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?
What about the folks who can't be made comfortable? I don't mean would you give a lethal dose but would you be as adamantly against it occurring?
I've only had two patients who were truly difficult to manage regarding pain and breathing issues. There is an option for palliative sedation but that's controversial as well.
It's delightful to read through this thread and meet the individuals who feel so strongly that I must live, regardless of my personal values and desires. Thank you. Your concern for me and all of humanity is positively heartwarming.
You don't know me, haven't ever done a thing in the world for me, and would probably step over my dying body if I fell in the path of a white sale at KMart... but feel absolutely comfortable in dictating that I don't ever find it within my legal or "moral" power to check off this rock on my own terms.
Keep fighting the good fight 'til the end. Your reward awaits. I'm sure it's exactly as described in [insert name of chosen book]. The important thing is that you spend your days imposing your beliefs on the lives of others and working to decide what choices they are given. That's true service.
It's 100% related to me being Catholic. Human lives are not ours to take, not even our own. Obviously I believe in palliative care. I disagree that dying naturally lacks dignity. Euthanasia and assisted suicide advocates call their cause "death with dignity" and that really pisses me off. Hospice is all about respecting dignity and preserving it as well as possible for our patients. I think the attitude of prettying up suicide and murder with terminology like dignity both comes from a utilitarian view of human life and is used as a marketing strategy. Who doesn't want dignity? Just don't peep under that he surface at all those ethical issues.....
I saw an article recently that articulated my thoughts really well. I'll find it and post it.
This is why it's important that euthanasia not be illegal, but a regulated and strictly dispensed CHOICE.
For those who's belief system this violates, they are completely protected simply by choosing not to. Believers in general have differing beliefs than other believers. In my experience, the biggest differences in 'how it's OK to die' have been between ethnicities, rather than Catholics and non-believers. In my experience people of Asian descent are less willing to accept a DNR and/or palliative care. According to my friend a work from the Philippines, she said she KNOWS better than this but the belief in her culture is strong -- a DNR means 'giving up on the person' and you must NEVER give up, even if you live an extra two days in misery, it's 'better', it shows you never stopped trying. I had this experience with an American Chinese family (the daughter of the patient was my coworker). The patient had been battling pancreatic cancer for over a year, and was brought into the hospital with pain out of control and not quite actively dying. Her daughter (an RN) was extremely torn between what she 'knows' as a nurse and her family's experience and beliefs about death and dying.
Euthanasia is going to be more acceptable with certain ethnic groups than others, which is another reason it must be a strictly controlled choice.
My moral limitations apply to me and my practice. I will politically advocate against laws with which I disagree, in full understanding that my side may lose.
How does that work if you are voting on this at the next election? Completely honest question. You disagree on principle (due to religious beliefs) and would never want this option yourself. Is it ethically wrong, for you as a Catholic, to vote 'yes' although you'd never want or choose this option for yourself or a loved one?
I'm just glad that a religion does not dictate my practices. I am pro-choice if it is abortion or what we currently refer to as "physician assisted suicide". I want to have a say over my body and what does or does not happen to it. My husband and I have already planned a move to a state that allowed P.A.S. if one of us is diagnosed with a terminal illness. Hospice has its place, but it is not for everyone. "Physician assisted suicide" is merciful, but it has flaws as well.
You are engaging in philosophical debate on a message board where colleagues can share honest and unfiltered opinions. This does not mean any of us would impose our beliefs or values on another person. As a consumer of healthcare, you have the right and ability to seek care from a provider agreeable to your wishes. In fact, if you don't do that, you are doing yourself and your providers a disservice.
You will read honest opinions here because we are speaking colleague to colleague. Should I, or Red, be face to face with a patient who opposed our views, I'm certain we both would understand that that would not be an appropriate time to climb on the soap box. But now? Here? We are free to be honest. This is not a debate that has an easy yes or no, and each of us bases our thoughts on this in different belief systems and life experience/knowledge. Neither Red nor I am wrong. Our opinions differ. I respect that, and am thankful for the ability to learn more from Red's point of view.
It pains me to read the religious blaming of a person's decisions. Especially on a healthcare webpage. I do believe that religion is important no matter what you practice. But each one of us on this website have no room blaming religion for our decisions. If you all believed that it is up to God or whatever Deity you worship than none of you were to practice any form of healthcare. If the decision was up to "___" than the wellbeing of that person as well would be up to "___". If a patient were to come in and not be able to breath on their own, therefore in need of a ventilator, it would be against your religious beliefs to give it to that person because if it was truly up to "__" that patient would have passed of natural causes. We practice what we take from our religion, a pick and choose process. We are all guilty, so why should my pick and choosing impose on your picking and choosing? Just because my beliefs are how they are does not mean that everyone else's ability to make decisions should go away. Not to mention religion is not supposed to be brought into legal issues, especially with the array of religions within our country. I am not saying that it doesn't happen, I am just simply stating that it shouldn't. Sorry, all of these religious posts were bugging me. You can't say I am "this" so I don't believe in it, when you are a portion of "this" you choose to believe. I am Christian but just because I believe in Euthanasia does not make me any less Christian, it just shows I interpret my religion differently from others who claim Christian and do not believe in Euthanasia.
