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Physician assisted suicide is a voluntary termination of one's own life by administration of a lethal substance with the direct or indirect assistance of a physician.  These words may sound harsh when you read the definition of physician assisted suicide. In my belief one who is terminally ill and suffers from pain, anguish, and hopelessness should have the decision of terminating life if they have been evaluated and treated for depression.  If one does not have the mental capabilities of making such a decision it should never be a topic in my belief.  This should be the last option when making the decision.  Patients should have to follow through with all medical care for their illness before making this their final wish.  In Mr. Johnson’s case battling cancer for 20 years is a long time of suffering and pain. I believe this is a long and slow way to die.  If there is additional help in aiding with suffering so excruciating why not offer this after all medical necessities have been met.  Nursing is centered around patient care and to respect their wishes and concerns as they recover or not recover from illnesses that attacks our bodies.  So, therefore should it be left to the higher power or the medical professionals to decide our fate.

SB

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Like Mrs. Jones stated I an quite impressed with all of your responses.

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Physician assisted suicide is a voluntary termination of one's own life by administation

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After reading the struggles of Mr. Johnson, one would assume that Dr. Jackson's act of alleviating his patients pain is of no harm. However, his procedure conflicts with Mr Johnson's religious background, as well as mine. Their deliberation, prior to the agreement, should have included a pastor of some sort, to give their input and knowledge in this matter to ultimately make a well rounded decision for Mr. Johnson. Clearly, the patient is concerned with religious punishment and consequences, or else he would have already committed suicide. With this in mind, his doctor should have involved other members of his care team or in the least, get feedback on a life sustaining decision. I am aware that in the end, it is the patient's decision, but, if this kind of decision conflicts with the facility's affiliation to its church, then Dr. Jackson is in the wrong plain and simple. The article even references this action as a term called "terminal sedation" and "lacks precision." This alone further validates the action of Dr. Jackson as unknowledgeable and not an advocate to his patient. Whatever disciplinary measures come to this doctor should be welcomed with open arms. With that being said, this situation reminds me of my grandfather when he was on palliative care. I come from a big family that is very religious, and even when my grandfather was dying, he always made decisions with a priest by his side. This could have also been the same situation for Mr. Johnson. Although the doctor's method was of empathy, he failed to necessitate all areas of life with his patient.

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After reading both articles I am reminded of a girl in Oregon a few years back that had cancer as well and made the choice to leave behind her husband and child and took part in the physician assisted suicide. At the time I was confused as to how not only a wife but a mother could leave behind her family by choice. As a mother and wife now I have come to see as to why she had made that choice. She had said that she didn’t want to leave her family with memories of her in pain and being sick. She wanted to leave her babies and husband with a peaceful memory of her as a person and not of her sickness. Therefore, I am for the physician assisted suicide. I feel that a person has to have the right reasons and is of sound and mind when making this decision. There should be a process of how the patient can make this decision and it should be evaluated by a group of medical and psychological qualified professionals. With that though I also feel that the patient should come to this idea on their own. I do not think that physicians should recommend this to a patient as that could persuade them into thinking they may want to go a way that they wouldn’t normally consider. I do hope that they will extend this right to people throughout the United States and not just keep it in the already approved 5 states. It is a right that I feel should be given to anyone and everyone that would benefit from it.

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Physician assisted suicide is something I have known about for a long time (in my short 21 years), and has always been something I believed should be the choice of the terminally ill person. In Mr. Johnson’s case, he was seeking haven from intractable pain that went along with his illness that he had suffered from for 20 years, and in turn would be the cause of his death in the long run. Dr. Jackson offered him that haven he was searching for without Mr. Johnson having to go through a bunch of hoops and malarkey to get what he really needed, peace. Suffering from an illness for 20 years is definitely enough to kill your spark from life. I believe assisted suicide was acceptable at this point. I believe it’s acceptable at any point in time when someone is ultimately going to succumb to the illness they are suffering from. We hear a lot about ‘providing comfort’ when we talk about hospice for a patient that’s on their death bed, but I believe this too should be something considered in all states rather than the few it is in now. There is one thing I’m not sure I completely agree with and that is Dr. Jackson straight out asking Mr. Johnson if this is something he wants to try, while some might disagree with that I believe that the patient themselves should come to the Dr. to ask about physician assisted suicide. I believe the Dr. should be well educated with the process and be prepared for their patient to ask many questions, but I think it should solely be the decision of the patient without the Dr. even giving the option until they bring it up. In that case, it’s giving the patient FULL choice in the matter rather than the Dr. being part of that decision (unless they’re asking questions of course).

