Voluntary Euthanasia

Nurses Activism

Published

I think one of the cruelest things we do is let patients lay in nursing home beds without the legal ability to terminate their own lives. I'd be interest in what other nurses think of this.

If you ask active people who are in their 40s and alert and you say to them "when you get older and you lose the capacity to know your surroundings and you no longer recognize your family members, and if you reach a point where someone has to change your brief in a bed or feed you your meals, would you prefer to live your life like that or would you prefer someone terminate your life painlessly and peacefully?"

What do you think most people's response would be???

Mine would be termination of my life! But guess what that is against the law in most states.

I'd be interested in knowing what other nurses think about this. We get trained over and over again about abuse. Well to me, the biggest abuse we commit is we do not allow Voluntary Euthanasia over laying in a soiled brief in a nursing home bed where we can't even feed ourselves anymore. Voluntary Euthanasia is illegal in all states and PAD is allowed only in Washington, Oregon, Montana, and Vermont.

Holy crap people!

Most of us kill our pets when they are terminally ill, it is our culture.

Why is this so upsetting in the context of this thread? I get that we have an emotional attachment to animals but seriously...

No, opiates and other drugs do not always provide the comfort that we would prefer, which is part of the reason that we kill our pets. We believe them to be suffering and we get to decide because there is no law which prohibits our killing of them.

Currently we have laws against killing humans and they are in place for some very good reasons, primarily because some people are simply not trustworthy and will kill for other than altruistic reasons., in my view.

No holy crap going on here. You stated" It is also VERY convenient and less expensive to end their lives" A generalization that certainly did not apply to SaoirseRN's situation.. ( or mine) and one that was most hurtful.

"If we begin to treat our terminally ill elderly and disabled the same way we treat the family dog or cat there will be problems". Will there be problems.. or will be preventing a useless prolongation of death ..that could be painful and demeaning?

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Specializes in NICU, PICU, Transport, L&D, Hospice.
You're entitled to your opinion. What you are not entitled to do is imply that I "killed" my pet because it was "convenient". You don't believe that euthanasia is a kindness and that's fine for you. But you don't get to tell me that my choice was "convenient" because there are no laws preventing it. You weren't there looking at my beloved friend suffering and unhappy and you weren't there to understand that there was absolutely nothing convenient about my choice. So please, believe what you like, but don't apply your own beliefs to the actions of others.

You are free to personalize my comments about killing our pets at end of life. Keep in mind that this thread is about euthanasia and not about any specific individual.

I didn't "liken" the killing of your pet to anything.

I didn't say anything about "kindness" relative to euthanasia of pets or people.

I actually do get to say that euthanising pets is convenient and cheaper than the alternative, you simply don't have to apply my opinion to your own personal situation.

The problem here is not that I applied my beliefs to you but that YOU applied my beliefs to your own life and this caused you distress during an emotional time.

I am sorry that you were offended by my comments.

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Specializes in Float Pool-Med-Surg, Telemetry, IMCU.

I was originally opposed to the "Death with Dignity" act in my state because in my mind it implied that patients who needed care and were gravely disabled or ill were somehow lacking "dignity". The wording disturbed me and as a strong proponent of hospice and palliative care I felt as though people may feel forced to make the choice to end their lives because of a lack of better options. The slippery slope factor worried me as well. (And for the record, I am an atheist so religion did not influence my opinion on the matter)

But..after a few years working on a medical unit where I have seen some pretty awful deaths, I've changed my tune a little. I can't honestly say that I could be the one to euthanize a patient but if it was their wish than maybe I could. I don't know; my hospital doesn't practice it (Catholic) so I don't have to be in that position.

I recently cared for a terminally ill patient ravaged by cancer who requested euthanasia and after watching the suffering that no amount of pain medication alleviated I found myself wishing that it was an option for them. (The process takes several weeks which this patient did not have.)

I think the end of life can be a beautiful, meaningful time- but it isn't always. And for those individuals I am glad that this option exists where I live. Despite initially voting against it (and I agonized over that decision), I have come to realize that I can't allow my personal beliefs to interfere with the rights of others. If I lack the courage to hand someone the drink, I am glad that there are others who don't.

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I have come to realize that I can't allow my personal beliefs to interfere with the rights of others.

This is one of the best statements I've seen here on AN! I love your entire post, but this particular sentence really stood out.

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How many times has anyone who is a hospice/palliative care nurse seen families and even the patient themselves avoid us like the plague. Do everything feasible to attempt to treat a terminal illness at its most final stages?

There are far more people who choose quantity over quality.

We are also assuming that all people who are in nursing homes or who are elderly somehow are this far from being tied to a bed and left to hang out for days on end. There are just as many who are active to their function, in well run homes that put quality first.

