Nurses: Assisted Suicide vs. Supporting End-of-Life Care - Essay Sample

Introduction

According to the ANA's (American Nurses Association) Code of Ethics for Nurses, it is the obligation of professional nurses to offer supportive care services and intervene to enable dying patients. The expectation is to offer as much physical, social, emotional, and spiritual wellness as possible (Olson & Stokes, 2016). The term assisted suicide refers to the provision of means where a suffering person can kill themselves. The notion is commonly confused with euthanasia, which is the practice of putting a person to death due to terminal illnesses or incapacitating physical disorders (Emanuel et al., 2016). The intention is allowing them to die by either withholding medication or artificial means, thereby limiting the suffering of the patient. Nevertheless, assisted suicide remains to be a contentious, emotive, and ethical issue within the healthcare community (Emanuel et al., 2016). It is, therefore, critical for arguments from both sides to be assessed before professionally voicing opinions.

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The ANA's perception towards assisted suicide is that it is unethical as it contradicts the core values of the organization and the practice of nursing. Therefore, nurses represented by the organization are ethically mandated not to participate in the practice but rather offer all-embracing care (Emanuel et al., 2016). However, with regulations such as the Oregon Death with Dignity Act passed in 2008, contradicts the ANA's policies by allowing the act to be done medically on the request of the patient (Emanuel et al., 2016). Such actions have raised both national and international deliberations on the issue of autonomy and the right for individuals to choose the means and timing of their death. Currently, assisted suicide is legalized in California, Colorado, District of Colombia, Hawaii, Montana, New Jersey, Oregon, Vermont, and Washington states (Emanuel et al., 2016). In the state of Nevada, the terms for assisted-suicide must be determined by a court ruling.

Nevertheless, nurses are the first point of communication for patients; therefore, each nurse must determine the actions to be taken when presented with patients requesting assisted suicide (Gross & Schwarz, 2012). Such situations are recognized for being challenging as it attributes to uncertainty and personal conflict. The notion contributes to the ethical pressures associated with addressing requests for assisted suicide considering nurses protect life morally and professionally. Assisted suicide is not a new practice, but one that can be dated back to the 5th century (Gross & Schwarz, 2012). Then, ancient Greeks and Romans were tolerant of the notion of assisted-suicide as well as euthanasia. The type of society had yet to identify the value of human life cogently.

Pros and Cons

Supporters

There are numerous contentions towards the support and rejection of the practice of assisted-suicide, with both aspects offering ethical and moral considerations. Among the first supporters of assisted suicide is ICN (The International Council of Nurses). The organization stated in a 2012 article, Nurses' Role in Providing Care to Dying Patients and Their Families, that the right to die is a fundamental human right (ICN, 2012). The organization further supported by the ALCU (American Civil Liberties Union), which supports the exercising of personal autonomy, particularly when addressing death. From the perspective of the identified organization, death should attain similar recognitions as life. Humanity has the freedom to decide when to die as well as how to live. The notion is then expected to be supported by the legal system equally.

The other organization support assisted suicide is Compassion and Choices. The organization states that palliative care should be mandatory for patients with terminal illnesses (Srinivasan, 2018). However, it is critical to note that the definition offered by the organization does not offer much guidance on the process. Regardless, it works on the assumption that specific conditions are terminal, and the best alternative is to offer sufficient hospice care where primary care was neglected. The organization considers the various levels of suffering experienced by terminally ill patients and suggests that assisted-suicide can offer much-needed peace (Srinivasan, 2018). Finally, according to an article presented by NRP (the National Public Radio), When Prolonging Death Seems Worse Than Death, states the current healthcare system in America only prolongs death for terminally ill patients. The interview detailed the various causes for people to request assisted suicide (Gross & Schwarz, 2012). Among them was the fact that most terminally ill patients do not enjoy life. The pain caused by the condition is manageable (Gross & Schwarz, 2012). However, the psychological and emotional damage contributes to the desire to end one's life.

Detractors

Among the leading organizations rejecting the notion of assisted-suicide is the Supreme Court, as depicted in the 1997 case, Washington v. Glucksberg, 521 U.S. 702. The landmark case positioned the legal system against assisted-suicides in the United States. The case decision argued that assisted suicide was protected by the Due Process Clause under the Fifth and Fourteenth Amendments of the constitution (Washington v. Glucksberg, 1997). The court found assisted suicide as being a superfluous liberty interest. Assisted suicide is not genuinely rooted in the country's history, thereby fails to qualify as a liberty interest (Washington v. Glucksberg, 1997). Finally, its structure and purpose in neither protected nor supported by the constitution.