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I believe nursing is completely about patient centered care. If they patient gives the consent, we should be following their wishes. If the patient has a living will, their wishes are followed. I also believe that patients shouldn’t have to "suffer" when having to be in such a state, such as cancer. Nobody wants to be in pain nor see anybody in pain, but I do believe that the circumstances should be looked over before just making a solid decision that puts somebody in an unconscious state. They have services such as hospice, that do everything to give those people "comfort measures." Mr. Johnson was suffering because of his cancer spreading and it was causing pain. I believe he should have been educated more on other options, instead of jumping to what should have been, the last resort. He wanted to do whatever helped relieve that pain at that point. Pain is pain and us nurses are supposed to comfort and help the patient. This subject is touchy, because I am all for helping those who need the help. Mr. Johnson has every right to make his decision and some may look at it as, that’s not right or why was that option chosen, but patients have their rights and one of those rights is to, make their own decisions. I am for it, in the sense of following their wishes and nobody wants to see somebody suffering. I am against it because I believe every person should be treated as a human until it's their actual time.

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I can see the topic of physician assisted suicide from both ends of the spectrum, but I personally believe that physician assisted suicide should be an option available to anyone diagnosed with a terminal illness. I wholly believe that if someone is suffering from a terminal illness they should have the option of a peaceful death. In my five years in long term care I have seen my fair share of suffering due to terminal illnesses. I have often wondered to myself if these people diagnosed with terminal illness had the option to end their suffering before it even really began, would they? The pain and suffering that, not only the individual diagnosed goes through, but the family as well could possibly be eased. This isn’t to say that physician assisted suicide is the “easy way out”. Death is difficult for anyone to experience, but it may ease the family’s suffering if they knew their loved one’s suffering was minimalized and they had come to terms with their own death. Ultimately, physician assisted suicide is a way for people to come to terms with their own mortality and to abbreviate their suffering if they so choose. It gives people the option to die at home, which is an option most Americans would choose if given the choice. Looking at things from a second point of view, it is a physician’s job to heal people. Assisting with suicide is not most people’s idea of healing, but to this I say isn’t easing someone’s suffering from an ultimately terminal illness not a form of healing in its own right? If someone is terminal it then becomes the health care professional’s duty to make the patient comfortable, not heal them. I won’t even begin to bring religion into this.

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Physicians who want to participate in physician-assisted suicide should have to further their education and specialize in that particular area. They should have to also go through psychosocial evaluation to properly determine if they are of sound mind to make that judgment call for their clients. There should be strict laws in place to diminish malpractice and keep ethical standards as this area of practice will be expanding and evolving over time. There should continue to be laws in place to protect physicians who do not wish to participate in physician-assisted suicide. They should have the right to refuse to partake in this level of care according to their spiritual and ethical values. They should not have to be forced against their conscience or judged for their decision not to participate. Visa –versa. This also goes for all healthcare workers involved. With that being said people have the right to determine what is right for their own bodies if they are of sound mind; according to their own spiritual values and morals. I believe this issue should continue to be voted at state level and not federal. Citizens from each state that are involved in or interested in this type of care are equally entitled to their own opinions and have the right to vote for it or vote against it.

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Physician assisted suicide isn’t a right or wrong thing, people have the right to bear arms and the freedom of speech. We should have the freedom to make dicision on wheather we want to live or not it’s our life. I believe we should allow those who are terminally ill with a limited amount of time left to live how they want. It’s easy to say what I would do in this line of work but it’s not my scope of practice and it’s not about me it’s all about the patient and what’s best for them, and what they want. Death is never an easy topic and when it comes to a decision on living or dying I believe that every measure should be done to provide the patient with the best care, which was clearly done. Was he right for listening to the gentlemen’s wishes? I think so. Was he wrong he could be in many peoples eyes. Truly I believe there was no right or wrong. It’s a decision that the patient wish for. At the end the final result in his life was death. The question is how much should one person have to endure before we all set aside our own personal beliefs and do what is right? Or wrong? How do you know when enough is enough? When we are not in his shoes to feel what he feels. I believe it’s enough when the person is in so much pain they are willing to commit suicide, but fear and religious holds them back. No matter how you see it you will always be judged. Love, Veronica

