How Should a Nurse Support Patients in Choosing a Time to Die?

Two of my six aunts died from Alzheimer disease (AD). They didn’t live nearby, so when I saw them every few months, the deterioration from the illness was evident. Both showed the same behavioral trends: some mild forgetfulness and repetitive questioning at first, then what seemed a prolonged period of incessant questions and bewilderment and anxiety over not understanding where they were or why they were there, who others were. Wandering outside at all hours, agitation and resistance to hygiene, eventually disappearing into a nonverbal, nonresponsive state.

It was painful to watch these formerly active, smart, and vibrant women decline in such a way. The most painful part was when they still understood that they were becoming confused and how frightened that made them.

Now there are alternatives available for those who don’t want to go down that road—but they are hard to come by, especially if you live in the United States.

People with dementia face particularly high hurdles.

A special feature in the March issue, “Medical Aid in Dying: What Every Nurse Needs to Know,” covers medical aid in dying and the nurse’s appropriate role in many end-of-life circumstances, including the ethically and logistically challenging situations of those with dementia who seek some agency over […]

2022-03-28T09:59:28-04:00March 28th, 2022|Ethics, Nursing, nursing roles, patient experience|0 Comments
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Nurses, Dying, and Who Gets to Decide

by Ramon Peco/via Flickr

On Wednesday, a California court declared the state’s right-to-die law unconstitutional. The End of Life Act (AB-15) was passed in 2016 in a special session called by Governor Gerry Brown, and permitted physicians to prescribe medications to a patient “for the sole purpose of ending his or her life.” California was one of just a handful of states that had such legislation. Reports note that an appeal is likely.

And also last week, Australian scientist and right-to-die advocate David Goodall, who was 104 years old, flew to Basel, Switzerland, to take advantage of its right-to-die law and end his life. According to the New York Times, Goodall, whose health had been deteriorating since a fall, said, “One wants to be free to choose his death when death is at the appropriate time.” Mr. Goodall lamented that his home country didn’t allow him to die there.

An ongoing debate.

These events last week underscore the struggle over whether people have a right to choose to end their lives and who should decide that. It’s also why we are very pleased to highlight this important topic in the current issue of AJN.

In “Assisted Suicide/Aid in Dying: What Is the Nurse’s Role?”, ethicist Ann Hamric and colleagues report on […]

2018-05-18T14:04:40-04:00May 18th, 2018|Nursing|1 Comment
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Aid-in-Dying: A Daughter’s Challenging New Nursing Role

A father’s request.

The March Reflections essay in AJN is by a nurse whose terminally ill 92-year-old father asked her to help him legally end his own life under the requirements of Oregon’s Death with Dignity Act. The short essay is intimate, informative, and honest. Here’s a brief excerpt from near the end:

Although I miss my father terribly, I have no regrets. Mostly, I am thankful for his strength and courage, his clear-mindedness, and his willingness to work with me to repair our relationship. I am also thankful that nursing prepared me for the role of nurse advocate and taught me how to ‘be with’ a person at the end of life, even when that person was my father.

By Barbara Hranilovich for AJN.

Death With Dignity laws.

It can’t be easy for a nurse, whose job usually focuses on restoring patients’ health and preserving their lives, to help a family member die in this way. Nor is the process without challenges: the requirements of Death with Dignity laws are rigorous, layered with checks and double-checks to guard against potential abuses. […]

2018-02-26T10:41:13-05:00February 26th, 2018|Nursing, nursing stories|1 Comment
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Nurses, Brittany Maynard, Methods of Hastening Dying: No Easy Options

By Amanda Anderson, a critical care nurse and graduate student in New York City who is currently doing a graduate placement at AJN two days a week.

Last weekend, 29-year-old Brittany Maynard died, in her bed, in her bedroom, with her husband and immediate family beside her. I learned of her death on Twitter, along with millions of other readers. Several weeks earlier, Maynard had publicly announced, in a YouTube video, the way she planned to end her own life: using a lethal dose of medications prescribed to her for that purpose.

Maynard, while a compelling public advocate, is not the first to choose to die this way. Compassion and Choices, the organization that worked with Maynard to publicize her choice, lobbies for the drafting and passage of “death with dignity” laws, which currently exist in some form only in Oregon, Washington, Vermont, New Mexico, and Montana. Arizona.

In Oregon, where Maynard moved in order to be able to legally end her life before she was incapacitated by the effects of terminal brain cancer, approximately 71 other people made the same choice in 2013, the most recent year of reported data—the peak of a gradual increase from the law’s inaugural year of 1998, when 16 people did so.

Illustration by Denny Bond for AJN. All rights reserved.

2016-11-21T13:03:35-05:00November 5th, 2014|Nursing, nursing perspective, patient engagement|8 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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