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Washington state to allow `dignity' deaths

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by Ayvah Ayvah (New Member) New Member

Ayvah has 10 years experience and works as a RN.

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OLYMPIA, Wash. - Terminally ill patients with less than six months to live will soon be able to ask their doctors to prescribe them lethal medication in Washington state.

But even though the "Death with Dignity" law takes effect Thursday, people who might seek the life-ending prescriptions could find their doctors conflicted or not willing to write them.

Many doctors are hesitant to talk publicly about where they stand on the issue, said Dr. Tom Preston, a retired cardiologist and board member of Compassion & Choices, the group that campaigned for and supports the law.

"There are a lot of doctors, who in principle, would approve or don't mind this, but for a lot of social or professional reasons, they don't want to be involved," he said.

But Preston said discussions about end-of-life issues between doctor and patient will increase because of the new law, and he thinks that as time goes on more and more doctors who don't have a religious or philosophical opposition will be open to participating.

"It will be a cultural shift," he said.

http://news.yahoo.com/s/ap/20090301/ap_on_re_us/assisted_suicide

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1,435 Visitors; 34 Posts

I think it is important to realize that "Under the Oregon and Washington laws, physicians and pharmacists are not required to write or fill lethal prescriptions if they are opposed to the law. Some Washington hospitals are opting out of participation, which precludes their doctors from participating on hospital property." It will be interesting how this comes about... I have read that several hospitals are not going to consider using this and several are open to the idea.

I personally am for fighting for life regardless - but that is a whole new posting ;)

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azhiker96 has 10 years experience and works as a PACU.

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I think this is a good thing and I also don't have a problem if some doctors don't want to participate in the program. I'm sure there will be doctors who are willing to respect their patient's requests and their names will quickly become known. Pharmacies who refuse to fill the prescriptions may find themselves boycotted. Both are valid forms of free speech IMO.

I favor quality of life and when there is no quality I don't see the point of keeping someone contained in a pain-racked prison. If the patient chooses to stay in a life of tube feedings, deep suctioning, lab draws, etc, that's fine. It's their choice. But if they wish to leave a broken vessel and see what's on the otherside, I can support that too.

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Jarnaes has 14 years experience and works as a OR Nurse.

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I'm all for death with dignity. Let people with a terminal diagnosis chose how and when they want to go, instead of slowly rotting away in some ICU bed.

Freedom of choice rules.

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nerdtonurse? works as a ICU, RN/BSN.

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Rather than that, I'd rather docs as a group have a serious sit down discussion about futile medicine. The reason most of these folks get into such horrible straits is that we're using futile medicine -- not to prolong life, but to prolong death.

If a person is essentially brain dead, over 100 years old, and eaten up with cancer, why are you putting a PEG tube into them? You can't "save" them, you are only torturing them.

If you've got a person with no kidney function, over 80 years old, multiple CVAs that have left them with just enough functioning brain tissue to keep them breathing, stage 4 sacrum that you could put your foot down into, and constantly bleeding from their dialysis cath because their body is rotting and their veins are collapsing, why are you telling the family you're putting a PEG tube into them because you're getting them ready for the "transplant list" when no one is ever going to give this person a kidney? Turns out with that person, they put in the peg, and the person hemmorhaged to death on the floor when they came back from surgery because their coags were in the toilet.

Why do docs put PEG tubes in an elderly person who can eat, simply because in my state that qualifies them for skilled care, and bumps them up the list to get a placement? The person threw a CVA after the surgery, threw two more, had a major MI and finally got out of the doc's hands.

If you want to sign up for the whole thing, full code to the end, fine. Come to work with me for a week, and see and experience what you're actually going to sign your mom, your dad, yourself up for. These docs tell the families they can save people that are dying, and should be let to go in peace!

Now climbing back down off my soap box.

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Chico David RN works as a Cardiac Rehab Nurse.