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Physician Assisted Suicide is a very controversial topic and is illegal in most of the United States, however, in five states and five other countries, it is legally practiced and in Oregon has been happening for eighteen years.  After reading the article about Mr. Johnson's twenty year battle with cancer, and looking at this topic from both viewpoints, I have found it to go against the fundamental values of being a doctor, and I do not agree with the practice of Physician Assisted Suicide.  I feel that patients should have control and understand the care they are receiving, however assisting someone in death goes against the Oath of to only heal, never to harm. According to Dr. Yang and Dr. Curlin, this is the same reason doctors refuse to participate in torture, cooperate in capitol punishment, and why many refuse to be active combatants overseas. It downgrades a doctor to a mere service provided to carry out only the wishes of a patient and anyone asking for death could possibly be a candidate for a mental health condition such as depression. I know that there are able minded people that might consider this as a way to hasten death and a better way to pass away than the inevitable. It is my belief that any where there is life, there is hope. I find Physician Assisted Suicide an unnatural means to an end and I do not support it as an act of healthcare.

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As i'm reading the article, I can imagine that working in health care is not something easy. Sometimes you want to help your patient, but you have to think if what you are doing is in your scope of practice. In that case, I can imagine how life was very difficult for Mr.Johnson knowing that he had prostate cancer for the past 20 years. He has also been suffering mentally and physically. He soon became diagnosed with a metastatic cancer in his lungs, spine, and brain; he was probably desperate with no hope in his life, feeling severe anxiety and depression. Maybe he needed support group therapy, relaxation technique, stress management teaching along with the analgesics. Dr.Jackson maybe felt guilty of not being able to provide a cure and wanted to help him out in a different way. However, I totally disagree with the way he approached him about ending his life. As we all know, there is no cure to metastatic cancer and he would have eventually die at some point. But as a doctor in the health care professional, I don't think it is fair to help a patient die even if it is acceptable in some states.

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Physician assisted suicide has been a debatable topic for many years. Some people agree and some people disagree strongly. I personally feel that a person should be able to decide their fate, if the person is terminally ill and all options have been failed. Autonomy is something as a nurse u have been taught to respect. We must respect the decision of a person who knows and understands the consequence of any decision made concerning their well-being. In life we will face many decisions that need to be made, and when it comes to Physician assisted suicide, that is a personal decision that should not be questioned. We as people have many beliefs about how death should come and the back- lash that can comes from these beliefs can leave us questioning a persons decision on life or death. Again, I support the decision to choose ones own fate, when all option on have run out

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If any of you are interested, below is a discussion board post I wrote for my Healthcare Ethics course through Drexel University in 2015 regarding Physician Assisted Suicide and Euthanasia. Just something more to think about when encountering ethical decisions in healthcare!
Mrs. Kirkley

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Physician Assisted Suicide has been a thing for quite some time from reading the two different articles. A few different States even have it legal for a Physician to assist a client in death upon request. I honestly neither agree or disagree with it. I feel as though a client has the right to choose what kind of care they want based on the circumstance and the situation. If a client is terminally ill and on their death bed, I think they have a right to choose to end their life rather then suffer through life just knowing the terminal illness will end their life eventually. As the one article stated Physicians should pay attention to the clients symptoms and concerns regarding end of life decision. A client with a serious illness should have the right to have control over their bodies and should have the right to make decisions. The part I do not agree with is if someone is seeking Physician Assisted Suicide for a mental illness or just because they are worried about possible illness in the future. I think someone who has a mental health illness needs to be given proper care and counseling and shown they have a reason to live life. However, again, they have a right to choose what they want done with their body but I don't think it's right for a Physician to assist a mental ill person with suicide just because they want to end their life. This subject was very touchy for me, and I really don't know weather to agree or disagree with Physician Assisted Suicide.

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First off class #39 I am so impressed with your responses! Physician assisted suicide has been gain speed in the last 10 years. As mentioned before it is legal in 5 states, so that means it is happening. As nurses you will be faced with many ethical issues and this is just one of them. You will have decide where you stand on issues and then develop your practice to adhere to that.

