Euthanasia! your opinions needed please

[81shelbay]

Hi there I am a 3rd year nursing student. Our class at university have been asked to compile a debate for and against euthanasia/assisted suicide, our class has been divided into two groups and I have been placed in the group for. I have been appointed as one of the main speakers to argue our case and this is where I ask for your help. I would be very grateful if anyone can post their opinions on this matter and their reasons why? It can be for or against but because I am on the for team I would love to see if anyone agrees with it. I personally agree with some aspects of it but I am on the fence due to it being such a sensitive issue. The results from this post will be used in the debate but just the numbers of people not details etc... So opinions are very welcome thank you for reading, much appreciated.

[CHESSIE]

I do believe we should be able to use DNR Or to remove life support of someone who cannot recover. Actual euthanasia is an option I am not comfortable with. We can keep a patient comfortable but to actually take their life is a decision above us all! That one belongs to the Man in heaven.

The "man" in heaven? No, the decision should be that of the patient, if he/she so chooses. Patient autonomy should be honored.

[bluebonnetrn, BSN, RN]

I think this is a very interesting article. It is thorough and does a good job of representing the thoughts and feelings of each side. Here are a few quotes I find particularly interesting:

"In the past five years, the number of euthanasia and assisted-suicide deaths in the Netherlands has doubled, and in Belgium it has increased by more than a hundred and fifty per cent. Although most of the Belgian patients had cancer, people have also been euthanized because they had autism, anorexia, borderline personality disorder, chronic-fatigue syndrome, partial paralysis, blindness coupled with deafness, and manic depression. In 2013, Wim Distelmans euthanized a forty-four-year-old transgender man, Nathan Verhelst, because Verhelst was devastated by the failure of his sex-change surgeries; he said that he felt like a monster when he looked in the mirror. Farewell, everybody,” Verhelst said from his hospital bed, seconds before receiving a lethal injection."

"In terminal cases, two doctors need to confirm that the patient's suffering stems from an incurable illness. For non-terminal cases, three doctors must agree. But doctors have adopted increasingly loose interpretations of disease. Distelmans told me, We at the commission are confronted more and more with patients who are tired of dealing with a sum of small ailments—they are what we call ‘tired of life.' ”

He was screaming, ‘You went along with the madness of my mother! You went along with her tunnel vision, her defeatism. You've just taken away the suffering of one person and transposed it to another!' ”

"Although the latter concern blurs a fundamental distinction—under the Nazis, the sick and the disabled never asked to die—it was exacerbated by the fact that Distelmans led seventy medical professionals and scholars on a study trip” to Auschwitz last year. A brochure for the trip explained that for those who are constantly confronted with existential pain and questions about the meaning of life” Auschwitz is an inspiring place to contemplate these issues.”

http://www.newyorker.com/magazine/2015/06/22/the-death-treatment

[bluebonnetrn, BSN, RN]

sorry about the weird FONT markers - I don't know how to get rid of that

[floatingribs]

not sure if you're still reading these but what i find interesting is that many of these comments are b/c of the health care provider's (i.e. the nurses in this situation) beliefs. not the patient's beliefs or choice, but on pre conceived notions on what is okay and not okay. And while not all may be blatantly saying it's up to God etc, a big reason why so many people are against it is b/c of ideas that may have stemmed from religion without us even realizing b/c judeo-christian norms are pretty much integrated pretty soundly into the US as a whole.

I'm a practicing muslim, so I personally believe based on my faith and thus my view on life being influenced by it that I personally would not choose so for myself. BUT I'm sure as hell not going to put my beliefs or even mention them to a patient. B/c it's their life and that means ultimately their choice. And as nurses and especially in palliative care (which isn't always synonymous with hospice) is to make life as comfortable for the patient. If that means allowing the option of euthanasia no matter how uncomfortable you get you have to take a step back and realize, this is not your body, nor is it your mind so you can't understand the patient's logic behind it. It's not your job to 100% understand why, it's your job to give a well informed list of all options available and let the patient make a decision.

