Molly55

I am appalled by the lack of understanding on how the law works. Physicans do not get to decide on who lives and dies. It is only the patient who can pursue it. I am shocked at that vehement opinions that are not even based in the legality of the issue. In regards to Gil's post I too am awake and I do not recall taking an oath to be the watchdog of everyone else morale compass when I became an RN. What I did learn and do practice is advocacy by letting patients decide for themselves what they want...not the self appointed guardians who imposed their values and decide for them. Please read the law.

Amen. This is as it should be.

the only state in the union that allows PAS is Orgeon. That law states the person must be a/oX4 under go psychological exams and be ok'd by two other physicans agreeing the patient is terminal. The patient must then ingest the medication by THEMSELVES. It cannot be given IV, thru gastric tubes or any other method. It is not by anyones hand. It is by the patients hand alone. They must be able to take the medication out of the physicans hand and ingest it orally. It is the patients decision not the families and the patient must go through the all of the testing etc before the medication is ordered by the physican. If the patient cannot take the medication BY THEMSELVES they can not participate in PAS period. Nurses are precluded by law from assisting in anyway. We can there if the patient wants there and we agree to be there but only as a friend. The work is betweent the physican and patient only. The family does get to intervene. The physican cannot administer the medication, they can only order it and be there at ingestion to render aid if the medication causes adverse effects (vomiting etc) This is not giving someone a shot or an IV to kill them. This is patient driven only. There is a mythology that nurses or doctors will be asked to decide who dies then go render the fatal dose. This is not the law. And this is not the law the states are comteplating.

I support PAS. I have lived and worked in Oregon as hospice nurse. It was a requirement that the patient considering PAS be on hospice so I had the opportunity to work with three patients in the PAS program. Statistically there were 12 episodes of PAS in the state during 2001. Of the 12 people in the program all had terminal illnesses, one patient pursured PAS because of financial reasons (terminal illness bankrupting young family) and the other eleven were because of one reason alone...lack of control. I was orginally against PAS when I started working with the patients but have since changed my mind. I now believe that people should have the choice of what they want to do with there lives and that includes how they want it to end. Just like physicans and nurses should have the choice to assist PAS patients or not. If people believe that there are moral and ethical consequencs to choices then it up to the individual to decide how to justify and live with, or with die with those choices. It is not up to society to decide for others. As health care professionals we can chose to particpate in PAS patients experiences or not. It is not mandatory that all of health care be pro PAS. But, the right to live or die in inherent to each human being and those decisions should be sacred to the individual. PAS should be available to those that desire to participate. Would I pursue PAS? I am not sure but when I think about ALS or some other horrible chronic terminal illness in relationship to me I think yes I would pursue PAS. There is nothing noble about suffering. Hospice can control pain and symptoms but we can not give you back your control. The individual must remain intact and sole authority on what is quality of life and how much is enough. Just my opinion.

I am so sorry for your situation. I understand how upsetting this is especially without hospice support. Kidney function failure can sometimes take some time, but it is best to prepare for daily changes in your mom's condition. talk to your mom again about hospice but this time tell her it is for you and your siblings so that you have someone to rely on to help you understand what you are seeing daily. Sometimes loved ones will accept hospice care if they know it is a kindness to the caregivers and relations. The only thing your mom would have to agree to is to see and meet the nurse from hospice once every fourteen days. Certainly you may have more visits and interventions but your mom might be more receptive if she knows she does not have to be overwhelmed by the hospice team. Without hospice try to stay in contact with your physican and report changes as you see them hopefully your doctor will be willing to explain what you are seeing. If your mom has not made care decisions that are on paper like living wills etc now is the time to talk about it as she begins to get sick issues like hospitalizations and agressive therapies will have to be decided and it might have to be decided by you. Do not be afraid to contact your local hospice for support they might be able to speak with your mom. You and your family can request someone from hospice meet with you anytime without a doctors order. Getting a small get together at the home with a hospice staff member may help reassure everyone including your mom. Or if not, go in and see the hospice team. They may give you lots of advise. Remember kidneys take care of the fluid in your body. Seeing swelling is perfectly normal when kidneys can not fully function. If your mom becomes uncomfortable at all call the doctor. Take good care of yourself, try to stay calm and supportive but try to get the help you need to navigate this. Molly55