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My perspective on physician assisted suicide is that I disagree. I respect individuals rights and ability to decide on their own beliefs, values and life plans. Autonomy is a right that a patient has even when their dying. My ethical dilemma is regarding a dying patient, is once therapy begins the patient can not make decisions regarding ending life care or understand consequences. My religious upbringing has taught me that each person is a unity of body and soul. The soul gives life to the body; therefore; as long as the humans body is alive the person is present. As people we should value the meaning of life as we been taught to love and serve God. Ending a person's life is wrong even if the individual has been determined to not have a good quality of life.

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My perspective on physician assisted suicide is quite simple. I fully agree and support the decision for an induvial to have that right under certain circumstances. For instance, if a patient has a terminal illness that will result in death, I believe they should have that right without questioning. Prior to being given the ok to begin the process, I agree with the article that counseling should be offered to ensure the patient is well educated and understand everything fully. In one of the articles it stated, “patients already have the right to refuse life-sustaining treatment and the liberty to end their lives in ways that do not involve physician.” With that being said I do acknowledge that is true yet, in my opinion there is more that needs to be discussed. There is a difference between having the right to refuse medical treatment and suffering through a terminal illness and being given a medication to yield the pain while peacefully dying. In addition, I believe that physicians should also have the right to not take part in this. For example, If a patient is seeing a certain physician that does not agree with Physician assisted suicide, I believe that they too should have the same right as the patient and be able to care for that patient without it being discrimination. Yet, they should have to refer the patient to someone that can further assist them. In conclusion, I believe everyone should have the right, without fight or judgement, to determine and have the right to partake in assisted suicide by the physician when a terminal illness is present.

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Physician assisted suicide has been a hot topic for quite some time, and for good reason. I can understand why many people think it is "wrong" or "not god's will" but I still think if someone has been battling a terminal illness and has exhausted all other options that they are entitled to controlling how they leave this world. This makes me think of the movie "Still Alice" where she records herself instructing her future self how to, essentially, die with dignity before things get too far and she loses complete control of her body and mind.
The other issue I can see people having would be having to live with the fact that you helped "kill" someone. But like i said earlier, I think that if all other reasources have been used and there is no relief from pain then they should be able to go in peace, and that provider can look at the situation as helping them leave with dignity and free them from the pain and suffering, and it might even help the family with coping in the long term if this is something that can be planned and controlled.

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Physician-assisted suicide is defined as the act of assisting people with their death in order to end their suffering. Physician assisted suicide is legal in 5 states according to CNN.com. In my opinion I think the patient has the right to choose when he/she wants to end their suffering of pain with a disease that is terminal with less than 6 months to live. I believe they should be in the right state of mind, and  witnesses present at the time of consent. I would leave this treatment as a last resort only if the patient is alert and has gone through an assessment. I think that the patient should be well aware of consequences that could effect their  health and what other measurements could be used to help with palliative care. I believe that having a pain free death is everybody's dream but in reality no one knows when or how they are going to die. On the other hand the patient may feel some relief because they are not taking their own life which they would refuse because of religious reason. So if someone is assisting with the death with a sedation to make the patient unconscious the patient is relieved that she/he will not be punished in the afterlife.

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Terminal sudation is when a patient it put into sudation using medications, this will lead to the patient being able to die peacefully. In my option I believe that if a patient wants to seek out terminal sudation or physician assisted suicide that it should be their right if they are terminally. I think that it is a patient right to die with dignity. It is that the last right that a patient can have the last decision that they can make while are still compensated. I know that if I was dying a long painful death and didn’t want to drag it out until I wasn’t able to control my body anymore. I would want to allow that same courtesy to a dying client. I know for some there is a religious component to take in consideration when making this type of decision. I think that for them I would recommend the terminal sudation because it is putting someone in to a coma to ease their pain and not providing them with above and beyond measures. In a sense they are passing in their sleep. I know this is not for everyone but for the ones that want this option I would be willing to help them with this task. I know that if they are at peace with their choices then I am not here to judge them or there choices.  If they are already dying then why must they die in slow, painful way?