I find it fairly medieval that people say no just b/c they believe in God. The patient may not and the patient's wishes when their health is obviously declining should be respected. It's important to lots of people to die at their own terms and having the piece of mind that they had choice and were able to function to the level of their wanting whether it be for dignity or anything else in itself may be a therapeutic and uplifting thought to them. And if that alleviates the patient stress and makes them mentally more healthy then our religious views need to be kept to ourselves (regardless our relgious views and opinions on matters need to be kept to ourselves). The patient comes first. And tbh it makes you uncomfortable but the person on that bed thinking about death is prob more uncomfortable.

[That Guy, BSN, RN, EMT-B]

We all have to die someday. Why can't I decide when?

[MunoRN, RN]

How about ABC News? In 2008, a 64-year-old woman on the state-funded Oregon Health Plan (Oregon Medicaid) found out her lung cancer had returned. The state refused to pay for a $4,000/month drug her oncologist wanted to try, but it would pay $50 for assisted suicide meds.

I'm no fan of FOX News, but they covered her story and that of Randy Stroup. In 2009, he was 53, with prostate cancer. He was also on Medicaid, which refused to pay for chemo, but would pay for assisted suicide. He appealed, and got his chemo covered. His story is also in the documentary How to Die in Oregon.

I'm not sure where you're getting that these coverage denials were in any way related to the availability of PAS. (Or how this relates to a morphine OD)

Oregon health was a program run by the state of Oregon to provide coverage for the working poor who were not poor enough to qualify for medicaid but who also could not afford private insurance. Being state run, it cannot run a deficit, a certain amount is allocated each year and once it's gone, it's gone, so they had a system in place to make sure it was used for the most benefit. In the case of the lung cancer patient, she had multiple rounds of treatment paid for by the plan when there was a potential for sufficient benefit from treatment. The cancer that returned later was not treatable, except for a very expensive medication that at best might extend her life by a matter of weeks, she died after being on the medication for three weeks. Had the plan paid for this treatment it would have had to deny treatment to someone else who may have had the potential for much greater improvement.

If you've got two patients who need the same drug, and you only have enough money to give it to one of them, do you give it to the one who might have their life extended for a few weeks with the medication, or one who might have their cancer go into remission with the medication? Seems pretty straightforward.

But either way, this system of triaging limited funds existed before PAS was made legal in Oregon and had no effect on it.

[MunoRN, RN]

I do believe we should be able to use DNR Or to remove life support of someone who cannot recover. Actual euthanasia is an option I am not comfortable with. We can keep a patient comfortable but to actually take their life is a decision above us all! That one belongs to the Man in heaven.

I here the "when someone dies should be up to God" argument a lot, but it's pretty clearly not as true as people suggest it is when it comes to PAS.

Take for instance a patient who came in having an MI. If we apply the "God decides" argument at this point then we clearly shouldn't do anything to intervene, since God had decided this person is supposed to die of a heart attack. But of course this isn't how it works, instead we follow the "God helps those who help themselves" rationale and use the abilities God gave us to alter that situation.

The patient ends up requiring an IABP which results in a massive stroke. He is unable to eat but is able to confirm that he does not want a feeding tube, so the result is that we allow the patient to starve to death. We refuse to avoid that experience through an intervention because suddenly we don't believe we should alter God's intentions, even though it was our failure to do that which directly led to the situation the patient is in now.

It's seems be this fickle application of this standard is a response to our desire to deny the fact that people can suffer beyond our ability to treat that suffering, so if we just refuse to do anything about it then it doesn't exist.

[Libby1987]

I here the "when someone dies should be up to God" argument a lot, but it's pretty clearly not as true as people suggest it is when it comes to PAS.

Take for instance a patient who came in having an MI. If we apply the "God decides" argument at this point then we clearly shouldn't do anything to intervene, since God had decided this person is supposed to die of a heart attack. But of course this isn't how it works, instead we follow the "God helps those who help themselves" rationale and use the abilities God gave us to alter that situation.

