Should Nurses help Doctors in Physician assisted suicide (euthanasia)

[Caleb12]

I believe that nurses have a legal responsibility and a moral obligation to keep patients alive not to help them commit suicide.

What do you think about euthanasia and are you for it or against it.

[nurseprnRN, BSN, RN]

Quote from Caleb12

I believe that we have a responsibility to keep individuals alive no matter what the costs. Thats what we do, help keep others alive not help them kill themselves.

Yeah, well, thus speaks a young and naive person who has never, ever encountered such a situation and cannot really imagine what it means. And probably doesn't have pets, either.

Don't feel bad, most of us probably said the same thing when we were young and inexperienced in life, not just in nursing. Now... nah, not so much. We are old enough to remember before Dame Cicely Saunders and Elisabeth Kubler-Ross (both of whose works I commend to your attention), when we did, in fact, do everything to keep someone "alive."

If there is a God, when we stand in his presence, may he mercifully forgive us our youthful inexperience. We were unspeakably cruel to do it without knowing any better, most of us would never, ever do it again, and one of our deepest fears is that some naive youngster would do it to us.

[mrsboots87]

In my opinion, there's a HUGE difference between "comfort care", "euthanasia", and "Physician-assisted suicide." Two of these concepts allow for the nurse to advocate for the patient. One of them allows for the patient to be comfortable while "nature takes it's course" and one allows the terminal patient the right to choose when they're ready to go, in essence to control the process themselves. One is, essentially, murder. All of these are usually only considered when the patient has a terminal prognosis and death is inevitable from a disease process.

Great care should be taken to NOT cross the line between Physician-assisted suicide and euthanasia. The final decision, and act, is the patient's alone.

I believed I slipped in "euthanasia" unintentionally. Eeks, as if people are like animals and should be "put down." My bad.

[mrsboots87]

lol. yes. Meant "sun". I use my phone most of the time, and don't always verify what autocorrect has done to my comments.

[mrsboots87]

Yeah, well, thus speaks a young and naive person who has never, ever encountered such a situation and cannot really imagine what it means. And probably doesn't have pets, either.

Don't feel bad, most of us probably said the same thing when we were young and inexperienced in life, not just in nursing. Now... nah, not so much. We are old enough to remember before Dame Cicely Saunders and Elisabeth Kubler-Ross (both of whose works I commend to your attention), when we did, in fact, do everything to keep someone "alive."

If there is a God, when we stand in his presence, may he mercifully forgive us our youthful inexperience. We were unspeakably cruel to do it without knowing any better, most of us would never, ever do it again, and one of our deepest fears is that some naive youngster would do it to us.

THIS.

I am a "youngster" (26) and a nursing student who completed block 1 a few weeks ago. I will admit I started with thinking we do EVERYTHING. Not necessarily no matter what, but close to that. I changed my mind when I was in clinical in a LTC facility. A resident was on the brink of dying. The nurse said it could be that day or the next, or even just an hour or two. I asked to help with her care because I thought it would be a good experience to see the dying process and see how I would react to it. There was something beautiful with how the resident was cared for. Not the death itself, but just how wonderful the nurses were to her as she was meeting the end. When I walked in she had mottled skin, was very stiff, and even the slightest touch was very painful to her and she would moan. She had cheyne stokes breathing pattern (confirmed by nurse), and overall appeared to be in agony. They were "treating her" and comforting her family. I'm sure there are interventions that could have been done to keep this patient alive, but at that moment I learned that just because something can be done, doesn't mean it should be done. I don't have a lot of experience, but I definitely feel that experience was very humbling and am glad to have been there.

I believe that we have a responsibility to keep individuals alive no matter what the costs. Thats what we do, help keep others alive not help them kill themselves.

And those costs can be astronomical... and I'm not referring to finances.

I have always gotten the heeby-jeebies, skin-crawling, nauseous feeling whenever politics enters this realm. Nothing good can happen from it. However, political leanings aside, I think we view futile care in much the same way.

Politicians... keep them away from anything of significance. There's nothing they couldn't muck up.

Except that we're talking about a realm where legal constructs are necessary and laws are written by politicians.

And coming from a state with a robust initiative process, I think the "people" screw it up every bit as badly as do the pols.

Slippery slope. I don't want economists OR politicians getting in to this realm. It should be the patient and his/her care-givers.

Except that the financial costs are borne by us all... and recognizing that those caregivers often have a huge financial stake in the process.

What's so wrong with limiting the use of extreme interventions at the end-of-life?

[Esme12, ASN, BSN, RN]

Except that the financial costs are borne by us all... and recognizing that those caregivers often have a huge financial stake in the process.

What's so wrong with limiting the use of extreme interventions at the end-of-life?

When the hospital and the government begin making decisions for the patient and family based on financial liability or expense it is a slippery slope of deciding who is worthy and who is not based on the ability to pay (or not pay)....that frightens me. What is next in the decision process....race? Religion? Body Mass?

While I believe that there are cases of medical futility, like Jahi McNath...and I believe in a patients right to choose their exit by providing their exit of choice. It brings to mind death panels.

You cannot use financial burden as a measurement of worth.

[akulahawkRN, ADN, RN, EMT-P]

When the hospital and the government begin making decisions for the patient and family based on financial liability or expense it is a slippery slope of deciding who is worthy and who is not based on the ability to pay (or not pay)....that frightens me. What is next in the decision process....race? Religion? Body Mass?

While I believe that there are cases of medical futility, like Jahi McNath...and I believe in a patients right to choose their exit by providing their exit of choice. It brings to mind death panels.

You cannot use financial burden as a measurement of worth.

Great care should be taken to NOT cross the line between Physician-assisted suicide and euthanasia. The final decision, and act, is the patient's alone.

There's a reason why I wrote this. Medical science is amazing and it's often prolonged the dying process so much that often we can't see it for what it is. It is only when the patient can not act for themselves that we turn the responsibility over to the family. That's not euthanasia. That's a family's decision. As soon as we take that responsibility away from the patient or the family and put it in the hands of some other committee, that's when we've crossed the line. That's when we've functionally created a "death panel" and then mission creep sets in and care starts being rationed according to someone's worth to society, as perceived by some committee.

[applesxoranges, BSN, RN]

I feel like the adults on South Park during the episode called "Death." Personally? I think that people should have the right to make their own decisions in regards to terminal illnesses. However, I personally will not want to be in the role to help them carry out their wishes. I don't think my employer would ever endorse that action anyway.

[Episteme]

And coming from a state with a robust initiative process, I think the "people" screw it up every bit as badly as do the pols.

Well, there is that.

Still... I would hope that we (professionals) define our own ethics. From the Tuskegee Syphilis experiments, through Nuremberg... there has been a steady progression of thought on ethics and robust discussion within the involved professions. I think we have an excellent framework for thoughtful decision making.

We can do it better than anyone who only knows the political process.

[PMFB-RN, RN]

Nurses, rarely, if ever, take an active role in ending a life. My job is to provide comfort, alleviate pain and suffering, to make decisions that only they can make.

While not ending a life, withdrawing of care, usually resulting in immediate patient death is a very common task for me and the nurses I work with.