The second opposer to assisted-suicide is the ANA; the organization detracts the notion of assisted-suicide. The organization claims that nurses, both individually and cooperatively, have the duty to provide comprehensive and empathetic end-of-life care for terminally ill and other patients facing death (Olson & Stokes, 2016). The notion is to promote comfort, emotionally, physically, and mentally, thereby, based on the identified reasons nurses are ethically prohibited from participating in assisted suicides (Olson & Stokes, 2016). The practice violates the Code of Ethics for Nurses as well as the ethical code of the profession, as initially mentioned. With states such as Oregon supporting assisted suicide, the ANA revised its policies and only allows nurses to prove patients with decision making as well as pain management. Finally, religious organizations such as the USCCB (United States Conference of Catholic Bishops). USCCB cites medical and nursing organizations such as the ANA and ACP as being against assisted -suicide (Cataldo et al., 2019). However, the practice continues. According to the organization, life is valuable, and individuals involved in the act of taking lives regardless of circumstance are no similar to murders. They argue that pain medication has developed to the point of being able to be applied to terminally ill patients. Therefore, they refute the argument posed by supporters that assisted suicide is a form of mercy on the side of the patient.

Personal Viewpoint

The viewpoints expressed by the ACP highly concur with personal views from a nursing perspective. The assessment of assisted-suicide identified that pain is not the leading cause for desiring assisted suicide but rather the depression of being a burden or not being able to revert to previously mundane activities. With clinical depression being identified as the critical cause for the desire of assisted-suicide, the best action to be taken should be addressing the depression. Being a realist, the notion of depression does not support the cause; instead, it offers a permanent solution to a temporary problem. The role of nurses is to preserve life, and assisted suicides negate the responsibility expected of nurses. Provision 4 states that nurses have the authority, accountability, and responsibility for the nursing practice. It identifies that nurses must assist patients, however, in the preservation of life. Though the code of ethics was modified, it still prohibits assisted suicide. The notion of preserving life is further noted in provision 8, where nurses are required to collaborate with other medical professionals as well as the public in upholding human rights and health mediation. Nurses are expected to value patient's lives as they do theirs; the notion is depicted in provision 5 that states that nurses owe the same obligations to patients as they do to self. It is then reinforced by provision 9 that asserts that the nursing profession through professional organizations must express the core nursing values among them is the preservation of life.

Nursing Strategies

Nursing ethics is a critical part of the profession's training curriculum, and it is implemented for the main reason for delivering appropriate care to the patient. However, when addressing assisted-suicide, numerous strategies can be applied. The first is viewing everyone as somebody, viewing other people as colleagues are critical when addressing patients seeking assisted suicide. For practitioners to impart them with necessary information on their decision, they must be treated with respect. It is stated to facilitate communication. Secondly, when addressing the patient, they must be educated with facts rather than opinions as they are subjective. Subjective information may be viewed differently by both parties, thereby resulting in misinformation. It is coupled with the fact that people have different grieving patterns. The third approach that applies to patients seeking assisted suicide is observing patient rights and needs. The approach is ethical for numerous reasons among them, the patient being offered what they need to sustain life rather than what they want. Seeking expert opinion or consultation on such matters can also offer proper insight on how best to handle the situation. Nurses are medical professionals and humans as well. They are not informed of everything, thereby seeking assistance is a viable approach while maintaining ethical expectations. Finally, all patients must be handled with respect regardless of their decisions regarding life. Therefore, nurses should respect the expectations of patients but comply with nursing regulations.

Conclusion

Nursing is a critical profession that directly attends to the medical needs of patients; it is controlled by ethical principles that dictate the best approach to the occupation. Nevertheless, in nursing, life is valued, and therefore, notions such as assisted suicide are disproved from practice. The evaluation identified that the preservation of life is the core principle of nursing, and assisted suicide contradicts it. Numerous other organizations support the practice claiming that humanity has the right to death just as we have the right to life. The argument, however, is not applicable in nursing; some states have modified their regulations, such as Oregon allowing for assisted suicide. Nursing as a profession disapproves of the practice finding it unethical and going against the majority of the regulations set by nursing organizations.

References

Cataldo, P., O'Brien, D., & Byock, I. (2019). Palliative care and Catholic health care. Springer, Cham.

Dwyer, D. (2019). Psychological Issues in Catholic Palliative Care: The Challenge of Requests to Hasten Death. Philosophy And Medicine, 109-117.

https://doi.org/10.1007/978-3-030-05005-4_8Emanuel, E., Onwuteaka-Philipsen, B., Urwin, J., & Cohen, J. (2016). Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe. JAMA, 316(1), 79. https://doi.org/10.1001/jama.2016.8499

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