The right to die raises questions for healthcare professionals

By CareerSmart Learning Contributor, November 2014 , as published by Healthcare Hot Spot

The debate surrounding Death with Dignity loudly resurfaced this year due to the story of Brittany Maynard, but the issues related to Death with Dignity have been the subject of passionate debates for generations. Some view Death with Dignity as a compassionate means of allowing individuals to end their own pain and suffering, while others view it as an act of suicide in direct violation of religious and moral principles.

What is Death with Dignity?

Oregon is the first state that passed a Death with Dignity Act on Oct. 27, 1997. The act provides those who are mentally competent, terminally ill the right to end their own lives with the self-administration of lethal medication, which must be prescribed by a physician. In order to ensure compliance with the applicable statutes, the Oregon Health Authority collects information about patients, family members, and physicians involved in the care of those invoking their rights under the Death with Dignity Act. Two other states that enacted similar Death with Dignity Acts are Washington in 2009 and Vermont in 2013 (Death with Dignity National Center, 2014).

Who is Brittany Maynard?

In 2013, Brittany Maynard, age 29, was diagnosed with an advanced brain cancer and given six months to live; however, she fought on through aggressive treatment while dealing with the pain, seizures, and malaise of stage 4 cancer.

In January 2014, Brittany came across a site on the Death with Dignity Act while searching for another answer to caring for her illness. As time passed, she made the decision to end her life on her own terms, and she moved to Oregon, which has laws that allow patients to have the right to die with dignity under certain conditions. She was able to spend her last days with her mother and husband, and on Nov. 2, 2014, Brittany Maynard ended her own life under the care and supervision of a physician and in a manner consistent with the laws of the state of Oregon.

How Does the Debate over Assisted Suicide Impact Healthcare Providers?

Earlier this year, Brittany realized that vast numbers of people who want to die with dignity lack the right to do so in the majority of the United States. She began sharing videos of her journey for the world to see in hopes of raising awareness for the right to die with dignity. The outpouring of support from followers of Brittany’s story has rekindled the controversy of Death with Dignity, or more commonly referred to as “assisted suicide.”

But for healthcare professionals, the issue can create a conundrum. Although not required by law, most physicians and physician assistants take the Hippocratic Oath upon completion of their training. One of the stipulations of the Hippocratic Oath involves not allowing others to harm themselves or bring harm to others, which directly contrasts with the idea of assisted suicide. On the other hand, the Hippocratic Oath also encourages healthcare providers to do everything they can to prevent another from suffering, which seems compatible with the idea of assisted suicide, so long as it is intended to end suffering and promote individual dignity and personal rights.

Ethical principles for healthcare professionals are developed to help guide behavior when such conundrums exist. Physicians, nurses, and case managers, for example, each have their own codes of ethics that should be referenced and consulted when faced with these kinds of ethical challenges or debates. What does a nurse do if he or she practices in a state where Death with Dignity is allowable, and they have to care for a patient requesting assistance in this regard, but it conflicts with their personal religious or philosophical beliefs? What does a physician do if his or her personal or philosophical beliefs support Death with Dignity, and they are asked to assist a patient suffering from a terminal illness in facilitating their death, yet they practice in a state where this is illegal? Just because laws of the state in which a healthcare professional practices support one side of the debate or the other does not eliminate the existence of ethical concerns for healthcare professionals struggling to balance their own philosophies, professional judgments, and competing pressures from patients, families, managed care providers, popular discussions, etc. This is what the Brittany Maynard story has highlighted, and this is why the debate, which is a healthy one, should continue.

What do you think about this story?

 

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February 20, 2015

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