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The reason I am here to talk about medically assisted suicide is because many people do not have access to it. It is directly affecting terminally ill patients in they most vulnerable time of life. They are forced to watch as their life, bodily functions, and dignity are stripped away until they pass. Many will be in excruciating pain near the end that they will have rely heavily on medication to control the pain. They need to have the option to choose their way out of this life rather than have a disease make that decision for them. As it stands many do not have the choice because in most of the United States it is still illegal.

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1. Circumstances affecting patients’ euthanasia or medically assisted suicide
decisions from the perspectives of patients, relatives, and healthcare
professionals: A qualitative systematic review

This article reviewed multiple studies and most of the families were receptive to euthanasia. Many families saw it as a way to be in control until the end. The study showed that understanding culture, religion and heritage helped to facilitate the conversation between staff and families (Xu, et., al. 2023).

2. Rethinking Medical Aid in Dying: What Does It Mean to ‘Do No Harm?’

This is a study that goes into the opinions of healthcare workers as well as some of the statistics of who is most likely to use it. Many opinions change when the wording changes. The study uses the example of the difference between "do not resuscitate" and "allow natural death". They mean the same thing but have a different impact on the one hearing it. The same is found to be the case with euthanasia. The term "medically aided death" was found to be a lot more ominous than "dying with dignity" (Lawry, 2023).

3. Opinions of nurses regarding Euthanasia and Medically Assisted Suicide

This research was aimed to know the opinions of hospital staff on the legalization of medical euthanasia. This study found that over 75% of hospital staff were in favor with 66% saying that it should be a joint collaboration between the nurses and providers. Hospital staff are the ones who, unfortunately are very familiar with the pain that people experience through certain diseases. Many found that it was more in line with the "Do no harm" clause to give patients the option rather than force palliative care (VelascoSanz, et., al. 2022).

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In 2019 the American Nurses association put out a positional statement regarding medically aided death. They state that a nurse “should provide interventions to relieve pain and other symptoms in the dying patient consistent with palliative care practice standards and may not act with the sole intent to end life.” They went on to explain that a nurse may give the medication to the patient for them to take however they will not administer the medication themselves that will end a patients life. Like any other procedure the nurse is responsible for monitoring the patient, advocating for their needs, and providing information and education. The nurse is responsible for the same things they would be before any surgery. They listen to the patient and ensure that they're not having second thoughts.

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In the day to day life of a hospitalized patient the doctor usually sees them for a maximum of 30 minutes a day. A nurse is coming in and out of their room. The nurse is the one talking to the patient and building a bond with them. A nurse is usually the first one that a patient will confide in. This is important because that bond will allow for open and honest communication about medically assisted suicide. They will be able to educate the patient on areas that they are unclear. The nurse can advocate for a patients choice even if the patient's family is pushing for something else. A nurse is the frontline defender of a patient's autonomy and right to choose.

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1. Religious beliefs

In certain religions it is prohibited for one to take or assist in the taking of another's life. It cannot be right for a person to go against those beliefs and assist in the medically aided death of a patient. If the policy was adopted for nurses it could cause resentment and the loss of nurses that were forces to choose between their religious beliefs and their nursing care obligations. This presents a legal/ financial obstical for a hospital because if freedom of religion is enfources by the constitution and as a hospital it would be dangerous to fource someone to go against their religion.

2. States where it is legal

Currently there are only 11 states where "Death with dignity" is legal. Those states include california, colorado, DC, Hawaii, Maine, Montana, New Jersey, New Mexico, Orogon, vermont, and Washington. However, There are multiple states that are considering adopting it this year. Those states include Arizona, Connecticut, Delaware, Florida, Illinois, Indiana, Kentucky, Maryland, Massachusetts, Missouri, Nevada, New Hampshire, New York, Rhode Island, and Tennessee. In other states is is still illegal and blocks access to patients in need (Death with Dignity, n.d). All of this presents legal implications because if medically aided suicide is illegal it would make the act seen as murder.

3. Ethical barriers

Many people (including nurses) are against euthanasia. It is sometimes seen as wrong because it goes against many cultural and social norms. We are taught from a young age that we obey the law, respect others, and protect life. The purposeful ending of a human life goes against many of the things we were taught even if it will save the patient from suffering. Many also believe that it is a slippery slope to involuntary euthanasia and gives people who are suicidal a way to do it without giving them help and support. These are all things that are and need to be talked about in states where legalization is being considered. The social and financial implications for a hospital could be great if the public loses trust in the hospitals.

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1. Right to opt out

Nurses need to have the choice to opt in or out of this program. For some this program goes against their core beliefs. Weather those are moral or spiritual beliefs they need to be respects. This program should be run only by staff who choose to opt in. This respects the staff beliefs while still providing patient care.

2. Classes In preparation

Before implementing this into any hospital there needs to be classes for any of the nurses who wish to participate. These classes can cover how it works and clear up any questions surrounding it. When providing this type of care a nurse needs to be prepared for how to have conversations surrounding death. A class can help prepare nurses prior to patient interactions.

3. Extra counselors on staff

While the research has shown that many nurses would be willing to facilitate and participate in this care it can still take its toll. If we want to have nurses that care for patients with dignity and respect then we need to take care of their needs as well. There should be measures in place to provide extra counseling staff ready to listen. This would allow the nurses to talk about the stress surrounding it with a trained professional.

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Leadership qualities SCOHS has taught me.

Self Care

SCOHS taught us from day one that we needed to take care of ourselves if we wanted to take care of others. The same applies to nurses taking care of patients at the end of life. While it is a noble job to be able to give someone a dignified death it can also weigh on the soul. As a leader, we will have other people relying on me to be strong and have answers. Taking care of oneself to be present and ready at work is something that cannot be understated.

Therapeutic Communication

Therapeutic communication does not just extend to interactions with patients. It can assist in the way that we talk to families, colleges, and even supervisors. Being a good leader assists means that the people who follow you need to feel heard. Having the tools to assist in productive and fruitful conversations will help in the stressful circumstances of assisted suicide. When dealing with these circumstances, having a leader that listens and can communicate is essential.

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Death with dignity U.S. legislative status state map. (n.d.). https://deathwithdignity.org/states/

Lawry, (2023). Rethinking medical aid in dying: What does it mean to ‘do no harm?’ Journal of the Advanced Practitioner in Oncology, ¹⁴(4), 307–316. https://doi.org/10.6004/jadpro.2023.14.4.5

VelascoSanz, et., al. (2022). Opinions of nurses regarding euthanasia and medically assisted suicide. Nursing Ethics, ²⁹(7–8), 1721–1738. https://doi.org/10.1177/09697330221109940

Xu, et., al. (2023). Circumstances affecting patients’ euthanasia or medically assisted suicide decisions from the perspectives of patients, relatives, and healthcare professionals: A qualitative systematic review. Death Studies, ⁴⁸(4), 326–351. https://doi.org/10.1080/07481187.2023.2228730