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.

[Nurse Leigh]

Let me clarify my views...I am opposed to euthanasia, but a very fervent supporter of assisted suicide.

The difference between the two interventions is choice: in euthanasia, the healthcare provider chooses to end one's misery, whereas assisted suicide entails acting upon the patient's informed choice to end his/her own life.

Healthcare providers are ultimately going to render value judgments about peoples' lives when they choose whom and whom not to euthanize. However, assisted suicide places the end-of-life decision in the hands of the patient.

Commuter, you and a few other members here are so great at putting *my own* feelings into words much better than I could!

I like learning from those with differing views but sometimes it is nice to be "around" people who think like I do on some topics. ♡♡♡

[mrsboots87]

Also, outside of opinions from others, a good argument for something will come from research data. Use your schools library resources to find research data on why physician assisted suicide would be beneficial. Then find some research why it would not be beneficial so you can use good rebuttal arguments.

[kbrn2002, ADN, RN]

First I would need to determine that you are truly arguing for euthanasia and not assisted suicide as your poll has both in the "for" option. These are very different things and my answer is very different for these two options.

In the case of euthanasia somebody other than the person that is dying is making that decision for them. That person may be their responsible family member and it will be with the agreement and participation of the health care provider. The decision might be made by some health care ethics committee. I do not agree with this as no matter who makes the decision it is taking the choice away from the person most affected, that is the person who will die.

Assisted suicide is another matter altogether. I am all for a person having the right to choose the time and the means of their own death when that death is inevitable and the end will be painful. Hospice is in my opinion the better choice for handling end of life issues but if an individual chooses assisted suicide after education and counseling on all options then that should be their right.

[Lev, MSN, RN, NP]

I am against it. I think that it makes people make a very difficult decision at a time that they are so vulnerable. When you are in pain and feel helpless emotions rule and you can't make a clearheaded decision. I also think people can be guilted into it by their families who don't have the emotional fortitude to care for them. In truth, I think it is impossible to consent for euthanasia unless you made the decision before illness set in.

I am all for hospice. Death can be a beautiful thing without "ending it" by swallowing a pill.

ETA: I see people are making a distinction between euthanasia (so called "mercy killings") and being given a pill to commit suicide.

I am against both. Unless someone made a decision about how their life will end before they became sick and miserable, a clear headed decision cannot be made. Terminal extubation is a completely different conversation. I do not agree with letting people linger on vents.

[nutella, MSN, RN]

Please check the American Nurses Association (ANA) and their position statement on euthanasia and assisted suicide. The ANA beliefs that euthanasia as well as assisted suicide violates the nurses code of ethics.

So given that nurses have to abide the code of ethics it is somewhat difficult to argue for this kind of action.

[MunoRN, RN]

I am against it. I think that it makes people make a very difficult decision at a time that they are so vulnerable. When you are in pain and feel helpless emotions rule and you can't make a clearheaded decision. I also think people can be guilted into it by their families who don't have the emotional fortitude to care for them. In truth, I think it is impossible to consent for euthanasia unless you made the decision before illness set in.

I am all for hospice. Death can be a beautiful thing without "ending it" by swallowing a pill.

ETA: I see people are making a distinction between euthanasia (so called "mercy killings") and being given a pill to commit suicide.

I am against both. Unless someone made a decision about how their life will end before they became sick and miserable, a clear headed decision cannot be made. Terminal extubation is a completely different conversation. I do not agree with letting people linger on vents.

I find the opposite to be true; it's only when someone is "sick and miserable" with a terminal condition that they can make a truly informed decision about how they want to deal with that situation.

And while we are capable of making the dying process minimally miserable, there are also times that despite are best efforts we can't minimize the suffering.

[Rose_Queen, BSN, MSN, RN]

Please check the American Nurses Association (ANA) and their position statement on euthanasia and assisted suicide. The ANA beliefs that euthanasia as well as assisted suicide violates the nurses code of ethics.

