Voluntary Euthanasia

Nurses Activism

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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.

Specializes in School Nursing.

I also want to add that people are on much, much more powerful pain medications that aren't in Hospice, who live for years taking doses that make the small doses of morphine most home hospice patients take comparable to a Flintstones vitamin.

Terminial people already in the active dying phase deserve comfort care, and morphine is a great drug for that. And not even close to the most potent drugs we could be giving, if it was our goal to hasten death, which is it NOT.

Specializes in Emergency Room, Trauma ICU.
I also want to add that people are on much, much more powerful pain medications that aren't in Hospice, who live for years taking doses that make the small doses of morphine most home hospice patients take comparable to a Flintstones vitamin.

Terminial people already in the active dying phase deserve comfort care, and morphine is a great drug for that. And not even close to the most potent drugs we could be giving, if it was our goal to hasten death, which is it NOT.

Yes there are people walking around with enough narcs on board to kill a horse that's not the point. I guess I'm coming at it from ICU/ER vs hospice, where we give much higher doses of meds to pts we're withdrawing care on. But you cannot say that any narcs or sedatives don't hasten death. They absolutely do.

But that is not what this thread is about. It is about voluntary euthanasia, not hospice or withdrawing care. And I'm a firm believer in allowing terminal pts the chance to choose how they want to die. If they want to fight till there last breath with minimal pain meds, more power to them. If they want to end it before their quality of life diminishes, I'm right by their side. Our opinion, especially in regards to the "morality" of it, doesn't matter. It's about what the pt wants and what is legal. And if you don't agree, which is absolutely your right, then don't get in a field that would make you help those pts.

People seem to assume morphine is what kills these dying patients.. That simply isn't the case most of the time, it's the disease process that kills, not the comfort meds.

Ah, it is not the drug itself, for sure. However, what the drug causes the body to do most certainly assists in comfort, however, decreases breathing. And we are talking about increasing drips of morphine (or dilaudid or whatever...)

When it's about what *I* am expected to do in *my* work, then it's about me. And I will not violate my own moral beliefs. No one has the right to ask that of me, or of anyone else. I will have to answer for the choices I make, therefore I have to be responsible about making them.

Since I work in hospice, the idea that I am opposed to death with dignity is ridiculous. I just don't agree with you about how that looks.

When you become a nurse, you will find that there may in fact be patients that on a daily basis will not remotely compare to your moral beliefs.

I see them every single day.

But you would never know that, as it is not MY moral beliefs that have one thing to do with the practice I employ.

If you truly believe that you need to "answer for the choices you make" then in fact you should realize that your patient will have to as well. And perhaps that will make you a more compassionate nurse. But a nurse's own morality doesn't belong at the bedside. Especially when one is in the dying process.

I disagree. An example, hospice pt hadn't had morphine because aside from SOB, didn't appear in pain. A dose of .5 mg morphine recommended by hospice nurse because his respirations were 45 bpm. Dose given and 2 hours later, RR reduced to about 25bpm. No further morphine given. Patient declined and died several hours later that evening. That man was actively dying. The morphine didn't 'speed' up anything, it did what it was designed to do, bring the respirations down from

Morphine isn't administered to STOP breathing. It reduces RR, it doesn't STOP respirations.

What part of a 25 RR is comfortable for an adult? (if this was an adult). And 2 hours from 45 to 25 is a LONG time to wait. Morphine is not just used for pain, but for ease of breathing as well. I would have advocated for more than .5 of morphine to make this patient a heck of a lot more comfortable in a shorter amount of time, however....if the patient declines, the patient declines.

And yes, given in doses most seen in end of life care it DOES stop respirations.

But, back on topic--even in states where euthanasia is legal, it is in the control of the patient. And not something that a nurse or any other health care provider assists with, other than the MD who gives the prescription.

The real question here is why do some people think that their own morals should be a factor in another person's healthcare decisions.

I have no problem with someone thinking it's wrong, but for other people to vote against legislation that would inhibit a person's right to act in their own self interest is immoral, in my opinion.

Specializes in Emergency Room, Trauma ICU.
The real question here is why do some people think that their own morals should be a factor in another person's healthcare decisions.

I have no problem with someone thinking it's wrong, but for other people to vote against legislation that would inhibit a person's right to act in their own self interest is immoral, in my opinion.

Because they know what's best...for everyone. Didn't you know? Sigh. It's very frustrating to be told what you can and cannot do with your body by a complete stranger based on their morals. Especially when it turns out they more immoral than you could ever be.

Specializes in School Nursing.

And I'm a firm believer in allowing terminal pts the chance to choose how they want to die. If they want to fight till there last breath with minimal pain meds, more power to them. If they want to end it before their quality of life diminishes, I'm right by their side. Our opinion, especially in regards to the "morality" of it, doesn't matter. It's about what the pt wants and what is legal. And if you don't agree, which is absolutely your right, then don't get in a field that would make you help those pts.

I never said I didn't agree. You're preaching to the choir on this one.

Specializes in hospice.
The real question here is why do some people think that their own morals should be a factor in another person's healthcare decisions.

I have no problem with someone thinking it's wrong, but for other people to vote against legislation that would inhibit a person's right to act in their own self interest is immoral, in my opinion.

So you would say the same to people who voted against Prop 8 in California then, right? Their moral views should not impact legislation.

Specializes in School Nursing.
So you would say the same to people who voted against Prop 8 in California then, right? Their moral views should not impact legislation.

That was gay marriage, right? I would definitely say the same thing about those who voted against it!

Specializes in hospice.

No, it was a proposition to define marriage as between one woman and one man. It passed, resoundingly, but the court struck it down.

Specializes in Emergency Room, Trauma ICU.
So you would say the same to people who voted against Prop 8 in California then, right? Their moral views should not impact legislation.

How in the world does my marriage effect you?? And voting against prop 8 was a vote FOR gay marriage. Yes, your morality should have nothing to do with legislation. If you don't believe in gay marriage, abortion or euthanasia then don't get it. But don't stop me from getting something based on your morals.

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