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 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.
That's interesting, I would have guessed the opposite. Collectivistic cultures tend to have high suicide rates in the ill as people do not want to be a burden to their loved ones and do not want to be in an undignified, weak state. Interesting that does not seem to extend to PAS.
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.
I agree that it is families and physicians. That's why we try to do education in both realms.
Docs are trained to save people . . . .Dr. Byock talks about how hard it is to get a physician to change that mindset.
People are afraid of hospice - they think we come in and kill their loved one with the dreaded M O R P H I N E.
We have a lot of work to do regarding educating on palliative care and hospice. I really think that is the direction to go instead of, as previously stated, jumping right to euthanasia and assisted suicide.
I love what I do and that's amazing to me as I had a fear of death and dying before becoming a nurse. I'm grateful for the change in my mindset. I've had amazing experiences with hospice.
One gentleman with esophageal cancer came to us in what we all thought were his last days. He was curled up in the fetal position in terrible pain. Our first goal was pain control. We started a CADD Pump which delivered SQ Morphine at a continuous dose and then we had a bolus dose available for breakthrough.
We were happy with the results because the pain lessened from 9/10 to 3/10 which the patient felt was manageable. He ended up being able to get out of bed. He was able to eat again. He actually lived another year and was able to see two important goals realized. He saw his granddaughter born. He took his grandson to our local fair.
He was on what many would consider astronomically high doses of MS but was able to go out with friends into the woods and cut firewood.
That pain had simply gotten the better of him - he wasn't at death's door. We were able to give him a gift of reducing the pain so he could see some of his goals achieved.
We got a framed photo of him standing next to his grandson on the carousel at the fair. Every time I look at that photo, I am grateful for my job as a hospice nurse.
Would he have achieved those goals if he'd been offered a way out of the pain that meant instant death?
I really think hospice has a lot to offer. But then I'm biased.
Glycerine, what you describe is not euthanasia or suicide. It's choosing to accept the inevitable consequence of disease. I don't know if medication counts as an extraordinary or heroic measure, but when someone is taking 10, 15, 20 pills a day, I think we might consider it to be.
Right, which was my point. She had no options available to her, she wasn't terminally Ill and her doctor couldn't or wouldn't d/c her meds, make her comfortable and let nature run it's course. I"m positive that she would have elected euthanasia if it had been a possibility, and I can't say that I would have blamed her because it would have been more humane than what she went through.
It doesn't matter whether it's one's religion, conscience, philosophy, personal experience, or whatever else drives them to make a decision. Don't assume that if religion is the basis for one's decision-making that they are like a blind sheep. Many religious people are great critical thinkers and search their souls and choose to adhere to the tenants of their religions because it also aligns with who they are inside as an individual. Conversely someone who does not use religion to make decisions is not assumed to be immoral, even if those decisions do not align with those of the religious person.
As nurses the intent of all of us to is to comfort the patient through every stage of life. Even if we are on different sides of a debate, I am honored to belong to a community who seems to always put the patient first, even if the issues are tough and the lines are not well-defined. Having these debates makes me think, makes me decide what my feelings are, and it's valuable to me even if I don't agree with everyone.
I agree that it is families and physicians. That's why we try to do education in both realms.
Docs are trained to save people . . . .Dr. Byock talks about how hard it is to get a physician to change that mindset.
People are afraid of hospice - they think we come in and kill their loved one with the dreaded M O R P H I N E.
We have a lot of work to do regarding educating on palliative care and hospice. I really think that is the direction to go instead of, as previously stated, jumping right to euthanasia and assisted suicide.
I love what I do and that's amazing to me as I had a fear of death and dying before becoming a nurse. I'm grateful for the change in my mindset. I've had amazing experiences with hospice.
One gentleman with esophageal cancer came to us in what we all thought were his last days. He was curled up in the fetal position in terrible pain. Our first goal was pain control. We started a CADD Pump which delivered SQ Morphine at a continuous dose and then we had a bolus dose available for breakthrough.
We were happy with the results because the pain lessened from 9/10 to 3/10 which the patient felt was manageable. He ended up being able to get out of bed. He was able to eat again. He actually lived another year and was able to see two important goals realized. He saw his granddaughter born. He took his grandson to our local fair.
He was on what many would consider astronomically high doses of MS but was able to go out with friends into the woods and cut firewood.