So given that nurses have to abide the code of ethics it is somewhat difficult to argue for this kind of action.

Not necessarily. My opinion is that the ANA is out of touch with what happens at the bedside. Just because they've issued a publication doesn't mean that all nurses have to comply without question. It's possible to change publications and position statements and laws.

[MunoRN, RN]

Personally I don't find that it's contrary to the overall ethical decision making process we allow patients to use every day. The determination process we normally accept has two parameters; quantity of life and quality of life. We allow patients to make decisions that might shorten the quantity of life in order to gain more quality of life, we also allow patients to make decisions that risk quality of life for quantity of life. We apply a value to quality of life and we recognize that this can be both a positive number and a negative number. We estimate what different decisions would produce in terms of quality multiplied by quantity, with the goal being to make the decision that gives the patient the highest number. When quality of life is a negative number, we allow patients to forgo measures that would provide more quantity of life because more of a negative value is worse, not better.

I find our sudden refusal to not take part in changing that calculation when it still fits the accepted parameters to be a bit fickle and selfish on our part.

[nutella, MSN, RN]

Not necessarily. My opinion is that the ANA is out of touch with what happens at the bedside. Just because they've issued a publication doesn't mean that all nurses have to comply without question. It's possible to change publications and position statements and laws.

Rose - you make a good point when you write that position statements and laws are subject to change plus that there may be a disconnect between bedside nursing and those creators of a statement.

I think that "suffering" can be very subjective - I worked in hospice where palliative sedation is an option to deal with suffering in an effective way when other options fail.

A couple of years ago I took care of a patient in a hospital who had a neuromuscular illness that had progressed. She got admitted for SOB and put on BIPAP. She came to a med/surg floor because there was no bed in critical care and she had stated that she would not want to be trached or intubated - though short term bipap was ok. In any way, they were unable to wean her off bipap and she made the decision to say "good bye" to her family and after that take off the bipap and die. But she wanted to be comfortable, which seemed more than reasonable to me. Her attending made the plan to medicate her with morphine and ativan iv once the mask was about to come off to help with the suffering related to extreme SOB. It turned out that family was not able to come that same day, people had to travel, so she planned to stay on bipap for one or 2 more days (can't remember exactly). Once that plan was in place nurses spoke up and felt uncomfortable and questioned everything. The attending stated that he only wanted volunteering nurses to take care of this patient during the end of her life as he did not want nurses to feel they were "killing" the patient. She died peacefully once everybody had come to say good bye. It was not the physician or nurse who administered the medication who killed her - the illness killed her - she turned purple from head to toe after a few seconds off bipap. But some people still thought that administering medication to relief the obvious suffering was equal to assisted suicide - there is so much confusion out there!

In my personal opinion nobody should suffer at the end of life and people should have options for assisted suicide if they belief it will allow them to choose the point of death without suffering in a terminal illness. But euthanasia has a bad taste for me.

[4boysmama]

The most recent issue of JAMA (the Journal of the American Medical Association) is dedicated to death, dying and end of life issues. There's very good papers arguing both sides of this particular debate - I would suggest looking for it through your university's allied health database and reading the entire issue. Also take a look at past issues of the Journal of Hospice and Palliative Care Nursing.

[offlabel]

Assisted suicide necessarily leads to euthanasia eventually. The two are not mutually exclusive.

But it's not just these two things. When a mindset becomes one of seeing the death of a human being as a solution to a perceived problem, there is no end to which one will not go.

[hppygr8ful, ASN, RN, EMT-I]

As you may be aware California just passed a law granting terminal patients to right to physician assisted suicide. I haven't read the whole thing but in essence you have to have terminal diagnosis confirmed by 2 doctors with less than 6 months to live. Then your doctor can prescribe a lethal dose of barbiturates or opiates that you can take when you are ready to go. I have mixed feelings on this but I know I wouldn't want to linger in pain and sometimes hospice just takes to long. If I could make the decision to go out on my terms I would do so.

Hppy