Death by suicide is widely held as an undesirable outcome. Most Western countries place emphasis on patient autonomy, a concept of controversy in relation to suicide. A literature search was conducted using search terms of suicide and ethics in the PubMed and LexisNexis Academic databases. Article titles and abstracts were reviewed and deemed relevant if the paper addressed topics of rational suicide, patient autonomy or rights, or responsibility for life.
Nursing Spectrum15 May, Copyright Nursing Spectrum provides this article as an informational service and takes no position on assisted suicide. Her eyes moved over him slowly, assessing him closely.
They joked about baseball, about family, about life. When she finished, she gathered her belongings, extending her hand to him as they said their goodbyes. The next day, surrounded by those he loved, Gus swallowed a lethal mixture of medications that had been prescribed by his physician and fell into a deep sleep.
He died soon after, wearing his favorite baseball cap. He wanted simply to die on his terms, under circumstances he chose. Since Oregon broke new ground with its Death with Dignity Act - becoming the only state in the nation to legalize PAS - nurses there are assuming roles they may not have anticipated, sometimes uncomfortably so.
Patients often feel nurses understand their wishes for good quality of life and good quality of death, too. Home care and hospice nurses actively help patients understand their rights, acting as advocates for those who are considering PAS. Some physicians have stated publicly that they may not be the best members of the healthcare team to lead assisted dying, confessing that they are not always the most properly prepared for the task.
We [physicians] should be able to treat those who are dying, relieving their pain and symptoms, but not helping them kill themselves. Or, suggests Karlawish, "maybe a new profession should be created to perform PAS - a nurse with additional certification, or a physician with additional certification.
PAS divides many in nursing. Assisted dying, they say, goes on every day in subtle, unspoken ways. One percent of the RNs admitted helping a patient commit suicide, 4. Some patients visit several physicians before they find one who will help them carry out PAS.
Currently, only one in 10 patients who request PAS are given a prescription for it.
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The law was finalized in October The act legalizes PAS, but clearly prohibits euthanasia. Ironically, however, the only legal "assistance" physicians may provide for terminally ill patients a prescription for a lethal dose of medication.
No recipe or magic potion exists - physicians work with pharmacists to tailor-make a mixture for each patient. Patients take the oral medication themselves and must meet other stringent criteria before a prescription is written.
Aside from being a legal resident of Oregon, anyone interested in PAS must be at least 18 years old and capable of communicating his or her healthcare decisions. Patients must also be diagnosed with a terminal illness and have fewer than six months to live.
The request for PAS must be voluntary. One written and two verbal requests must be made, and the verbal requests for PAS must be separated by at least 15 days.
The patient must also be made aware of comfort measures that are available through hospice services. Not everyone in the state has the right to PAS. According to a Oregon Health Division report, federal law prohibits participation in PAS by patients or physicians within federal healthcare systems, such as Veterans Administration hospitals.
Some private healthcare systems, including one Catholic medical system in Oregon, have placed similar restrictions on patients and staff within their facilities. The average patient was 71 years old.
They also feared people would flock to the state because of the availability of PAS. So far, neither fear has become reality.Heath Andrew Ledger (4 April – 22 January ) was an Australian actor and director.
After performing roles in several Australian television and film productions during the s, Ledger left for the United States in to further develop his film career. "To say that physicians alone are the only ones capable of assisting a patient's suicide is not that easy," says Jason Karlawish, MD, of the University of Pennsylvania Center for Bioethics' Assisted Suicide Consensus Panel, and coauthor of the AIM article.
Aug 21, · The Conversation with images from PeabodyAwards/flickr June 9, Why predicting suicide is a difficult and complex challenge Joseph Franklin, Florida State University.
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Investigating suicides following the death of Robin Williams, a beloved actor and comedian, on August 11 th, , we used time-series analysis to estimate the expected number of suicides during the months following Williams’ death.
Monthly suicide count data in the US (–) were from the. Abstract. ABSTRACT: This paper reviews the literature which relates to the role of social isolation in suicide. Major areas reviewed include theories on suicide and social isolation, measures of social isolation, and empirical studies which concern the relationship of social isolation to suicide.