'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?

Specializes in SICU/CVICU.
The great state of Oregon pioneered the The Right To Die with Washington state following suit and now others. The law in Oregon, as I'm sure it is in other states, only refers to terminal illness. It has nothing to do with advance directives or not wanting to be kept alive by artificial means or against your wishes. It's important to know the difference. One is euthanasia and the other is not. If I had a terminal illness and was racked with pain or trapped inside a useless body, you better believe I would exercise that right. I'm sick and tired of all the right wing loonies trying to abolish that right. If you don't want to do it, great. Just don't ever tell me what to do based on some twisted religious belief. This has nothing to with religion except your own. As far as I know, a physician must be present and is the one to administer the medications. The nurse may start the line and provide support to the patient and the family but he/she is not the one to give the meds. I'm not interested in debating this issue with the exception of ethical concerns. I will not engage with anyone based on religion.

I will gladly administer medication to make my patient more comfortable at the end of life even knowing that it may shorten his life but I won't administer a lethal dose of medication when the sole purpose is to cause death.

The problem I have with assisted suicide is that some people may chose this to be les of a burden to their family or community. The other issue I have is that it is a slippery slope and soon all sorts of not perfect people will be "offered the option" of assisted suicide.

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The great state of Oregon pioneered the The Right To Die with Washington state following suit and now others. The law in Oregon, as I'm sure it is in other states, only refers to terminal illness. It has nothing to do with advance directives or not wanting to be kept alive by artificial means or against your wishes. It's important to know the difference. One is euthanasia and the other is not. If I had a terminal illness and was racked with pain or trapped inside a useless body, you better believe I would exercise that right. I'm sick and tired of all the right wing loonies trying to abolish that right. If you don't want to do it, great. Just don't ever tell me what to do based on some twisted religious belief. This has nothing to with religion except your own. As far as I know, a physician must be present and is the one to administer the medications. The nurse may start the line and provide support to the patient and the family but he/she is not the one to give the meds. I'm not interested in debating this issue with the exception of ethical concerns. I will not engage with anyone based on religion.

That's not how it goes in Oregon. The physician writes the prescription. The patient or designated family member picks it up. The PATIENT self administers. No health care team is involved in the death event beyond the writing of the prescription.

I only know this from reading about Brittany Maynard and her situation. She moved to Oregon and established residency there in order to have the option to end her life before her brain tumor made things unbearable.

ETA:

The DWDA specifically prohibits euthanasia, where a physician or other person directly administers a medication to end another's life.

https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/requirements.pdf

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ETA I don't think anyone should be made to participate, just don't impose your beliefs on everyone else.

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If someone is terminally ill, is of a sane mind, and is going to undergo a painful death then I believe they should have the right to go out on their own terms. I would not personally help with the clinical aspect of this, but I do support it.

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Specializes in Nursing.

Here is my take on the Right to Die with Dignity issue. I am for it. I feel that in Western medicine, we give too many treatments to pro-long life, and continue suffering. Death is sad, but suffering is worse.

Could I "assist" with someone's death as a nurse? I don't know. I suppose that would depend on what specifically that entails. I could remove a tube. I can turn off life support, but could I administer a lethal injection? I can hold someone's hand as they slip away. I think it would be emotionally difficult to administer a lethal injection. I don't know ethically how I would feel about something like that in the long term. But I wouldn't judge someone who did it. I guess I would have to cross that bridge when I came to it!

Anne Marie

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Specializes in Nursing.

I think the struggle for me is that I have had two very close family members commit suicide. One was 34 when he shot himself in the head, and one was 32 when he hung himself in the garage. The loss of these family members has caused so much pain and sadness. It is heart-wrenching. They were not in "physical" pain, but both had substance abuse issues, and I believe they were both in a lot of emotional pain.

Do I see Death with Dignity as a form of suicide? I suppose in some ways I do. How can I reconcile "suicide" with Death with Dignity?

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Specializes in Ambulatory Care-Family Medicine.

I support the right to die and would participate if needed. I think everyone should be able to choose for themselves. I don't want to die a slow painful death from cancer or any other terminal end stage process. I watched my grandfather die slowly and painfully over the coorifice of 6 months from metastatic liver cancer. He was constantly in pain and asked several times for it to be over. I don't fault anyone for not agreeing with right to die and death with dignity laws as it is a very personal decision and I can understand why some would compare it to euthanasia or assisted suicide. I just hope that those that don't support never withhold that treatment from a patient based on personnel beliefs. If it does pass and become law in all 50 states I hope that those that don't support this are not forced by their employers to take on the patients. I hope these patients are assigned to nurses and providers that support this and can carry out the order.

