Helping patients kill themselves

[Cwoods]

Colorado is now the 5th state to adopt a form of physician-assisted suicide.

O' wait, I said that the wrong way... "Death with dignity" or "Right to die"

What do you think about the law?

Will it, at some point in the future, fall into NPs hands?

Apparently, insurance companies in California feel great about denying a terminally ill mother costly chemo tx and offering to subsidize a life-ending treatment for $1.20.

Can you imagine? I could potentially extend my life, again for my children, for a few months but bankrupt my family or I could end it all for the cost of a cheeseburger...

Assisted-suicide law prompts insurance company to deny coverage to terminally ill California woman - Washington Times

[offlabel]

I'm all for you exerting your right to protest, attempt to institute change or whatever especially in the matters of ethical issues however the bottom line is, at least in my state, we are employed at will. I've had employers institute all kinds of policies I didn't appreciate and in the rare instances they were things I considered deal breakers I left. No hard feelings just agreed to disagree and I showed my displeasure with my feet.

There is no equivalency between, say, compulsory overtime or loss of vacation and compulsory participation in abortion. Once that line is crossed, as it has been in Europe, anyone can be forced to do anything.

[offlabel]

Are you saying providers are now forced to do abortions and/or terminate life for patients who choose to die because they are very and irreversibly ill - like with severe neuro illnesses, horrendous pain, and the like?

I was not aware that anyone was forced to do abortions or prescribe suicide or forced to actively end a patient's life.

They are...or they lose their livelihood. If you are OK with this, you have to ask yourself if there is anything that you would object to doing? If there is absolutely nothing that would disturb your peace of mind, you're safe. But if you draw the line somewhere, you may very well have to change what you do for a living or violate your conscience.

What if you were forced to provide futile care for a terminal patient in intractable pain or lose your ability to earn a living as a nurse in your chosen profession?

Court rules: Catholic midwives can't object to abortion on moral grounds (From HeraldScotland)

[Rose_Queen, BSN, MSN, RN]

They are...or they lose their livelihood. If you are OK with this, you have to ask yourself if there is anything that you would object to doing? If there is absolutely nothing that would disturb your peace of mind, you're safe. But if you draw the line somewhere, you may very well have to change what you do for a living or violate your conscience.

What if you were forced to provide futile care for a terminal patient in intractable pain or lose your ability to earn a living as a nurse in your chosen profession?

Court rules: Catholic midwives can't object to abortion on moral grounds (From HeraldScotland)

That ruling does not force them to participate in abortions. If one is against providing a type of care, then one must be willing to delegate it to others who are.

As conscientious objectors, the senior midwifery sisters have had no direct role in pregnancy terminations, but they claim they should also be entitled to refuse to delegate, supervise and support staff involved in the procedures or providing care to patients during the process.

[offlabel]

That ruling does not force them to participate in abortions. If one is against providing a type of care, then one must be willing to delegate it to others who are.

Court ordered supervision of abortions is not participating in abortions? How does that work?

[anon456, BSN, RN]

As a hospice nurse, I will never be able to participate in assisted suicide. My job as a nurse is to provide maximum comfort to a patient while allowing the natural disease process to end the patient's life. It goes against my code of ethics in my role as nurse-- which is to promote health and well-being.

This is not to say I don't personally believe in assisted suicide under very specific conditions. But I have to differentiate between my personal beliefs and my practice as a nurse under my license and in that role to the patient. This is something nurses do every day with a variety of ethical and personal beliefs.

[offlabel]

As a hospice nurse, I will never be able to participate in assisted suicide. My job as a nurse is to provide maximum comfort to a patient while allowing the natural disease process to end the patient's life. It goes against my code of ethics in my role as nurse-- which is to promote health and well-being.

This is not to say I don't personally believe in assisted suicide under very specific conditions. But I have to differentiate between my personal beliefs and my practice as a nurse under my license and in that role to the patient. This is something nurses do every day with a variety of ethical and personal beliefs.

So, you contradicted yourself there...you believe in assisted suicide under very specific conditions. If that is true, you should have no hesitation in hastening your patient's death by your direct action under those conditions. Yet you just said you will never be able to participate in such an act...so, which is it?

[Purrsx2]

Moreover, patients, even children, have been euthanized there without their consent or knowledge.

Thank you for the googled links. I carefully read all the information provided on those links, but still did not find any cases where "patients and children have been euthanized without their consent or knowledge".

Here is the quote from the article:

"Belgian parliament on Thursday agreed with the doctors who argued that in rare cases of unbearable and irreversible suffering, children should have the same right as an adult to ask to die with dignity.