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yanelys denis-centeno (nelly)  The hard case of palliative sedation the palliative care movement has been instrumental in bringing attention to experience of pain at the end of life and tools to lessen it. The population keeps growing this mean that the increase of individual with illness either chronic or acute will live longer will the advance of technology and prevention. Sedation palliative care is an affective symptom control strategies for patients who suffer with irreversible symptoms at the end of their life. palliative sedation is an intervention for extreme situations s  In my opinion I think it should be a decision that the family and the patient should agree while the patient is able to express their will, and for some other patients who cannot make the decisions for themselves and if not family members available they should not suffer at all. I think no one should suffer at the end of their life. They should be comfortable and be able to pass away peacefully. On the other hand patients has the right to refuse any treatment and any medical emergency need it. I agree with palliative sedation I think is a better way to keep patients away from being in pain or suffering, I also think is a difficult decision to make for families and patients. The palliative care can be done at home or at a facility with help of a physician and social workers can be involve too to make those kinds of arraignments. if the person has the right to be given the right care and the right environment they should have a peaceful death. 

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yanelys denis-centeno (nelly)  The hard case of palliative sedation the palliative care movement has been instrumental in bringing attention to experience of pain at the end of life and tools to lessen it. The population keeps growing this mean that the increase of individual with illness either chronic or acute will live longer will the advance of technology and prevention. Sedation palliative care is an affective symptom control strategies for patients who suffer with irreversible symptoms at the end of their life. palliative sedation is an intervention for extreme situations s  In my opinion I think it should be a decision that the family and the patient should agree while the patient is able to express their will, and for some other patients who cannot make the decisions for themselves and if not family members available they should not suffer at all. I think no one should suffer at the end of their life. They should be comfortable and be able to pass away peacefully. On the other hand patients has the right to refuse any treatment and any medical emergency need it. I agree with palliative sedation I think is a better way to keep patients away from being in pain or suffering, I also think is a difficult decision to make for families and patients. The palliative care can be done at home or at a facility with help of a physician and social workers can be involve too to make those kinds of arraignments. if the person has the right to be given the right care and the right environment they should have a peaceful death. 

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Personally, I have always felt that assisted suicide should be an available option for those who are dying from an illness that is deemed terminal. I also feel that it should become less of a stigma; that people are choosing to “give up” and that they need to “stay strong and keep fighting.” Not only is that dismissive of another person’s feelings regarding their life and illness, it is unreasonable to expect someone to willfully continue to suffer, when there are options available that will end their suffering. Assisted suicide allows a person to be in control of their life and their death, and they deserve the right to choose whether or not they have to suffer through their impending death, if they don’t actually have to. I understand that it is a moral concern, as brought up by both articles. The oath to “do no harm.” But what we sometimes fail to understand is that our morals and values don’t mean much to someone else. Especially someone who is suffering. They have their own morals and values and they also have rights. It isn’t about what anyone else wants, or how anyone else feels; it’s about the patient and their desire to have, and I am a firm believer in this concept, a Good Death. A Good Death could mean different things to anyone; dying in your sleep, dying quickly without pain, etc. I doubt many people who say their idea of a Good Death would be “dying of terminal cancer, unable to breathe and choking for air” or something similar to that. As people in the USA, we have a right to choose how we live, what religion we follow, how we care for our loved ones, and who we choose to love; we should be able to be in control of our deaths as well.

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Physician Assisted Suicide-- Emily Lindeman

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Physician Assisted Suicide-- Emily Lindeman

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My belief about physician assisted suicide has changed over the years. Originally I felt as though it was a horrible injustice to intentionally end someone's life, but now that I've  been around patients as they pass away I've grown to appreciate that some states offer an alternative to suffering through pain. According to the article about Mr. Johnson, he suffered from prostate cancer. He had known for 20 years that he was going to die, and was given the option of sedation into a comatose state from the anesthesiologist Dr. Jackson, so that he wouldn't be consciously suffering from pain. The Dr. also gave Mr. Johnson the option of a feeding tube to be placed after he would be put under sedation so that he wouldn't die from dehydration but rather the natural progression of his illness would end his life instead. Once Mr. Johnson started going through organ failure, a local bishop was upset with the way things had been handled. Mr. Johnson essentially was dying from dehydration complications, which the bishop felt was unethical.
This article is closer to how I feel about Physician Assisted suicide. There are so many emotions felt around the time of death by both the patient and their family alike. My opinion on assisted suicide hasn't changed, I still feel as though a healthcare professional should be doing all they can to help someone maintain life. There are many people who would disagree with me and say that doing what the patient desires is whats most important for end of life care but I disagree in that I still believe maintaining life and overall health should be my main goal as a nurse.