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?
And frankly, your nastiness seems strong enough that you might want to report to BON for "psychologically being unable to do the job" with some "anonymous call" (yes, people can be that nasty, so watch out) so I'm also glad this is an anonymous forum, without enough personal-info out there for you to do so.
As a person with a mental illness, I think it should be made clear that there are different levels of illness, in relation to work. There are those with mild forms, those that with minimal to moderate disease that stay relatively stable and can easily stay employed safely. And there are those that have extreme difficulty being stabilized, to the extent that their current job may no longer be suitable, and changes need to be made. This the same with many illnesses, like strokes/TIAs, cardiac disease.
In addition, there are some who so dislike the meds, the visits to psych, the treatments, the lifestyle changes required, etc., that they choose to limit or neglect treatment. As long as they pose no harm to others, or theirselves, they may often do so. However, many mental illnesses interfere with normal function, especially employment in some functions, such as healthcare. As this can pose distinct dangers, to others that are unacceptable.
There are no laws against mental illness, however, if one mentally ill person's actions pose a significant danger, the individual may be held/admitted to a healthcare facility. The medication and the hold are not punishment, they are treatment or protection.
I have dealt with a number of mentally ill people, including my sister. I have been present during some of her episodes, and afterwards, heard her tell stories of what happened that completely false. I have had pts where the nurses went in the room, by 2 or 3, because of the stories that the pts would tell about individual care after the fact.
Mental illness is in no way illegal nor is suicidal ideation. One believing such does not make it real.
DNR may actually be based on good medical practice. I have recently have dealt with several (sad) cases, of young pts with refractory cancers that were not so much incurable as untreatable, due to comorbidities. There was acute bone marrow suppression with pts that were severely refractory to platelet transfusions. Severe lung damage and cardiac dysfunction including major right sided heart failure, refractory to numerous treatments. When code status was addressed, cardiology explained that staff could do CPR for hours, because of the permanent damage, the blood would still not circulate, and it would only damage things. With plt cts of 1k or less, intubation would damage the airway, and artificial vent either would set to low to help adequately, or if on higher settings would probably further damage the lungs and/or cause such bleeding that the pt would drown in her own blood and secretions.
There are times that "full code" is the more destructive treatment, and "DNR/DNI" is the best most appropriate treatment.
I would hope and pray with all my heart, soul, and mind to NOT have a nurse with this outlook, were I to be at the end of my life. Give me hospice PLEASE!
Back before Hospice existed, I worked at what was known as a "Chronic Disease Hospital". Had a pt w/ rampant metastasis. She was 'allowed' to have a small dose of morphine via injection Q6 hrs, but only if her resp rate was above 12. So, her resp rate was between 10 and 11 ( I counted SEVERAL times.) It was 1/2 hr until her next shot was due, and back then they were sticklers about not giving anything a minute earlier than ordered. There was no 1/2 hr on either side of the dose time for pain meds.
She was moaning and moaning, I asked her about her pain (no pain-level parameters 1-10 back then either) and she moaned louder. I went and got her puny dose of morphine and gave it to her. She died within 45 minutes. I only hoped that the morphine eased her passing just a little bit; it sure wasn't the cause of her death.
I also witnessed at that hospital a patient who had to have her hip and leg removed due to bone cancer. Well, it had spread to her spine as well. She would scream "SOMEBODY KILL ME PLEASE!KILLLLLMEEEE!" all hours of the day and night. Her morphine shot was also a strict Q6 hrs. The nurses would close the door of her room, so she wouldn't "disturb" the other patients.
But, by gawd, she was as lucid as could be, so I guess that's okay.
I remember working in a hospital a while back and we had patients that started out as DNRs, went through treatment, found out that there condition was terminal and that their death was soon and inevitable. Sometimes the doctors would still be writing orders for tests/treatments where the results would be useless. The patient and/or the family expressed that they didn't want anything else to be done, that they wanted to die in peace. At this time the MD could be contacted and they would give an order for CMO status and if the patient wanted pain medication sufficient to ease the pain regardless of what the side effects were (as in decreased respirations), since they were CMO we could still give the medication if requested by the patient/family. I remember some nurses that would state, "I can't give it because their respirations are too low"....um, they are comfort measures only. We are literally waiting for them to die (not getting transferred to another facility for end of life care). The patient is in serious agony with their pain and their respirations are going to ultimately stop while they are here anyways. MEDICATE THE POOR PATIENT! There's an order and they are dying and in pain. The doctor finally wrote an order that should not have needed to be written. "give patient pain medication if requested during the time frame ordered. DO NOT HOLD for decreased respirations/respiratory status. Patient is DNR and CMO". If a nurse ethically does not feel comfortable giving the medication for what ever reason then they should be allowed to be taken off the assignment and have the patient reassigned to some who is okay with the situation.