Under the amendments to the country's 2002 euthanasia law, a child of any age can be helped to die, but only under strict conditions. He or she must be terminally ill, close to death, and deemed to be suffering beyond any medical help. The child must be able to request euthanasia themselves and demonstrate they fully understand their choice. The request will then be assessed by teams of doctors, psychologists and other care-givers before a final decision is made with approval of the parents."

Provided links did not support your statement that "patients and children have been euthanized without their consent or knowledge".

[offlabel]

Thank you for the googled links. I carefully read all the information provided on those links, but still did not find any cases where "patients and children have been euthanized without their consent or knowledge".

Here is the quote from the article:

"Belgian parliament on Thursday agreed with the doctors who argued that in rare cases of unbearable and irreversible suffering, children should have the same right as an adult to ask to die with dignity.

Under the amendments to the country's 2002 euthanasia law, a child of any age can be helped to die, but only under strict conditions. He or she must be terminally ill, close to death, and deemed to be suffering beyond any medical help. The child must be able to request euthanasia themselves and demonstrate they fully understand their choice. The request will then be assessed by teams of doctors, psychologists and other care-givers before a final decision is made with approval of the parents."

Provided links did not support your statement that "patients and children have been euthanized without their consent or knowledge".

So, the same child that, if healthy, would be denied his ice cream if he didn't eat his brussel sprouts, can demonstrate and fully understand asking for death. And, the assumption being, his parents and their desires and biases having no bearing whatsoever. Ostensibly, these children can't consent to not doing their algebra, but they can consent to a doctor, not their disease, bringing about their death.

If I could provide credible documented evidence of patients death being hastened by doctors without their consent, would you agree that it was wrong?

[abixxy, MSN, RN]

This form of death has been long going in the hospital setting, with DNR patient's getting Q1 Fentanyl. The translation to OP "death with dignity" is controversial, I agree but I also respect it. The patients don't fear death, they fear the prolongment of it.

[offlabel]

This form of death has been long going in the hospital setting, with DNR patient's getting Q1 Fentanyl. The translation to OP "death with dignity" is controversial, I agree but I also respect it. The patients don't fear death, they fear the prolongment of it.

Again, big difference between intentional, purposeful hastening of death and treatment of pain. Fentanyl given for relief v. given to cause death are two distinct ideas. It also profoundly alters the role of the person administering the drug. If a hospice patient is obtunded from fentanyl, morphine and Ativan, and therefore not uncomfortable, yet is maintaining his own airway and ventilation giving more in order to hasten death is intentional killing of that patient.

On the other hand, titrating narcotic to pain that brings about death is not the intentional killing of a patient.

[db2xs]

What an inflammatory title, yes. This is about choices.

[offlabel]

If I could provide credible documented evidence of patients death being hastened by doctors without their consent, would you agree that it was wrong?

So, in such an ideological argument such as this, no amount of evidence is enough to convince anyone to change their minds. The bottom line is that no one wants to see another human suffer. Everyone agrees.

And someone saying that PAS/euthanasia is not a good idea is not in any way saying that they are OK with someone else's suffering. By implication, those people are saying that for themselves as well, you'd assume.

Trying to articulate a religious/philosophical understanding of suffering is pretty useless here as well. If that is not your orientation, there is no way you'll be convinced by it.

I'll just say that I think it's a bad idea because of what we see happening in Europe: Involuntary euthanasia happens at least hundreds of times per year and the criteria for requesting PAS has been reduced to simply being of a certain age and being "tired of living".

It's all right here in a peer reviewed medical journal (Just skip to the last couple of paragraphs to cut to the chase if you don't want to read the whole thing)

In 30 years, the Netherlands has moved from euthanasia of people who are terminally ill, to euthanasia of those who are chronically ill; from euthanasia for physical illness, to euthanasia for mental illness; from euthanasia for mental illness, to euthanasia for psychological distress or mental suffering—and now to euthanasia simply if a person is over the age of 70 and tired of living.”

And

Dutch euthanasia protocols have also moved from conscious patients providing explicit consent, to unconscious patients unable to provide consent

Finally

Non-voluntary euthanasia is now being justified by appealing to the social duty of citizens and the ethical pillar of beneficence. In the Netherlands, euthanasia has moved from being a measure of last resort to being one of early intervention.

There is a lot more if you're truly interested, there is now concern about Oregon's law as well:

Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls

My opinion is that the sick and dying and society as a whole are better off when we find better ways to compassionately care for the dignity of human beings than just intentionally ending them.

That doesn't mean I don't care if anyone suffers.