Introduction
This paper studies assisted suicide and the issues concerning the topic. It provides an overview of the available terms and explains the difference between them. The article presents background on medical aid in dying as well as statistical data, including information about its incidence and the countries that support the practice. It also concerns the significance of assisted suicide to mental health issues. Finally, the paper reflects on caregivers’ role in the action and its relevance to nursing.
Overview
Assisted death has been an acute topic that raises questions of ethics, morals, and religion (Banović, Turanjanin, & Miloradović, 2017). It is necessary to distinguish between euthanasia, assisted suicide, and physician-assisted suicide. According to De Lima et al. (2017), euthanasia can be defined as an act of a person (usually a physician) ending another individual’s life by induction of drugs following their voluntary request. Assisted suicide is a general term that can be defined as an individual helping another person to terminate their life at a competent request by providing the means for conducting the auction. Physician-assisted suicide involves a medical professional that provides drugs for self-administration that a patient can use at a chosen time (De Lima et al., 2017). In the last case, individuals have full control over the process.
History and Statistics
It is unclear when the idea of euthanasia first emerged. Debates about legalizing it along with physician-assisted suicide have been present for the past two centuries (Emanuel, 2017). Switzerland was the first country to decriminalize medical aid in dying in 1942 under the condition that there were no selfish motives of a physician. Belgium and the Netherlands joined in the initiative in 2002, and Luxembourg supported it in 2009. Colombia and Canada decriminalized euthanasia and physician-assisted suicide in 2015 and 2016, respectively. Currently, physician-assisted death is legalized in five US states, including Oregon, Washington, Montana, Vermont, and California (Emanuel, 2017). It is essential to mention that even in the countries where such interventions are permitted, they are not frequently used. According to Emanuel (2017), in the Netherlands, less than 0,5% of deaths are cases of physician-assisted suicides. Oregon and Washington State report similar statistics.
Significance to Health Issues
A desire to die is closely related to mental health disturbances that can be caused by a prolonged period of pain. In this regard, medical aid in dying can be perceived as a way to stop an individual from suffering. Moreover, the decision to make assisted death requests is usually caused by hopelessness and patients’ increased dependency on their relatives or medical staff. It means that for some people, such action is a significant step since they believe that it can improve their family members’ lives. However, it is necessary to mention how assistance in dying can affect physicians’ mental health too. Helping someone end their life, even following their voluntary request, can cause regret, ambivalence, and discomfort.
Role of the Nurse
Nurses are often perceived as patient advocates as they can express individuals’ wishes for treatment and care. According to Wilson, Oliver, and Malpas (2018), over the last decade, caregivers have become largely involved in assisted suicide due to the legalization of the practice in several countries. Nurses are the first people with whom patients can discuss their assisted suicide requests (Francke, Albers, Bilsen, de Veer, & Onwuteaka-Philipsen, 2016). Unfortunately, only the Belgian euthanasia act and the professional guidelines of the Dutch national nurses’ associations concern the nurses’ role in the decision-making process. These documents state that physicians have to discuss assisted death requests with caregivers involved in the daily care of a patient. However, nurses are not allowed to administer lethal drugs (Francke et al., 2016). They can assist physicians in preparing the lethal drugs if those ask them to do so but cannot be directly involved in actions that result in the patient’s death.
Relevance to Nursing Practice
Assisted suicide is related to nursing practice. Even though caregivers have no legal permission to perform people’s death by administering drugs, it is essential to point out that nurses can contribute to individuals’ well-being by being committed to helping them. As caregivers are usually the first people with whom individuals discuss their concerns, it is clear that they should strive to build trust-based relations with their patients. In the case of medical aid in dying, nurses should communicate with their patients to explore the reasons for assisted suicide requests and, if possible, seek alternative solutions and provide emotional support (Sulmasy & Mueller, 2017). They should also ensure that patients are informed about their rights to stop taking prescribed medications or other treatment, as well as any medical interventions. It is essential to note that nurses can choose not to participate in assisted suicide.
Conclusion
Medical aid in dying is a highly controversial practice as it concerns ethical, moral, and religious issues. Currently, it is fully legalized in six countries and is partially implemented in the United States but is not used as a common practice. The question is strongly related to the physical and mental health disturbances of patients. Nurses have become increasingly involved in assisted suicide with its legalization in some countries. It means that caregivers’ role in communicating patients’ needs has enhanced as well. The issues of medical aid in dying demand further investigation to evaluate the benefits and limitations of the practice.
References
Banović, B., Turanjanin, V., & Miloradović, A. (2017). An ethical review of euthanasia and physician-assisted suicide. Iranian Journal of Public Health, 46(2), 173-179.
De Lima, L., Woodruff, R., Pettus, K., Downing, J., Buitrago, R., Munyoro, E.,… Radbruch, L. (2017). International Association for Hospice and Palliative Care position statement: Euthanasia and physician-assisted suicide. Journal of Palliative Medicine, 20(1), 8-14.
Emanuel, E. (2017). Euthanasia and physician-assisted suicide: Focus on the data. The Medical Journal of Australia, 206(8), 339-340.
Francke, A. L., Albers, G., Bilsen, J., de Veer, A. J., & Onwuteaka-Philipsen, B. D. (2016). Nursing staff and euthanasia in the Netherlands. A nation-wide survey on attitudes and involvement in decision making and the performance of euthanasia. Patient Education and Counseling, 99(5), 783-789.
Sulmasy, L. S., & Mueller, P. S. (2017). Ethics and the legalization of physician-assisted suicide: An American College of Physicians position paper. Annals of Internal Medicine, 167(8), 576-578.
Wilson, M., Oliver, P., & Malpas, P. (2018). Nurses’ views on legalising assisted dying in New Zealand: A cross-sectional study.International Journal of Nursing Studies. Web.