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Discussion

Voluntary Euthanasia

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.

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Euthanize..put (a living being, especially a dog or cat) to death humanely.

Killing..is causing the death of a living organism, for purposes of survival, including consumption and defense of self and or others. Killings of human beings are called homicides, and killings of humans done in malice are characterized as murder.

Therefore killing.. does not equal euthanasia.

Withdrawing care means letting nature take its course with an injured or ill person who would likely already have died without our intervention. That's not killing.

Killing someone, and euthanasia is killing, is taking an affirmative action to end someone's life sooner than it would have ended naturally. That's wrong and I will never be part of that.

Hospice should be separate from this. Euthanasia is, in my view, completely contrary to what hospice is supposed to be.

Sad times we live in when non-defensive killing of human beings is no longer universally acknowledged as wrong. :(

Withdrawing care means letting nature take its course with an injured or ill person who would likely already have died without our intervention. That's not killing.

Killing someone, and euthanasia is killing, is taking an affirmative action to end someone's life sooner than it would have ended naturally. That's wrong and I will never be part of that.

Hospice should be separate from this. Euthanasia is, in my view, completely contrary to what hospice is supposed to be.

Sad times we live in when non-defensive killing of human beings is no longer universally acknowledged as wrong. :(

Well luckily that is your opinion and you get to choose for yourself what you want. I would rather my family and friends die on their own terms rather than slowly rot when there's no chance of survival.

It's a sad time when we treat our pets with more love and compassion than we do other people.

I think it would be better to let nature take its course in the first place. I think there should be something in place stating someone DOES want a feeding tube, if the situation warrants, rather than they don't (I'm not talking about emergent situations, I'm talking about "Mom isn't eating well, maybe we should get her a feeding tube").

I think the wishes of the patient when they were alert and oriented should be followed, and that we should ignore their selfish family members when we need to.

I think people should LISTEN to their family members, and talk about what they want when/if they are in the situation, so that they CAN die with dignity and not be allowed to play in their own BM, which is only being produced due to the feeding tube that they never wanted to begin with.

I think if an 89 y/o demented patient refuses to eat, we should let them refuse.

If someone has zero quality of life, and they are suffering, miserable and afraid all of the time, we should let them die as nature intended, rather than continue medical interventions that extend their lives. I think it should be common practice to make it known if you wish to whiter away in a nursing home someday, rather than assume that everyone does.

I think we should start there, and ensure people are getting really good palliative care before we start picking them off.

Physician Assisted Suicide, however, I am all for, but only when consent can be given while the person is A&O.

I agree with everything Glycerine said, except the last paragraph. "Extraordinary measures" have become anything but extraordinary, and we are not providing more quality of life in most cases. Only quantity, and that's not always the right choice. From what I've seen, it's not even usually the right choice.

Our country does death and dying badly. That doesn't mean murder is the answer.

Would I euthanize someone? Damn right I would if that's what they wanted, and I hope someone would do the same for me. It's a damn shame it's not legal.

As legal euthanasia is practiced in Oregon, the PATIENT must drink the cocktail on THEIR OWN. The physician is the provider of the prescription which the patient has to fill on their own. The physician is present to open the capsules and mix the powder with a liquid. They do not even hold the container. They hand it to the patient who consumes it without assistance. I don't see any slippery slope here.

As for as DNR orders being ignored, we need to develop a body of case law where someone will sue on the patient's behalf. We already have organizations devoted to death with dignity. It's probably these groups that need to institute the lawsuits and I'm going to go out on a limb here and say the rate limiting factor is money and the public denial of death as a normal part of life.

Would I euthanize someone? Damn right I would if that's what they wanted, and I hope someone would do the same for me. It's a damn shame it's not legal.

This. Most of my friends and co-workers know in what situations I'd request them to put a pillow over my face, and know that I would do the same for them.

This. Most of my friends and co-workers know in what situations I'd request them to put a pillow over my face, and know that I would do the same for them.

Yep. I started in the trauma ICU and told my coworkers that if I came in as a quad or TBI to just smother me. I wouldn't want to live that way and being forced to live that way against my wishes would make everything that much worse.

Absolutely without a second of hesitation. In my short time in nursing I've withdrawn care on more people than I can count, always knowing it what was they and their family wanted. The chance to be there, talk with them and know they are beyond a doubt in their right mind making this decision, I would be honored to help them.

There's an enormous difference between withdrawing care -- removing artificial means of support, without which the patient will die -- and actually euthanizing someone.

There's an enormous difference between withdrawing care -- removing artificial means of support, without which the patient will die -- and actually euthanizing someone.

And as I said I have NO problem euthanizing a pt. I would do it a heartbeat without a moments hesitation.

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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