I have seen too many instances where a family member is left to "hang on" as someone is collecting their social security check and be darned if they can not live without it. That is people used as pawns as opposed to really caring about quality of life. And even more who have "no heroic measures" that the HCP is tripping over themselves to put in feeding tubes, "do everything" on their 99 year old mother, regardless of Mom's wishes.

We have also seen threads on AN that the family doesn't WANT pain medication lest their family member "get addicted" or "it makes them unresponsive" or any other litany of issues.

Bottom line is that unfortunately, for most people a HCP can not be insurance that one won't have to "suffer". Which is sad, considering palliative care is an amazing option for pain control and function until such time as function is no longer an option. Then, it becomes a matter of peaceful. Which there are a litany of medications that can make it so.

People need to become more informed about hospice.

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Specializes in SICU, trauma, neuro.
Sadly the families don't have to do what the patient wishes. I've personally seen a pt extubated, he told his wife he wished to be a DNR/DNI because he couldn't deal with the pain and was terminal. She agreed. Then as soon as he lost consciousness she had him intubated because she didn't want to lose him. Next of kin can overwrite your wishes, it's a horrible horrible thing to see.

No disagreement here. I just don't equate with withdrawing a ventilator with giving a big ol' dose of IVP KCl...so when I say I disagree with euthanasia, I mean the active variety. Palliation with as much med as needed is often the right thing to do.

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Specializes in Emergency Room, Trauma ICU.
No disagreement here. I just don't equate with withdrawing a ventilator with giving a big ol' dose of IVP KCl...so when I say I disagree with euthanasia, I mean the active variety. Palliation with as much med as needed is often the right thing to do.

That was just one example. And I don't know of any euthanasia where they give potassium except for lethal injection. Unless they're an "Angel of mercy" which is code for murderer. True euthanasia is approved by their doc, the rx is written, then filled by the pt and taken by the pt. But regardless of the terminology, if a pt is terminal and wants to end their pain, I believe they should have the legal right to die on their own terms. Painlessly and with dignity.

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Specializes in Emergency/Trauma/Critical Care Nursing.
That was just one example. And I don't know of any euthanasia where they give potassium except for lethal injection. Unless they're an "Angel of mercy" which is code for murderer. True euthanasia is approved by their doc, the rx is written, then filled by the pt and taken by the pt. But regardless of the terminology, if a pt is terminal and wants to end their pain, I believe they should have the legal right to die on their own terms. Painlessly and with dignity.

I'm not sure what meds are used for euthanasia, however your example is actually medically assisted suicide I believe. However, if I develop an awful, debilitating disease, I.e. crutzfield Jacobs (sp?) And know I will become unable to perform my role in medically assisted suicide, then let me give consent for euthanasia, don't make me suffer.

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Specializes in Emergency Room, Trauma ICU.
I'm not sure what meds are used for euthanasia, however your example is actually medically assisted suicide I believe. However, if I develop an awful, debilitating disease, I.e. crutzfield Jacobs (sp?) And know I will become unable to perform my role in medically assisted suicide, then let me give consent for euthanasia, don't make me suffer.

That's what we've been talking about, voluntary euthanasia, assisted suicide, etc.

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Errors are not intentional killing. Euthanasia is. Withdrawing aggressive care and letting nature take its inevitable course while providing comfort is not intentional killing. Euthanasia is intentional killing.

You specialize in hospice care. As the drip of morphine increases for the patient's comfort, it depresses breathing. In between, there can also be doses of Ativan. This is all combined to make a patient be able to die a peaceful death. As pain free as feasible. What part of that could NOT be considered by some people euthanasia?

Hence why people have issues/fears/pre-conceived notions regarding hospice care.

One's intent is to not KILL someone, rather, to make the process of death a peaceful one. With the assistance of medications. Which does cause the absence of breath. Which is what someone may choose to do well before they are in the final stages of a horrible disease process.

Choosing to withdraw care--again, it is cruel to withdraw care then let it be for nature to take its course. Sometimes for weeks. So again, there are medications put in place for comfort. Which as they increase could be considered euthanasia.

Which is all very different than intentionally killing someone.

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Specializes in hospice.

I'm sorry, palliation of symptoms and giving comfort care until nature takes its course is completely different from intentionally overdosing someone with the intent of ending their life.

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Specializes in Emergency Room, Trauma ICU.
I'm sorry, palliation of symptoms and giving comfort care until nature takes its course is completely different from intentionally overdosing someone with the intent of ending their life.

But that is not what we are talking about. This is about voluntary euthanasia. Where the pt makes the decision while they are still able and carries it out themselves. It is not overdosing the pt. But even if it was, that is up to the pt, not the care provider. And if you don't believe in euthanasia then don't ask for it. Simple as that.

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