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 Post Anesthesia.

As to the difference between "withdrawing care" and active "euthanizing"; 15 or more years ago it wasn't uncommon to actually euthanize a patient. It would be: diminished neurologic function(even due to sedation) end stage or terminal pathology... you would get an order for "morphine drip-titrate for comfort", and an order to "extubate if ventillated". Discomfort was defined as still having a pulse when we needed a bed in the ICU. The morphine was run wide open if needed until the patient stopped breathing. I know of one nurse that was counseled because she was to slow in terminal interventions and was accused of unfairly keeping her patient alive in order to dodge getting another admission. I've even seen paralytics used in combination with the narcotic drip- that was pretty sure-fire. Most of the time, from order to morgue care was 15-20min. This was before the days when you had to document just what observation you made that indicated discomfort or you would risk legal action(criminal and/or civil). I haven't always been in agreement with the decision to put my patient to sleep like an unwanted kitten. If I didn't participate I wasn't going to work in critical care very long. This used to happen WAY more often than the public realized. I for one am glad this stopped. I can think of 2 patients I thought had a chance(all-be-it slight) of recovery to some degree of meaningful life- A&O, able to interact with friends and family, that were "allowed to go" with a little pharmacological assistance. I'm glad I don't have to take home the guilt of more of those interventions.

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Specializes in hospice.
I've even seen paralytics used in combination with the narcotic drip- that was pretty sure-fire.

Wow....yeah....that's what we call execution by lethal injection these days. Holy mackerel.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

Used to be pretty common in Neonatology as well. Extubate and medicate with opiates, paralytics were not required.

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Specializes in hospice.

Except that that could hardly be called voluntary euthanasia, because the person being euthanized in that case certainly didn't consent.

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Specializes in Oncology; medical specialty website.

After what I have been through with cancer and the consequences I've suffered due to treatment, it's what I would want if my condition deteriorates. I don't think my parents could bear that though, so I have very explicit advanced directives. They know what they are and are fine with what I have decided.

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Specializes in Post Anesthesia.
Except that that could hardly be called voluntary euthanasia, because the person being euthanized in that case certainly didn't consent.

Well- they didn't say no.

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Specializes in hospice.
Well- they didn't say no.

Wow. :o

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Specializes in Med Surg.

"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???"

That's funny because a whole lot of those "people who are in their 40's" I run into seem EXTREMELY interested in keeping dad or grandpa breathing at all costs regardless of suffering, mental, or physical state.

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Specializes in School Nursing.

That's funny because a whole lot of those "people who are in their 40's" I run into seem EXTREMELY interested in keeping dad or grandpa breathing at all costs regardless of suffering, mental, or physical state.

People are happy to keep grandpa alive by all means necessary when they are tucked away in a LTC with other people caring for their everyday needs. These tend to be the same people who visit twice a year, birthday and Christmas. It's sad, really.

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Specializes in Emergency Room, Trauma ICU.
People are happy to keep grandpa alive by all means necessary when they are tucked away in a LTC with other people caring for their everyday needs. These tend to be the same people who visit twice a year, birthday and Christmas. It's sad, really.

I had an ICU pt where the family refused any narcs or sedatives in the chance one of them came to visit, they wanted to be able to talk to her. Well this pt was on a vent, pressure sores all over, in her 80's/90's, and was literally rotting away. I have never been so angry as I was when I had to deal with this family. Everything they did was for their comfort or convince and none of it had anything to do with their "loved one". Oh and they only visited once a week. So they kept her in constant pain for a 15 min visit once a week.

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Specializes in School Nursing.
I had an ICU pt where the family refused any narcs or sedatives in the chance one of them came to visit, they wanted to be able to talk to her. Well this pt was on a vent, pressure sores all over, in her 80's/90's, and was literally rotting away. I have never been so angry as I was when I had to deal with this family. Everything they did was for their comfort or convince and none of it had anything to do with their "loved one". Oh and they only visited once a week. So they kept her in constant pain for a 15 min visit once a week.

This ****** me off too. In my ICU rotation I had a patient, mid stage dementia who had just undergone open heart surgery, was in pain, and the family would not allow pain medications outside of PO APAP because they said the narcotic pain meds only confused her more. These are the same people who would demand a PCA for themselves if they had 3/10 pain but think it's perfectly okay to let someone else suffer! Ug!!

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It's sad to me that there are people would would choose euthanasia as an option, but are instead forced to slowly wither away. My view on this subject is that I don't see much difference in removing a feeding tube and giving medication. Both are actions that we know will result in the death of the patient.

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