It's a good question. There are some countries where assisted suicide is legal and that actually includes the United States- but it's not true of the entire country. In the US, states have been left to decide for themselves. As of this writing, there are nine states where PAD (physician-assisted death) is legalized: Colorado, the District of Columbia, Hawaii, Maine (as of September 2019), New Jersey, Oregon, Vermont, and Washington. Additionally, Montana and California allow it if court-mandated.
Even in those states, however, certain conditions must be met, including the patient having a terminal diagnosis and fewer than six months to live.
So are we mass-killing terminal patients? Of course not. In 2018, a grand total of 1,459 people died after ingesting medications legally prescribed to them for the purpose of PAD.
Note that physicians are allowed to assist these patients in procuring the medication but even then, the patient must self-administer it; euthanasia, where a physician administers the lethal dose, remains illegal in the United States and the vast majority of countries with a few exceptions.
Nurses are entirely forbidden from administering a PAD medication and any self-imposed "euthanasia" is open to full prosecution by the law. In fact, the ANA (American Nurse's Association) recently released a statement to clarify the nursing field's position on PAD; it advises that, while nurses are prohibited from administering aid-in-dying medication, they should remain objective when a patient is exploring this health option.
In other words, the ANA wants us to support patients in whichever treatment option they choose.
This is a sharp reversal from its former position, which strongly advocated for life. I find it encouraging, actually, because it shows a shift in nursing attitude from preserving all life, always, to preserving quality of life- a much more important measure.
The ANA emphasized in its press release that "euthanasia is illegal in the U.S. and inconsistent with the core commitments of the nursing profession." Nevertheless, it encourages nurses to become educated on the nuances and ethical dilemmas of this issue and use that knowledge to support the patients in their care.
In the future, I believe we can expect this position to evolve further. More states and more countries are legalizing processes by which terminal patients ingest legally prescribed medications to end their life, or are even legally assisted by a physician to do so. It remains a highly complex and personal decision for the patient, their family, and their physician.
What do you think about PAD (physician-assisted death)? Would you know how to support a patient who is considering it? Read the interesting experiences of nurses in Canada who have interacted with the MAID (medical aid in dying) program and their thoughts. Let me know your thoughts below!
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