BSNin2007

I think offering the opportunity for people to do so at that time, or another time that is universal (as universal as possible) would be a great idea. How about if our primary care doctors offered us a copy of the standard forms most emergency rooms carry and put it in our file at our yearly checkup?Who better to know our wishes than our physician? Yes I know many of us don't have A PCP, myself included, but the more opportunities we have to do something, the greater chance we may take one of these opportunites. I realize my idealism borders on delusional, especially at my age, but I believe there is an answer, and hashing out ideas together may provide us with one that may just work.

I am not under any circumstances suggesting that nurses publically advocate in favor of legislation allowing "assisted suicide" or withholding livesaving treatments. I would however advocate for legislation that would ENFORCE a document that was signed by a person of sound mind. Does this always happen with AD's? I think most of us know the answer to that question.

Please clarify what you mean by a five wishes packet. Is it a form of AD? Is it a standard form? If so, where can I access it?

this is the source from which i retrieved the piece and the questions. i am not supporting either side, i am looking for your opinion(s). i appreciate your input greatly and encourage opinions and facts from all sources. linder, d. (2007). does the constitution protect the decision to end one's own life, at least if own is terminally ill or in great pain? exploring constitutional law. retrieved february 22, 2007, from http://www.law.umkc.edu/faculty/proj...righttodie.htm

I would like to clarify that I am in no way stating that if in fact someone wants extraordinary measures to be taken that anyone should have the right to say otherwise. By the same token, if someone does not want these measeures taken isn't that also their right?

ponytailman, Thank you for your honesty and input. I guess what the ultimate goal of such a discussion is whether or not healthcare professionals as a whole need to be active in promoting legislation that puts our patients human rights first. We all have heard of cases where advanced directives are not adhered to because of battling family members rather than actual patient wishes. When does the healthcare profession as a whole make a stand one way or another. Is it the rights of the patient, or the families or the position of the establishment. I do not suggest that every case will fall into a category where it will be easy t say "This is definately the right thing to do" however I do think that the parameters need to be more clearly defined.

the following posting is in reference to a class project regarding the topic of the right to live versus the right to die. our group of senior nursing students, at the university of west florida, will be presenting this topic for a healthcare issues course. please note that any replies may be incorporated in our powerpoint presentation to elicit group participation. we will present a scenario as well as questions to consider. please post your responses regarding this matter based on how you feel the situation should have been managed. the right to die the issue: does the constitution protect the decision to end one's own life, at least if one is terminally ill or in great pain? the court first addressed the issue of the right to die in the 1990 case of cruzan v. director, missouri department of health. in cruzan, the court considered whether missouri could insist on proof by "clear and convincing evidence" of a comatose patient's desire to terminate her life before allowing her family's wish to disconnect her feeding tube to be carried out. although eight of nine justices--only scalia disagreed--concluded that the right to die was a liberty protected by the due process clause, a bare majority of the court upheld the state's insistence upon clear and specific evidence that the patient would wish to have intravenous feeding discontinued. the cruzan decision spurred considerable evidence in "living wills" which clearly express an individuals desire to discontinue treatment or feeding in specified circumstances. (later, additional evidence of nancy's wishes was discovered and feeding was discontinued, leading to her death.) seven years later the court faced right to die issues again in two cases involving challenges to laws criminalizing physician-assisted suicide. the lower courts in each case, one involving a washington state law and another a new york statute, found the laws unconstitutional--at least as applied (the 9th circuit decision rested on due process right-to-privacy grounds, the 2nd circuit decision on equal protection grounds.) the supreme court reversed in both cases, finding the laws to be constitutional. although the court interpreted cruzan as recognizing a right to refuse medical treatment, the court found no constitutional basis for a right to assisted suicide. three justices in concurring opinions (o'connor, breyer, stevens) indicated that they might be willing to uphold "more particularized challenges" to such laws, such as--for example--an as applied challenge to a state's refusal to assist a terminally ill patient in severe pain from ending his or her life. in 2006, in gonzales v oregon, the court decided another right-to-die case, although this one primarily on administrative law grounds, not constitutional grounds. voting 6 to 3, the court ruled that attorney general ashcroft exceeded his powers under the controlled substances act when he threatened prosecution against oregon doctors prescribing lethal drugs under that state's death with dignity act. writing for the majority, justice kennedy concluded that regulation of medical practices was primarily a job for the states and that ashcroft failed to recognize "the background principles of our federal system." questions 1. doctors examining nancy cruzan concluded that she was in a persistent vegetative state, had no awareness of her environment, and had no hope of ever having awareness of her environment. what reason is there to doubt that any person in nancy's circumstances would want--if they were capable of even wanting--feeding to be continued? was there any evidence at all suggesting nancy would want to continue to "live"? 2. in what sense could nancy cruzan even be considered a "person"? what are the essential attributes of a person? 3. since nancy could feel neither embarrassment nor pain, isn't it really only the empathetic interests of the family at stake? 4. what if missouri defined nancy as dead and ordered her feeding discontinued against the wishes of her parents? would they have any constitutional claim? 5. was missouri using nancy as a symbol? as a symbol for what? 6. should it matter whether the decision involved was to discontinue feeding rather than extraordinary treatment such as a ventilator? 7. could missouri have prevented the cruzans from taking nancy to another state that would allow their wishes to be carried out? 8. if there was a right to assisted suicide, as the 9th circuit found, why should the right be limited to terminally ill and competent adults? why would persons in great pain, or who are severely depressed, also have such a right? 9. does the distinction between passive euthanasia (withdrawal of feeding tubes, for example) and active euthanasia (administration of lethal drugs, for example) make sense to you? 10. what state interests supporting laws against physician-assisted suicide do you think are the strongest? linder, d. (2007). does the constitution protect the decision to end one’s own life, at least if own is terminally ill or in great pain? exploring constitutional law. retrieved february 22, 2007, from http://www.law.umkc.edu/faculty/projects/ftrials/conlaw/righttodie.htm please peruse the above and consider your own position. as nursing students who will be graduating in two months, many of us haven’t had this experience. while we all have individual opinions we, as a group, believe the positions of our peers is of great significance. we welcome responses, from pre-nursing students as well as vested clinicians, in the hope that we, as well as you, will take something of consequence from this discussion.

