not actually matter if the person is suffering or kept sedated. Maybe all that matters is that quality of life is over for them and they don't want to spend the last weeks of their life in a particular state, maybe they don't even want tax dollars spent during their dying phase. Whatever the reason, why shouldn't people be able to die on their terms? (If they have completed legal directives and legal assistance)
I gather from this comment/question that you suspect that the individual might have suffered and lived for a longer period of time had they not been provided sufficient morphine to treat their symptoms.
That may be true, but it may also simply be correlation. It may be that the person, relieved of the physical suffering, is then left to complete the desired and appointed emotional/psychological/spiritual work of letting go of this life and the beloved which occupy it.
I am often struck with the sense that many people who are in the active phase of dying have more "control" or "influence" than one might think in the timing of their death.
Good question.
Currently the data on hospice indicates that those folks who choose hospice actually live slightly longer than do those folks with similar dx and symptom burdens who do not elect the hospice benefit. I think that those people who come to hospice literally hours from death are not representative of how morphine is used to promote comfort without hastening death and to suggest that the morphine hastened their deaths is unreasonable.
There are large scale studies which show that those who are offered palliative care counseling live about 20% longer than those who aren't. This is due to their reduced likelihood of choosing aggressive, life-shortening treatments, less time in hospitals, etc. Morphine and other opiates can actually be therapeutic and effectively treat disease processes is amounts relatively small compared to what is used in acute care end of life management, but there is no evidence or reason to believe that these levels of symptom treatment actually extend life, there is extensive evidence that they do the opposite, not that there is anything wrong with that, comfort is the overriding goal, but I do think it's important not to intentionally become oblivious to the well established effects of opiates.
We don't dose like that . . . . dose to avoid adverse effects and not control pain. And I've honestly never given morphine or another drug that hastened death.
That's why you need the well-trained hospice nurses to come in and manage these patients. Or do some in-depth training to the nurses in the ICU.
I've given boatloads of Morphine and Dilaudid . . . and didn't kill anyone.
A patient is getting continuous and boluses of Dilaudid . . . . (deleted details due to privacy) . . . And she walks and talks and eats and laughs.
We dose to treat pain as much as possible while avoiding adverse effects in non-comfort-care patients, the whole point of comfort care is that these restrictions due to adverse effects go away so that comfort, not prolonging life, becomes the priority. I can't imagine letting a dying patient suffer and flail because I want to keep their Co2 levels normal.
I would assume I'm misunderstanding your post, but you seem to be suggesting that the training ICU nurses need is to under-treat symptoms at the end-of-life?
We dose to treat pain as much as possible while avoiding adverse effects in non-comfort-care patients, the whole point of comfort care is that these restrictions due to adverse effects go away so that comfort, not prolonging life, becomes the priority. I can't imagine letting a dying patient suffer and flail because I want to keep their Co2 levels normal.
I would assume I'm misunderstanding your post, but you seem to be suggesting that the training ICU nurses need is to under-treat symptoms at the end-of-life?
I wasn't sure if "We don't dose like that . . . . dose to avoid adverse effects and not control pain. And I've honestly never given morphine or another drug that hastened death" was supposed to read as "we don't dose like that, we dose to avoid adverse effects and not control pain".
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Even if "Keep Your Laws Off of My Body!" is used by the pro-choice movement, don't people with cherished religious beliefs want certain laws kept off of THEIR bodies?
Those with cherished religious beliefs seem to operate on the theory that if they believe something is wrong, NO ONE should have the option for doing that thing. If *I* believe that abortion is wrong, it ought to be illegal so that NO ONE can ever have one. The "Keep your laws off my body" bumper sticker essentially means that if you believe abortion is wrong, don't have one. But don't limit other peoples' choices because of YOUR religious beliefs.
Most of us in this country believe it's wrong for the Taliban to prohibit women from driving, appearing in public without being fully veiled or to leave their home without a male "escort." But a large portion of this country, while believing that it's wrong to make laws about those things, believe it's OK to limit choices on abortion, same sex marriage and other cherished religious beliefs held by THEIR group.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
In as much as an individual's life is their own, so should and must be their death. If the state wants to control ones death as it seems to want to, what is it based on, science or religious persuasion? The state wants to control women's bodies insofar as it cares to control abortion. They're saying it is for societies good and to avoid abuse. I don't believe this is the role of government. Their role is to create a level playing field for ppl to make decisions which affect their lives. We don't choose to come into existence but we are told time and time again, it's your life. Fail or succeed on your own. So when it comes to end of life decisions, where is our choice in how we go out! Suffering seems to be a needless requirement in this society. I wonder where this comes from?
You can type out "religious persuasion" but not "people"?
But there is no convincing otherwise, self righteousness runs deep.
If I were basing anything on something I made up, I might understand this accusation. I'm really sorry you can't understand my point of view, but it has nothing to do with self-righteousness.
Spidey's mom, ADN, BSN, RN
11,305 Posts
I'm thinking as a hospice nurse about your patient with the blackened limbs and the agonal breathing. There are ways we can give comfort care for your patient to die a peaceful and pain free death.
I really think we need to do more education about how we can handle the terrible deaths I do see or hear about in ICU's or other parts of the hospital where end-of-life palliative or hospice care is not practiced. I grant you that people are dying terrible deaths due to ignorance regarding what could happen as an alternative. Family members don't want to let go and physicians don't want to give up. We should do a much better job of education.
And honestly I didn't mean to imply that this is about clubbing seals . ..I was trying to give an example not related exactly to human beings to make it easier to understand where some of us are coming from. Maybe not the best example I guess but is not an example of self-righteousness.
Just sharing thoughts and ideas.