12,481 Visitors; 624 Posts

I do have to say the openness of MDs to a more palliative approach has moved a great deal in the right direction. As a patient educator working with cardiac patients, I do the "core measures" instruction with CHF patients, many of whom are severely and chronically ill. Going through their charts, I see a lot more docs having discussions with the patient and family about their wishes for end of life care. We have a long way to go in this regard, but we are making progress. I'm for laws that let patients chose an easy way out if they need to, but I'm also for care that makes very few patients feel the need. With good enough palliative care at the end of life, rather few patients will choose active steps to shorten their lives. But those few who do, should have the right.

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StNeotser has 10 years experience.

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Quite honestly, I think that the hospice route with the patient being made NPO and given as much Roxanol and Actiq lollipops as they require works well enough.

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Junebugfairy works as a Full time nursing student!.

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i am very pleased to see this, and i really hope many more states will follow their lead. quality of life is everything, without quality of life you are not truly 'living', you are just 'there'.

we are all going to die one day. hopefully i will die in my sleep while having a nice dream about french polynesia.. i can say that i defnitely do not wish to die hooked up to every machine and tube, suffering through every last minute. we do not let our pets and animal friends die this way, and we should not let our fellow man.

i am so for death with dignity, and death with choice. i also support someone's choice to refuse such medications and measures.

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babyNP. has 10 years experience.

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So glad to see people agreeing! This is my home state and most of my family was against it, even my Dad who's an ICU RN.

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meluhn has 16 years experience and works as a ACUTE REHAB.

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Nerdtonurse, I totally agree with you about peg tubes but I think the way it happens is because the doctors are not sure what the patients potential for recovery is sometimes. I work in acute rehab and we have gotten people that have gtubes and trachs after and have been completely immoble in icu for 2 months. They come to us like rag dolls, completely debilitated and after a month or so we have them walking out. Others come to us with gtubes after a CVA and don't do so well. You just cant tell right away how much function they will recover and what their quality of life will be. But to put a gtube in someone that has extensive necrosis of their brain is just ridiculous, I agree. Just because we can do it doesn't mean we should.

I have heard that in the UK the national healthcare won't even pay for dyalisis for someone over the age of 55. Anyone know if that is true?

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sbic56 has 24 years experience and works as a Nurse Consultant.

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Nerdtonurse, I totally agree with you about peg tubes but I think the way it happens is because the doctors are not sure what the patients potential for recovery is sometimes. I work in acute rehab and we have gotten people that have gtubes and trachs after and have been completely immoble in icu for 2 months. They come to us like rag dolls, completely debilitated and after a month or so we have them walking out. Others come to us with gtubes after a CVA and don't do so well. You just cant tell right away how much function they will recover and what their quality of life will be. But to put a gtube in someone that has extensive necrosis of their brain is just ridiculous, I agree. Just because we can do it doesn't mean we should.

I have heard that in the UK the national healthcare won't even pay for dyalisis for someone over the age of 55. Anyone know if that is true?

That appears to be so...

http://www.pubmedcentral.nih.gov/art...?artid=1548515

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sbic56 has 24 years experience and works as a Nurse Consultant.

9,290 Visitors; 1,437 Posts

Not sure why that link doesn't work....but here's the content:

Successful treatment of middle aged and elderly patients with end stage renal disease.

D H Taube, E A Winder, C S Ogg, M Bewick, J S Cameron, C J Rudge, and D G Williams

This article has been cited by other articles in PMC.

Abstract

Many patients over the age of 55 with end stage renal disease in the United Kingdom are denied dialysis or transplantation. Although the reasons are complex, anticipation of a poor prognosis for these patients might explain why most British renal units impose an arbitrary age limit on the acceptance of patients for treatment. A study was therefore conducted to examine the prognosis and quality of life of 84 patients (mean age 59.6 years, range 55-72) accepted into our renal replacement programme from the beginning of 1975. The five year survival of the patients was 62.0% with 78.1% of the survivors either having successful transplants or caring for themselves using home haemodialysis or continuous ambulatory peritoneal dialysis. The results show that in terms of survival, economics, and rehabilitation it is both feasible and reasonable to treat middle aged and elderly patients with end stage renal disease. These patients should therefore not be denied dialysis or transplantation on the basis of age alone, and the lack of resources and other factors that allow this state to persist in Britain should be rapidly redressed.

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