'Right to Die', what's your take on it?

Nurses General Nursing

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So California recently passed the 'right to die' law and I recently saw an episode on 'Vice' where a woman in Europe actually allowed the journalist to record her euthanasia. A nurse was there who set up the heplock in her vein where the medication went in. Wanted to know what other nurses think of the 'right to die' law which is now legal in 5 states and if you would participate in it if there were a nursing job for that?

Deleted due to re-read for comprehension.

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Specializes in Acute Care - Adult, Med Surg, Neuro.

Does the death penalty count as euthanasia? Do RN's participate in that process?

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Dying in the hospital or facility, which is still very common, is a bad idea. While with hospice at home the patient can be kept very comfortable in most cases with less hesitation from personnel, patients tend to struggle more with symptom control in the hospital. The reason is that in the hospital, even though a patient may elect "CMO", nurses and healthcare providers are often afraid to administer sufficient doses to relief symptoms like pain, nausea, anxiety, agitation. The thinking in the acute care hospital is geared towards "treating" and not so much towards "palliation". While I have seen patients with iv cont methadone pumps at home on hospice to relief terrible pain and suffering related to it in terminal cancer, the same patient could not get sufficient pain relief in the hospital because prescribers are not specialized with not enough experience to manage severe symptoms.

Dying in the hospital nowadays does not mean that the patient will be free of pain, anxiety and other suffering with a nurse and aid there at all times. There is often a delay from ordering certain medication until they finally hit the floor plus nurses are often not comfortable to give the amount of medication combinations needed to relief symptoms.

When a patient needs high doses of dilaudid, ativan and haldol (terminal agitation) I look at the patient to assess their comfort - my goal is to help with the symptoms related to end of life - while most acute hospital nurses and providers look at the "numbers" administered and get concerned. It is hard to shift the focus from "treat" and "treat but be careful not to cause too many side effects" to "CMO - let's palliate symptoms effectively.

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Specializes in med-surg, IMC, school nursing, NICU.

From my understanding, a nurse has no role in the procedures allowed by the Death with Dignity laws in varying states across the US. As a previous poster said, a fatal dose of a barbiturate is prescribed and the patient takes it at the time of his or her choosing. I watched a great documentary called "How to Die in Oregon" that thoroughly but sensitively explores this very polarizing topic. I loved it. What especially touched me what a woman who was advocating for passing a Death with Dignity law in her home state of Washington. She talked about watching her husband slowly deteriorate from a terminal brain tumor and how he had mentioned on several occasions that he was "ready to go" but legally had no means of doing so. Everything from his health to his looks to his personality changed and he was in agony until he finally passed away. It was heartbreaking and I would never want that for myself or a member of my family.

So, to answer you question, I am in full support of any law that allows people in these excruciating circumstances make decisions about their lives. Including when they are no longer worth living.

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Does the death penalty count as euthanasia? Do RN's participate in that process?

No. It counts as punishment.

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Specializes in ICU, LTACH, Internal Medicine.
Dying in the hospital or facility, which is still very common, is a bad idea. While with hospice at home the patient can be kept very comfortable in most cases with less hesitation from personnel, patients tend to struggle more with symptom control in the hospital. The reason is that in the hospital, even though a patient may elect "CMO", nurses and healthcare providers are often afraid to administer sufficient doses to relief symptoms like pain, nausea, anxiety, agitation. The thinking in the acute care hospital is geared towards "treating" and not so much towards "palliation". While I have seen patients with iv cont methadone pumps at home on hospice to relief terrible pain and suffering related to it in terminal cancer, the same patient could not get sufficient pain relief in the hospital because prescribers are not specialized with not enough experience to manage severe symptoms.

Dying in the hospital nowadays does not mean that the patient will be free of pain, anxiety and other suffering with a nurse and aid there at all times. There is often a delay from ordering certain medication until they finally hit the floor plus nurses are often not comfortable to give the amount of medication combinations needed to relief symptoms.

When a patient needs high doses of dilaudid, ativan and haldol (terminal agitation) I look at the patient to assess their comfort - my goal is to help with the symptoms related to end of life - while most acute hospital nurses and providers look at the "numbers" administered and get concerned. It is hard to shift the focus from "treat" and "treat but be careful not to cause too many side effects" to "CMO - let's palliate symptoms effectively.

Only one thing left is how to explain family that the Mother is not going to make it any much longer and that taking her home with hospice care would be the the best option. Especially when there are doctors 'round saying that they can try a few more chemos to run and that K+ 7.5 is not a problem, let's just push Quinton in and give her a couple runs on dialysis.

Geez, we had to quietly call a priest in the middle of the night quite a few times because dear children would not let him near their dying parent's bed to administer Last Rites and let their mother or father to actually say their last devotions before ending on a vent.

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Could not do it. I have considered becoming a hospice RN, as I really think there is so much peace found in making people comfortable. I feel like letting ones body shut down how it may but making them comfortable in the process is humane. I feel like giving someone a lethal injection or letting them give it to themselves is bordering the lines of suicide. Thanks for posting such a thought provoking question!

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You are so right. I work PCU, and have had a lot of hospice patients when I worked in med- surg. I feel like most inpatient hospice patients are under-medicated. The drugs are frequent and higher doses than usually given. Home hospice is the way to go! Good point!

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Specializes in Pedi.
Does the death penalty count as euthanasia? Do RN's participate in that process?

No. Euthanasia is intentionally ending a life to relieve pain and suffering. The death penalty is the state punishing a criminal. And the ANA's code of ethics states that nurses should not participate in executions.

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Specializes in Emergency/Cath Lab.

I have seen people die peacefully and have a good death. Ive seen the other end and had to bear witness to the horrors of end of life for some. You are damn right I am all for death with dignity. Could I help, I think I would be able to but it is hard to say until you are in that situation.

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Specializes in Pharmaceutical Research, Operating Room.

I could, and would. I watched my father die from an exceptionally aggressive renal cell carcinoma when I was 18, and seeing that kind of suffering and pain has left a lasting impression on me. He was transferred into Hospice care, and the professionals there were completely, totally amazing and were able to make him comfortable in his last days (thank you Hospice nurses, the work you do is SO important). Our family has had several discussions regarding end of life care/the wishes of my grandparents, mother, etc., and I firmly believe that one should be able to decide when they have had enough. If such things were legal in our neck of the woods, and if nursing had a place in it, and if they chose to pass onto whatever is next using those methods, I would gladly assist in providing a comfortable, peaceful, quiet death. I feel like it would be the last gift I could give to someone who was tired of suffering.

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I could and would. After watching my grandfather in convulsions... His body was so strong, but his lungs were riddled with cancer. His accessory muscles were so powerful that he jackknifed every time he tried to get a breath. It was like watching a fish die on land.

I would love to be able to help ease the transition. I've written before about people who have begged me to kill them and how it has affected me.

I come from a strong Christian background, and I know death is seen as the final enemy in a lot of religions. I respect that belief, and I would never advocate euthanasia on someone who either isn't ready to go or whose family isn't ready to let go.

But, if a patient had a terminal condition and every waking moment was an agony, whether physical, psychological, or spiritual, I would do everything within my legal power to make that patient's suffering less. Including shortening the patient's life, if it was an option.

I have seen plenty of suffering in my time. I have no issues with the coupe de grace. We allow it for animals, why not allow it for our loved ones?

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