When someone is on their deathbed I do not view giving pain medication to ease the process euthanasia. Rather, I view euthanasia as someone who is chronically (possibly terminally ill but not dying anytime soon) and having the desire to end their life at the time that they chose with the method they desire. I think that should be a choice if they particularly want it after counseling to make sure that they understand what the prognosis of their condition and the decision that they are making to end their life. I personally could not administer it, but I'm sure there are some that could if it were legal. It's that person's life and they should have the right to choose what they want to do with it.
I didn't read all the comments, but anyone who has worked in critical care or geriatrics for any length of time will agree that quantity does not equal quantity. I have tortured patients to death (with procedures and treatments) because their families couldn't let go.
I think it's mercy in instances of things like ALS, not necessarily for terminal conditions. I think, like what was mentioned above, the conversation should switch toward more wise use of care and not trying all these crazy heroic measures to sustain life. My grandmother had a double bypass 6 weeks prior to her death at the age of 83. WHY? Who knows....? But did it really increase her lifespan while decreasing her suffering? Absolutely not. I believe the same thing is true with cancer. Unless a person really knows what they are in for, there should be more restraint in radical procedures and chemo after chemo after chemo....we should just be more honest about dying so that people can be spared the long, agonizing deaths with lives artificially sustained for no reason. We really should be more confrontational about death. We are in such denial with the result being horrific suffering extended for nothing. In the sober light of reality and outside of the emotions and grief, why do we keep people alive this way?
Specializes in Med nurse in med-surg., float, HH, and PDN.
I think it's mercy in instances of things like ALS, not necessarily for terminal conditions. I think, like what was mentioned above, the conversation should switch toward more wise use of care and not trying all these crazy heroic measures to sustain life. My grandmother had a double bypass 6 weeks prior to her death at the age of 83. WHY? Who knows....? But did it really increase her lifespan while decreasing her suffering? Absolutely not. I believe the same thing is true with cancer. Unless a person really knows what they are in for, there should be more restraint in radical procedures and chemo after chemo after chemo....we should just be more honest about dying so that people can be spared the long, agonizing deaths with lives artificially sustained for no reason. We really should be more confrontational about death. We are in such denial with the result being horrific suffering extended for nothing. In the sober light of reality and outside of the emotions and grief, why do we keep people alive this way?
The first time I experienced the "too much morphine" order I had come on to work and this man who was admitted on hospice but very healthy (lung cancer); I estimated a couple weeks for him to start to go. He had gotten an order from the doc to put on yet another 100 mcg fen patch. I was mad and said he'll die like that and took off one of the patches after calling the doc and asking him if he was aware that he was killing his patient (the patient was barely breathing)... I was so naïve. I later learned he told the doc he wanted to go.
I was off for the next 2 days and when I came back they had put the patch back on and he died 1 day after. Don't get me wrong, I am a hospice nurse at heart and have attended multiple morphine deaths after realizing that the people really wanted it. Sometimes it's a slow increase and sometimes it's not, sometimes it's truly their time to go. I want to be able to have that choice...
Killing people with intentional overdoses is NOT HOSPICE. That's the opposite of hospice. If you want to do that, move to Oregon, or hey, some places in Europe even allow you to murder children if that floats your boat.
The first time I experienced the "too much morphine" order I had come on to work and this man who was admitted on hospice but very healthy (lung cancer); I estimated a couple weeks for him to start to go. He had gotten an order from the doc to put on yet another 100 mcg fen patch. I was mad and said he'll die like that and took off one of the patches after calling the doc and asking him if he was aware that he was killing his patient (the patient was barely breathing)... I was so naïve. I later learned he told the doc he wanted to go.
I was off for the next 2 days and when I came back they had put the patch back on and he died 1 day after. Don't get me wrong, I am a hospice nurse at heart and have attended multiple morphine deaths after realizing that the people really wanted it. Sometimes it's a slow increase and sometimes it's not, sometimes it's truly their time to go. I want to be able to have that choice...
I doubt very much a 100 mcg fentanyl patch "killed" him.
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ixchel
4,547 Posts
Is this a threat???