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A ridiculous argument but you're not the first one to try to make it. First of all, as I said in my first response, the nurse DOES NOT give the medication. Only a physician can do that. There are safeguards in place to prevent choosing to end it because you're a burden. Also, right to die is not an option for the "not perfect people" you talk about. If you have ethical issues with it, THEN DON'T PARTICIPATE. When you can come back with a valid argument let me know.

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I would participate in this in certain circumstances only. I have seen many people in pain and dying from cancer who could not be saved. They had tried experimental trials and nothing could help. You get to a point where there is nothing that can be done and there is only suffering left. It is very sad. I believe that in cases like these someone should have a choice whether they can live or if they would like to end their own suffering as long as when they are in a right state of mind when they made this choice. If they are suffering from dementia or another impairing mental disease then this changes things. This is simply my opinion. I know there are those who will agree and those who will disagree and there is no right or wrong answer for this question. It is a very tough decision that hopefully I will never have to make for myself or anyone in my family.

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A ridiculous argument but you're not the first one to try to make it. First of all, as I said in my first response, the nurse DOES NOT give the medication. Only a physician can do that. There are safeguards in place to prevent choosing to end it because you're a burden. Also, right to die is not an option for the "not perfect people" you talk about. If you have ethical issues with it, THEN DON'T PARTICIPATE. When you can come back with a valid argument let me know.

So in which states does the Right to Die law allow physicians to give the medication. In the state you referenced, (Oregon), that is not the case, as the link I provided states.

I don't necessarily have a problem with this if criteria are met, I'm just trying to find out which states allow physician assisted suicide where the doc actually administers a lethal dose of medication.

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Okay, I found a pretty good link which talks about this issue:

State-by-State Guide to Physician-Assisted Suicide - Euthanasia - ProCon.org

California:

The physician may prepare the medication, but may not administer it.

A person who is present may, without civil or criminal liability, assist the qualified individual by preparing the aid-in-dying drug so long as the person does not assist the qualified person in ingesting the aid-in-dying drug.

Montana:

The physician prescribes, but the patient self administers.

Judge Dorothy McCarter ruled that a terminally ill, competent patient has a legal right to die with dignity under Article II, Sections 4 and 10 of the Montana Constitution. That includes a right to "use the assistance of his physician to obtain a prescription for a lethal dose of medication that the patient may take on his own if and when he decides to terminate his life." It further held that the right protects physicians who aid such patients by prescribing a lethal drug for the patient.

Vermont:

Physician prescribes but does not administer:

"A physician shall not be subject to any civil or criminal liability or professional disciplinary action if the physician prescribes to a patient with a terminal condition medication to be self-administered for the purpose of hastening the patient's death and the physician affirms by documenting in the patient's medical record [the required information]."

"A patient with a terminal condition who self-administers a lethal dose of medication shall not be considered to be a person exposed to grave physical harm... and no person shall be subject to civil or criminal liability solely for being present when a patient with a terminal condition self-administers a lethal dose of medication or for not acting to prevent the patient from self-administering a lethal dose of medication."

Washington:

Physician may prescribe, but patient self administers.

"An adult who is competent, is a resident of Washington state, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication that the patient may self-administer to end his or her life in a humane and dignified manner..."

Oregon:

Already noted in previous post that physician does not administer, only prescribes.

So it seems that the laws currently on the books in the US specifically prohibit the health care provider from actually administering the lethal drug. Therefore, imo this does not quality as "euthanasia," but instead as "physician assisted suicide." To some it may be a distinction of little import, but I imagine it could be very significant to the HCW involved.

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Specializes in Medsurg/ICU, Mental Health, Home Health.
Does the death penalty count as euthanasia? Do RN's participate in that process?

Nope, not even close to euthanasia...unless you think about the quality of life a death row inmate in solitary experiences. That's part of the reason why some people say that the death penalty is the easy way out.

However...

Maybe I'm very very sick but I could participate in lethal injection.

I'm pretty much a socialist but I'm very much for the death penalty even though my religious beliefs are completely against it.

Wow, I sound like a psycho.

Uhh...ignore me.

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