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.
Lots of different terms at play here. Here's how I understand them, these may not be the legal definitions.
I am for physician-assisted suicide, in which the oriented and consenting pt holds and consumes the lethal drug on their own, prescribed by a physician. To me, the only objection to letting an oriented person who is terminally ill end their life is a religious one, and that doesn't deserve a place in legal issues.
To me, this is the same as a person refusing treatment that will prolong their life and that will ensure their death if they do not get it -- I had a 97-year-old pt with complete heart block who refused a pacemaker, and no one had a problem with that, though she was progressively dyspneic and it was sure to kill her soon.
An alternative to this would be to make oneself a DNR, and then to commit suicide on their own. Granted, it is not always effective.
I am for voluntary and consenting euthanasia, in which an oriented and consenting pt who is UNABLE to administer the drug themselves (for example, ALS) has a healthcare provider do it for them. I would do this if I were the nurse, but if I were not comfortable with it, I would refuse, just as I would refuse to administer any drug I felt was unsafe or inappropriate to my nursing practice. Then someone else would do it.
I am for prior-consent euthanasia, similar to a DNR, in which a pt who is oriented lets their wishes be known ahead of time, and then when they are unable to consent and terminal, the healthcare team can abide by their wishes.
I am for withdrawal of care when someone is actively dying and had made their wishes previously known. For example, extubation, stopping feedings. I am in favor of morphine drips at this time but ONLY FOR COMFORT and not to hasten death. The pt who needs a ventilator will die without one -- make them comfortable with some morphine, but not enough to kill them before the lack of ventilation does.
I am opposed to involuntary euthanasia, which is the active killing/murder of someone who is not actively dying at this time, through the outside administration of drugs that cause them to die. I do not support the withholding of feedings from demented pts who can otherwise maintain their airway and have healthy hearts -- you are essential starving them to death because they're unable to hold a spoon.
It's not just on family members -- there are actually patients out there who, for whatever reason, want everything done for them forever and ever, and buy LTC insurance so they can sit in a nursing home until the good Lord takes them whenever He deems appropriate. Without proper documentation, I can't know their wishes, and am opposed to bringing about the death of someone just because I have judged their quality of life to be inadequate, and they can't tell me otherwise.
Lots of different terms at play here. Here's how I understand them, these may not be the legal definitions.
I am for physician-assisted suicide, in which the oriented and consenting pt holds and consumes the lethal drug on their own, prescribed by a physician. To me, the only objection to letting an oriented person who is terminally ill end their life is a religious one, and that doesn't deserve a place in legal issues.
To me, this is the same as a person refusing treatment that will prolong their life and that will ensure their death if they do not get it -- I had a 97-year-old pt with complete heart block who refused a pacemaker, and no one had a problem with that, though she was progressively dyspneic and it was sure to kill her soon.
An alternative to this would be to make oneself a DNR, and then to commit suicide on their own. Granted, it is not always effective.
I am for voluntary and consenting euthanasia, in which an oriented and consenting pt who is UNABLE to administer the drug themselves (for example, ALS) has a healthcare provider do it for them. I would do this if I were the nurse, but if I were not comfortable with it, I would refuse, just as I would refuse to administer any drug I felt was unsafe or inappropriate to my nursing practice. Then someone else would do it.
I am for prior-consent euthanasia, similar to a DNR, in which a pt who is oriented lets their wishes be known ahead of time, and then when they are unable to consent and terminal, the healthcare team can abide by their wishes.
I am for withdrawal of care when someone is actively dying and had made their wishes previously known. For example, extubation, stopping feedings. I am in favor of morphine drips at this time but ONLY FOR COMFORT and not to hasten death. The pt who needs a ventilator will die without one -- make them comfortable with some morphine, but not enough to kill them before the lack of ventilation does.
I am opposed to involuntary euthanasia, which is the active killing/murder of someone who is not actively dying at this time, through the outside administration of drugs that cause them to die. I do not support the withholding of feedings from demented pts who can otherwise maintain their airway and have healthy hearts -- you are essential starving them to death because they're unable to hold a spoon.