That pain had simply gotten the better of him - he wasn't at death's door. We were able to give him a gift of reducing the pain so he could see some of his goals achieved.
We got a framed photo of him standing next to his grandson on the carousel at the fair. Every time I look at that photo, I am grateful for my job as a hospice nurse.
Would he have achieved those goals if he'd been offered a way out of the pain that meant instant death?
I really think hospice has a lot to offer. But then I'm biased.
In my setting it is not the physicans, most agree when it's appropriate. It's the qualifying that is the problem. There is no other form of palliative home care services other than hospice in my area. If they don't meet admission criteria even if they want and need palliative care they cannot get it.
That is another area to focus on, adjust the qualifying criteria for end stage chronic illness and we can increase the number of patients who die at home with hospice versus the hospital.
Thank you, ixchel! OP asked for opinions, and is getting opinions. For some of us, faith/religion informs our worldview; this should not be a shock. I don't think for any of us who identify as pro-life have advocated for delaying death at all cost. We have said that we couldn't have a part in actively euthanizing a person. And that is our right. All of us have advocated for proper palliative care. I'm not sure what the issue is.
Do patients have the right to their autonomy? Of course. And in this hypothetical situation, if it came down to a plan to push 50U of insulin, we RNs also have the right to quietly go to our charge nurse and say "I can't have a part of this, but I will switch assignments with anyone who can." Nobody is talking about chaining ourselves to the Pyxis.
I'm honestly not sure what the issue is. We have the right to our opinions and our autonomy--as long as we agree?
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.
In my setting it is not the physicans, most agree when it's appropriate. It's the qualifying that is the problem. There is no other form of palliative home care services other than hospice in my area. If they don't meet admission criteria even if they want and need palliative care they cannot get it.
That is another area to focus on, adjust the qualifying criteria for end stage chronic illness and we can increase the number of patients who die at home with hospice versus the hospital.
Absolutely agree. We had a very elderly resident pass away recently, family wanted Hospice care at the end and unfortunately terminal old age is not an accepted diagnosis. Fortunately her MD is the very understanding sort and came up with a qualifying diagnosis so Hospice was involved and their support was very much appreciated by the family.
Will add here before somebody accuses the doc of being unethical in making up a diagnosis. It was end stage CHF..maybe a bit of a stretch since she hadn't been previously diagnosed with CHF but at that point there is no doubt she was suffering heart failure.
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?
Short answer: yes. It is wrong for a Catholic to vote for laws that actively work against protecting and preserving human life. It can also be wrong for a Catholic to vote for politicians who advocate such laws, however, if there is no truly pro-life alternative, it can be morally acceptable to determine which politician is the least morally offensive to vote for. And let's be honest, when we vote, regardless of election, aren't we really just determining which candidate is the least offensive?
Its not my job to decide who should die or who should live. I personally would want no parts of it. If you want to kill yourself, you have that right but, I also have the right to NOT participate in it.
Furthermore, murder by definition is the "illegal killing"..so if its illegal in your state then Yes, its murder.
As others have said, I think it's important to differentiate PAS from euthanasia. I have absolutely no issue with PAS. I feel that a patient should have the autonomy to decide if, when, and how to end his or her life if suffering from a terminal or debilitating illness. I would have no trouble prescribing for such a patient (after much discussion) if PAS was legal in my state. I am on the fence with euthanasia. I feel strongly that hospice and palliative care should be discussed much earlier in the disease process, and that these services can often significantly ease suffering and allow a natural comfortable death. I also have seen circumstances where no amount of medication can ease a patient's suffering. In those cases I believe euthanasia could be an option, provided it had been discussed with the patient/patient's family prior to the patient becoming incapacitated. I don't think it should ever be decided by a health care provider. Could I administer the medication? I think maybe I could, if the patient was suffering. I do not believe in preserving life at all costs. I do believe in preserving quality of life, and sometimes there is no quality, only suffering. That is not life, in my opinion.
We allow our animals the right to a pain free death yet our human family members sometimes suffer unimaginable discomfort while dying. It doesn't say much for us as a society. I am all for assisting with a pain free dignified death.
ShelbyaStar
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That's interesting, I would have guessed the opposite. Collectivistic cultures tend to have high suicide rates in the ill as people do not want to be a burden to their loved ones and do not want to be in an undignified, weak state. Interesting that does not seem to extend to PAS.