Focker, Something as serious as someone who administers anesthesia doing illegal drugs? I don't see the justification in defending them unless you agree with it. I am not saying you,or anyone who feels it is okay is a user themselves, but I would question their ability to make responsible decisions and therefore their ability or priveledge, it is not a right, to hold a license. This is clearly not in the same league as defending being pro-choice or gay marriage. These "professionals" are violating people and risking lives through their illegal and irresponsible behavior.

Kaeri, This is not a political website so I will not defend my political views, I will however state that you have no idea who I voted for and what my stance on foreign affairs is so please don't assume you do.

kaeri, Just because someone disagrees with your point of view is no reason to condemn an entire country. Just as I certainly don't believe all Australians are sitting around doing X because one person made a, from what I gathered, sarcastic comment. If you don't like being judged or labeled why would you do it to others?

"originally posted by kaeri i believe you should not report them. it may be that the substance is illegal - but so is under-age drinking/drink-driving/homosexuality/ smoking pot etc.they are not using mdma the night prior to their shift. dont meddle - the chance of them making a mistake is less than the person who was on an alcohol soaked bender until 1 am monday morning. or smoked pot last evening. marijuana has a much longer half-life and 1 joint/bong can stay in the adipose tissue for 48-72hrs. i've seen +ve results 6 - 8 weeks after last joint." augigi, underage drinking is what was said ^ above. to me this comment about homosexuality was clearly either ignorance or prejudice. either way it is not for me to judge someone's sexual orientation, and it is certainly not illegal!

Halinja, I agree, and home cooking wouldn't be the only thing he'd of been deprived of in my house!!!

DKF, I think most of us,including yourself, know that users and addicts, in particular, can be the BEST liars and manipulators. I also believe if you work side by side with someone long enough, especially if you are a medical professional there should be some indicators. So as a patient who is receiving medical treatment from someone for the first time you may not have a clear indication if that person uses, but I'd bet a dime to a dollar someone they work with does.

RN/BSN/JD/ESQ Thank goodness for your conviction. I am seriously worried that I may receive medical care from some of the respondents to this thread. Some of these people are defending the actions of the alleged users so voraciously one may begin to question their motives.

It is extremely refreshing that you have such enthusiam and innocence, however you need to grow a thicker skin if you don't drive yourself over the edge. Healing isn't always a pretty process, and some things we do may be construed as "mean" or cold but, as many others have said, the vast majority of us do it because we do care.