Gertrude (not her real name; other identifying details have been changed) was 99 years old. Having survived the Holocaust and overcome many other challenges in her long life, she thought it ironic that she had to ask her children to help her die.

Although she was not terminally ill, the quality of her life was significantly diminished by many chronic ailments. Despite two hearing aids, her hearing loss was such that she could no longer indulge her one remaining pleasure: listening to classical music. She had fallen and broken a hip when she was 96 and now had to use a wheelchair when moving around her apartment. She had severe arthritis, and she rarely left her apartment except for medical appointments. All friends and many family members had long since died, and her deteriorating vision-a result of a recent bout of shingles-left her unable to read or watch television. After years of living with these and other chronic conditions, she told her family she was tired of life and was ready to leave. Her children and grandchildren told her to be patient. She was almost 100; surely she would soon die peacefully in her sleep.

The tone and frequency of her requests for help in dying changed dramatically after her ophthalmologist told her she would never regain her vision.

Read the rest of “Gertrude’s” story in the September issue of AJN here, and also a discussion of the ethics and legality of talking to patients about options for voluntarily ending their own lives. The author, Judith Schwarz, works for an end-of-life advocacy organization, and her position may be controversial with some readers. We invite respectful conversation on this or related issues. Whatever our beliefs or opinions, this is a topic we shouldn’t shy away from, since, as Schwarz points out, studies have revealed that a large percentage of nurses will at some point be asked by patients for help or advice about ending their lives.

Nurses, have you ever been confronted with such a request, whether for active help or for advice? And if so, how did you handle it?

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