The patient ends up requiring an IABP which results in a massive stroke. He is unable to eat but is able to confirm that he does not want a feeding tube, so the result is that we allow the patient to starve to death. We refuse to avoid that experience through an intervention because suddenly we don't believe we should alter God's intentions, even though it was our failure to do that which directly led to the situation the patient is in now.

It's seems be this fickle application of this standard is a response to our desire to deny the fact that people can suffer beyond our ability to treat that suffering, so if we just refuse to do anything about it then it doesn't exist.

Exactly.

And the irony is how barbaric we can be. Posters on this site have stated repeatedly that they wouldn't participate in PAS and especially not euthanasia but how many of us have participated in practices we felt horrible about because the family insisted.

If we can compromise our ethics when we're directed to towards that end, why can't we allow someone to make their own choices?

[Cactus Nurse]

I am for it and have been for as long as I can remember. Especially now more than ever. My boyfriend is a c1-c5 spinal cord injury. He can move only a little of his shoulders and head. It's going on 5 years. Although the my boyfriend can eat anything, thank goodness no g-tube, we go out almost whenever, he has his own van to travel in, he lives in a great place which is a home setting and his own private bedroom, at the end of the day my boyfriend can't walk or use his hands.

It it kills me knowing how frustrated he gets sometimes and sad he gets. When we first met he told me if he doesn't get better in a year or 2 he would do it....... We've been together over a 1 year and if it wasn't for me in his life who knows if he would have done it.

Sometimes people don't give up trying, but they see that hope might be impossible and the pain now is so bad that they don't want to "do it anymore".

My my boyfriend feels trapped in his own body. Who would want to feel that pain everyday? He doesn't know if he might ever get better, so secretly I know it's in his mind when he has a bad day. I understand and I can see why people would go through with it. It's their life and they are the only one who knows what they are going through.

that's my say when the person is physically making their own decision.

[SmilingBluEyes]

How to Die in Oregon

WOW poignant. I recommend everyone watch that.

[LadysSolo]

My mom (who was a brilliant woman) died of Alzheimer's, and her mom died of Alzheimer's, so my guess is I will get it too. She knew she was getting it, and she told me she had Alzheimer's. There were days when I looked into her eyes, and she was still there but could not make herself understood due to the disease. There were other days when "she wasn't home." I never want to go through losing myself and putting my family through that. When she was getting worse, I wasn't sorry for me because I knew what was going on, I was sorry because I knew she never wanted to be that way. She was "Mrs. Clean," scrubbed her garage floor weekly even in the winter, and to not have control of her bowels and bladder I am sure was devastating to her. If I am unable to "be myself," active and taking care of myself, I DO NOT want to be here, and I should have that right.

[sharkdiver]

I'm not sure where you're getting that these coverage denials were in any way related to the availability of PAS. (Or how this relates to a morphine OD)

Oregon health was a program run by the state of Oregon to provide coverage for the working poor who were not poor enough to qualify for medicaid but who also could not afford private insurance. Being state run, it cannot run a deficit, a certain amount is allocated each year and once it's gone, it's gone, so they had a system in place to make sure it was used for the most benefit. In the case of the lung cancer patient, she had multiple rounds of treatment paid for by the plan when there was a potential for sufficient benefit from treatment. The cancer that returned later was not treatable, except for a very expensive medication that at best might extend her life by a matter of weeks, she died after being on the medication for three weeks. Had the plan paid for this treatment it would have had to deny treatment to someone else who may have had the potential for much greater improvement.

If you've got two patients who need the same drug, and you only have enough money to give it to one of them, do you give it to the one who might have their life extended for a few weeks with the medication, or one who might have their cancer go into remission with the medication? Seems pretty straightforward.

But either way, this system of triaging limited funds existed before PAS was made legal in Oregon and had no effect on it.

Took the words right out of my mouth. The alleged actions had nothing whatever to do with DWDA.