Nursing Ethics: Reigniting the Debate over Assisted Suicide
The debate about assisted suicide has come back into the news with the recent arrests of four members of the Final Exit Network, a Georgia-based group accused of assisted suicide in the death of a Georgia man in 2008. The group also faces charges of assisted suicide in Arizona, stemming from a 2007 case that may have involved a patient who wasn 't terminally ill and may have had impaired judgment and questionable mental health at the time.1
The aging U.S. population and healthcare reform means that the debate about assisted suicide and natural death will only intensify. As nurses, we need to be well-informed in order to contribute clarity and information to this debate.
Untangling the terminology
Among the terms being used in the debate are assisted suicide, euthanasia, aid in dying, and the right to die. Assisted suicide, as understood nationally and as defined in Oregon 's Death with Dignity Act, is the act of providing prescription medication to a terminally ill patient at his request for the purpose of effecting a peaceful death. The patient requesting aid in dying must have full capacity to make medical decisions, make the request himself, and administer the medication himself.2 The medication prescribed, usually a sedative/hypnotic, causes deep sleep, leading to eventual cessation of respiration.
Suicide, differing from assisted suicide, is the taking of one 's own life without the assistance of another person.
Oregon 's law, which technically is a physician-assisted suicide law, has many safeguards in place to ensure adherence to the intent of the law:
* The person must make several requests for assisted suicide, with at least 15 days between the first and last request.
* Two physicians must determine that the person is competent.
* The person must be provided with information about hospice.
In 2008, according to the state 's Web site, 88 prescriptions for lethal medications were written under the provisions of Oregon 's law, and
The aging U.S. population and healthcare reform means that the debate about assisted suicide and natural death will only intensify. As nurses, we need to be well-informed in order to contribute clarity and information to this debate.
Untangling the terminology
Among the terms being used in the debate are assisted suicide, euthanasia, aid in dying, and the right to die. Assisted suicide, as understood nationally and as defined in Oregon 's Death with Dignity Act, is the act of providing prescription medication to a terminally ill patient at his request for the purpose of effecting a peaceful death. The patient requesting aid in dying must have full capacity to make medical decisions, make the request himself, and administer the medication himself.2 The medication prescribed, usually a sedative/hypnotic, causes deep sleep, leading to eventual cessation of respiration.
Suicide, differing from assisted suicide, is the taking of one 's own life without the assistance of another person.
Oregon 's law, which technically is a physician-assisted suicide law, has many safeguards in place to ensure adherence to the intent of the law:
* The person must make several requests for assisted suicide, with at least 15 days between the first and last request.
* Two physicians must determine that the person is competent.
* The person must be provided with information about hospice.
In 2008, according to the state 's Web site, 88 prescriptions for lethal medications were written under the provisions of Oregon 's law, and
References: 1. Rubin P. Death wish. Phoenix New Times News. August 22, 2007. http://www.phoenixnewtimes.com/2007-08-23/news/death-wish . [Context Link] 2. State of Oregon. Oregon Death with Dignity Act. http://oregon.gov/DHS/ph/pas/ors.shtml . [Context Link] 3. State of Oregon. 2008 Summary of Oregon 's Death with Dignity Act. http://www.oregon.gov/DHS/ph/pas/docs/year11.pdf . [Context Link] 4. State of Washington. Washington Death with Dignity Act. http://wei.secstate.wa.gov/osos/en/Documents/I1000-Text%20for%20web.pdf . [Context Link] 5. Final Exit Network. http://www.finalexitnetwork.org . [Context Link] 6. American Nurses Association. Code of Ethics for Nurses. Washington, DC: American Nurses Publishing; 2001. [Context Link] 7. American Nurses Association. Ethics and human rights position statement: assisted suicide. Silver Spring, Md; American Nurses Association: 1994. http://www.nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/ANAPositionStatements/EthicsandHumanRights.aspx . [Context Link] 8. Robeznieks A. Survey shows heightened focus on pain at death. Am Med News. 2004;47(32):14. [Context Link] 9. Tilden VP, Tolle SW, Drach LL, Perrin NA. Out-of-hospital death: advance care planning, decedent symptoms, and caregiver burden. J Am Geriatr Soc. 2004;52(4):532. [Context Link]