How do you feel about the right to die?

Specialties Geriatric

Published

I was just curious as to what other LTC nurses thought about the right to die? I am very supportive of someones rights to die with dignity. However I am quite uncomfortable with a current situation at work. We have a pt. who has a g-tube. Has had for two years now. The pt. is alert, can communicate with facial expressions, and yes or no answers, is usually smiling and waves and winks at the staff. Also holds staff's hands when staff is careing for the pt. The family has decided to pull the g-tube and let the pt. die. The pt. has no living will, and the family is insisting that the pt. "would not want to live this way" I do not know if anyone has asked the pt if he/she wants to pull the tube. The family is very supportive and visits daily for the last two years. But I do know that the dr. order has been obtained to remove the tube. I know there are many ways to look at this subject. I had a Dr. tell me once that after the first 48 hours the person does not feel hunger pains anymore. I just don't know how I feel about this. What are your thoughts?

Specializes in Corrections, Psych, Med-Surg.

"How do you feel about the right to die?"

Kind of a funny question when you think about it. Death is not a "right" any more than gravity is a right. It is simply built in.

The real question is "Just how does any governmental or other agency think it has the right to prolong anyone's dying against his/her will?"

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Specializes in ICU.

Look in your criminal codes we have a section called "Failure to supply the necessities" and it forbids anyone in a caring situation from withholding the "necessities for life and health". This is a very ancient act and was inherited from English law which is why I think you may have one similar.

It caused us legal problems until the "advanced Health Directive" act was brought in.

As to how to find this legislation - try searching your local library or contact your local union/professional organisation.

No one should be forced into the situation of withholding basic requirements of life from a patient if that patient has no say in the matter.

I work with a wonderful Cardiologist who always asks any elderly patient what they would wish to happen in the case of a cardiac arrest. I heard her instructing a new resident the other day on how to best broach the subject while reasssuring the patient that we were still going to give them full treatment otherwise.

I have to admit though, she is the first cardiologist I hav met who consistantly does this and certainly the first to make it a regular teaching point for residents. The end result is that we have quite a number of patients who maybe for active resuscitation but not ventilation - i.e. DC shock but no tube please or they may be total DNR but it lets the PATIENT decide.

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I am 100% for pain control and comfort measures. Personally I feel that for someone who already has a tube placed their feedings are a comfort measure. Now placing a tube in someone who wants comfort measures only is a different story. If the Pt is in anyway able to communicate with competence then it should be her call. I had a family like that once who basically in my oppinion wanted to hasten their mothers death. I did not agree with the order that the son was able to obtain from the dr and I refused to follow the order. I was transferred to another unit until her death. All my documentation and copies of t.o. orders I had taken disappeared. Needless to say I no longer work at that facility. I agree there is a huge difference in providing comfort and murder. JMO

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Just an update: After much thought the family decided they did not want to remove the tube, they did however d/c a lot of meds. Thankfully the family decided against this.

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He has the right to have the ventilator removed.

There was a great play about this written back in the 70s, "Whose Life is it, Anyway?"

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Another great movie I loved regarding this subject is called "The Sea Inside". It's also a true story about a Spanish man and his fight against the government of Spain and the Catholic church. Very moving. It really changed my heart on the subject of "death with dignity".

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During my years in LTC nursing I saw over and over again, many MD orders that were written to hasten the patients death. No outward signs of pain,allthough if the patient is non communicative, except for moans, grimaces, etc, who knows? I took care of a patient with such orders and I did feel a bit creepy giving the medication as ordered and the family INSISTED, but then again if it were my loved one.....

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There is a dark comedy called "Grace Quigley." It stars Katherine Hepburn and Nick Nolte. Even though it's "cute" you can see the truth in it.

Our instructor in nursing school had us watch it. It makes you think about life and when it just isn't worth living anymore.

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Specializes in nursing home care.

It truly is a difficult subject, if the patient is able to reach out or squeeze a hand, I would suggest he is able to use this method to answer specific questions, he is obviously aware of his surroundings. I remeber a difficult scenario concerning an alzheimers patient, she stopped eating, would refused to eat anything, no concerns about food poisoned or anything like that - she just said she didn't want it. The nurses were in 2 minds, some said she should be sent to hospital for iv fluids at least, some said like me that we should respect her wishes. She died peacefully a couple of weeks later and the thing that sealed we made the right decision was - her brother died on the same day literally hours before. Her choice paid off and brought great comfort to the family.

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Specializes in OB, M/S, HH, Medical Imaging RN.
What gets me is the full codes on some of these poor bedridden folks that are about 90# dripping wet with no quality of life.

Many times a families reluctance to make Grandma a DNR is a direct reflection of their guilty conscience. Didn't do anything for her when she needed help so we'll help her now by letting the nurses do everything for her in her time of need (i.e cardiac arrest). Don't want Grandma's death on their guilty conscience as well.

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Specializes in ER,ICU and Progressive Care Unit,Peds.

I truly believe in the right to die!

During my time at the VA, I saw many pts that we coded that should not have been. I also saw many pts on vents that shouldn't have been. There were many times that that I witnessed families making end of life choices based on what they the family wanted not what the pt wanted.

So witnessing all of this I have made it very clear to my husband, other family, and friends my end of life wishes. In fact, I will randomly quiz my husband to make sure that he has the plans correct ( I know that sounds aweful, but I like being prepared).

Also, early on in my carrer I learned that there is a big difference between living and being alive. Sometimes in the moment family members don't always see the difference. And....this is why living wills/advance directives are very important!

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