The intentional, directly intended taking of human life, when not done in self defense, is wrong. Period. All human lives, even those society deems worthless.
That's your opinion, not the absolute truth. Helping someone die with dignity is also a moral imperative, in my opinion (and following the person's wishes, of course. Not by my decision.)
Edit: I see by your other posts that we actually agree on this. Sorry for jumping on this one statement. I work hospice too and fully support end of life care for everyone, whether terminal or not. I also support autonomy and believe we should have the legal ability to choose when we die.
Sent from my iPhone -- blame all errors on spellcheck
It's delightful to read through this thread and meet the individuals who feel so strongly that I must live, regardless of my personal values and desires. Thank you. Your concern for me and all of humanity is positively heartwarming.
You don't know me, haven't ever done a thing in the world for me, and would probably step over my dying body if I fell in the path of a white sale at KMart... but feel absolutely comfortable in dictating that I don't ever find it within my legal or "moral" power to check off this rock on my own terms.
Keep fighting the good fight 'til the end. Your reward awaits. I'm sure it's exactly as described in [insert name of chosen book]. The important thing is that you spend your days imposing your beliefs on the lives of others and working to decide what choices they are given. That's true service.
To those getting offended -
You are engaging in philosophical debate on a message board where colleagues can share honest and unfiltered opinions. This does not mean any of us would impose our beliefs or values on another person. As a consumer of healthcare, you have the right and ability to seek care from a provider agreeable to your wishes. In fact, if you don't do that, you are doing yourself and your providers a disservice.
You will read honest opinions here because we are speaking colleague to colleague. Should I, or Red, be face to face with a patient who opposed our views, I'm certain we both would understand that that would not be an appropriate time to climb on the soap box. But now? Here? We are free to be honest. This is not a debate that has an easy yes or no, and each of us bases our thoughts on this in different belief systems and life experience/knowledge. Neither Red nor I am wrong. Our opinions differ. I respect that, and am thankful for the ability to learn more from Red's point of view.
Open your minds, loves.
ixchel . . . .thank you. I was getting ready to make the same comments.
I've been really pleased by this thread as I've been an allnurses member for a long time and can see how quickly some subjects can degenerate into animosity.
Bringing all thoughts about this into the mix is a great idea and in my opinion, so far, has been a fascinating look at this controversial subject.
I truly don't think that those of us with qualms about euthanasia or assisted suicide would ever walk over a person's dying body in front of a K-Mart white sale . . ... that's simply not a fair statement.
Let's keep it focused on the subject and not the poster. And continue to have a great discussion about this touchy subject.
As to hospice, we do have to do a better job of getting the word out about what hospice does. People have a false impression of hospice. This may contribute to how many people suffer at the end of their lives. We could and should do a better job - in medical school teaching doctors about hospice and in nursing school as well.
Despite recent growths in hospice awareness, access, and utilization, myths about hospice are still prevalent in our culture. These misconceptions contribute to the under-utilization of hospice services. Only 36% of people who died in 2006 died on hospice care. This is unfortunate, since so many patients who are in need of expert pain and symptoms control, as well as emotional, social, and spiritual support, don't receive them. ​What are these myths that are so detrimental to the care of the dying?
Hospice may not legally require a DNR but my experience with referrals is that the patient/family need to be in that mind space.
That rule changed a few years ago because this was one of the things keeping people from signing up for hospice. As the article states, no one should be forced to make that kind of decision to sign up for hospice. In my experience, as time goes on and we educate the patient more and they begin to trust us, that DNR does get signed.
As the article mentions, we need to introduce hospice much earlier than the stats show now. Helping someone in the last few weeks is good but starting much earlier is better.
There's the rub with hospice . . .many docs are not ready to "give up". So we need to do a better job of teaching doctors about palliative care and hospice. Dr. Ira Byock does this very well.
We do talks around our community explaining hospice (Rotary, local veteran's groups, churches). We also have to encourage our local docs sometimes.
IME it isn't the physicians as much as families not wanting to stop treatment for either terminal cancer or end stage chronic illness, or not qualifying. Not qualifying is a big one for non cancer dx's.
I'm a pusher when it's appropriate and the patient/family would benefit from the services and support. I routinely set up informational visits but it's either the family who isn't ready or the patient doesn't yet qualify. Trying to get an end stage chronic illness to qualify weeks/months in advance is very difficult and uncommon. By the time they do meet admission criteria they will have only benefitted from short term services before they die.
A particular case of mine, direct referral to hospice by ER doc, I do the discharge paperwork (home health) and think the patient is squared away. But I get a call from family the next day in near hysterics. "Patient is dying but they say he doesn't qualify.
I call the on call nurse and first say, what the hell??? Then explained and pleaded. She promised to visit the patient asap, was getting in her car, and would push hard for admission. He was admitted, and died the next day. But not before one horrific night of the wife all on her own because of the hospice's refusal to admit.
That was the worst gross example but I've had many less dramatic ones.
Spidey's mom, ADN, BSN, RN
11,305 Posts
I've only had two patients who were truly difficult to manage regarding pain and breathing issues. There is an option for palliative sedation but that's controversial as well.