It's not just on family members -- there are actually patients out there who, for whatever reason, want everything done for them forever and ever, and buy LTC insurance so they can sit in a nursing home until the good Lord takes them whenever He deems appropriate. Without proper documentation, I can't know their wishes, and am opposed to bringing about the death of someone just because I have judged their quality of life to be inadequate, and they can't tell me otherwise.
Again, these are my opinions, I respect yours.
I must have missed something, have there been arguments in favor of involuntary euthanasia?
I must have missed something, have there been arguments in favor of involuntary euthanasia?
Somewhere back in there was discussion against the insertion of feeding tubes for demented pts who had lost the drive or capacity to eat. Something about them not having quality of life and being confused and afraid all the time. Unless they had an advanced directive in place stating they did not want to be fed if they became too confused to do it themselves, I think this is wrong, in my own personal opinion. Though dementia in its very advanced stages will cause death, these people are not actively dying, and to withhold feedings is to starve them to death.
Specializes in NICU, PICU, Transport, L&D, Hospice.
Somewhere back in there was discussion against the insertion of feeding tubes for demented pts who had lost the drive or capacity to eat. Something about them not having quality of life and being confused and afraid all the time. Unless they had an advanced directive in place stating they did not want to be fed if they became too confused to do it themselves, I think this is wrong, in my own personal opinion. Though dementia in its very advanced stages will cause death, these people are not actively dying, and to withhold feedings is to starve them to death.
I believe there is a difference between withholding feedings and NOT force feeding someone who is no longer able to take oral nutrition because of their failing health, specifically forcing them by placing tubes into them, sometimes surgically.
Physican assisted suicide isn't the same as euthanasia.
What I was saying is that I can't get behind euthanasia of a patient who is bed-ridden, demented, etc. Although that's certainly my definition of suffering, I don't think the answer is euthanasia, but I do think it's cruel.
I think modern medicine should keep it's nose out of things far sooner than is normal, so the scenario I described above never happens to begin with.
A little off topic, but I'm just wondering... If a pt does physician assisted suicide, does it disqualify their family to receive any life insurance benefits for the patient, as can sometimes happen in suicide cases?
I don't think so. A lot of life insurance policies have clauses that allow for early withdrawal in the event of a terminal illness, so at least for policies like that, I would think it would be the same. I also think it depends on what the cause of death is written as. I'm not sure how that is documented in the case of PAS.
They make opiates and other pain medications for animals.
You opted to euthanize the cat rather than attempt to make it comfortable using modern pharmacological agents while allowing a natural death. It would seem that we assume that we cannot keep our pets comfortable and so we kill them.
In your case you state it is/was for reason of compassion, like so many of us might. It is also VERY convenient and less expensive to end their lives.
There is no way to make a terminal, suffering, cat comfortable. Just what they have to DO to them to get them to the place where they are getting "comfort" measures is horrendous and horrific for the animal.
Ever start an IV in a scared, confused cat who is in pain? They have to be around other animals who likely scare them, which makes it worse, and not to mention it's not exactly easy to medicate a healthy cat, never mind a sick one.
Euthanasia isn't cheap, neither is cremation or burial. Digging a hole isn't much fun either. It would actually be more convenient to leave the animal at home and wait for them to keel over, but someone who loves their animals couldn't care less about convenience, I assure you.
Okay, so then only those who hold traditional moral views shouldn't be allowed to influence legislation?
Because voting against Prop 8 was just as much a statement of a moral position as was voting for it.
Your view is skewed. Saying that you don't think there needs to be a restriction on a definition isn't saying that you feel one way or another about that matter, morally.
I would have voted NO, because I couldn't care less who gets married to whom, as long as its not affecting my marriage.
In other words, you don't have the right to tell other people what they can or can't do, when said thing will hurt no one.
I'll never understand how this isn't abundantly clear, to everyone, everywhere.
Seriously, though. How is your marriage any less of a marriage because frank and tony are also married?
Technically the morphine is decreasing their respiratory drive which slows down their breathing and they die. The morphine is given to ease the pain from the disease. If they were not given the morphine they would live longer. So while the disease is why they are getting the drug, don't fool yourself into thinking the drug isn't speeding up the dying process.
Yeah, but if they weren't dying, it wouldn't kill them.
lifelearningrn, BSN, RN
2,622 Posts
^^^ EXACTLY^^^