This is a guest blog post written by fellow nurse author, Susan Allison-Dean, MSN RN. This can be a pretty emotionally-charged topic and was interested to hear about her research during graduate school. Check out her post below and please comment with your thoughts and if you’ve personally done research on the ethics of this! Please, be respectful, professional, and appropriate with your responses as many have very strong beliefs and feelings about this topic.
The issue of assisted suicide, otherwise known as active euthanasia, is hot in the news again. Earlier this month, California Governor Jerry Brown signed legislation to make assisted suicide legal. The California law will permit physicians to provide lethal prescriptions to mentally competent adults who have been diagnosed with a terminal illness and face the expectation that they will die within six months. Last year another Californian, 29-year-old Brittany Maynard, made headlines when she elected to move to Oregon, where assisted suicide is legal, to end her own life. Maynard had been diagnosed with terminal brain cancer and wanted to “die with dignity”. Governor Brown and Ms. Maynard made their decisions using the ethical principle of autonomy – the right to self-determine a course of action.
It was the principle of autonomy that led me to select active euthanasia as the focus of my graduate ethics paper back in the early 1990’s. If I were in a hopeless medical situation, I would want the ability to get out of it, I remember thinking back then. Our professor also required us to choose a health ethics topic that was current. Dr. Jack Kevorkian was all over the news for his efforts in offering patients assisted suicide. I admit, this was an added benefit, I thought.. there would be plenty of sources to put a literature review together. Unbeknownst to me, a classmate across the room chose the same topic, with the same thoughts.
Flash forward to the end of the semester when each of us presented our ethics topic. Much to my surprise, I found that after a rigorous review of the active euthanasia literature and the ethical principles involved in this topic, much to my surprise I concluded that I was not in favor of active euthanasia. It was the principle of utilitarianism – a theory that supports what is best for most people, which led me to this outcome. The utilitarianism theory states the value of the act is determined by its usefulness, with the main emphasis on the outcome or consequences. An issue of great concern cited in multiple ethical journals regarding active euthanasia is the slippery slope effect.
Once intentional killing begins, however well intended it may be initially, it opens the door for humans to extend this practice. Those who may be deemed a ‘burden’ to society may fall victim to non-voluntary or involuntary euthanasia. It may also unknowingly pressure people who are not well to feel they ‘should’ kill themselves. Ironically, the other student in my class came to the same conclusion.
During the course of our analysis of this topic, we both found that we were in favor of passive euthanasia. Passive euthanasia means that when a person can no longer naturally sustain himself or herself for whatever reason, they should be allowed the right to die a natural death. This incurs by actively removing, or withholding, life-sustaining equipment. An example of this is refusing or removing a feeding tube or ventilator. Passive euthanasia leaves the decision of death in the hands of a higher power-God, The Universe, Mother Nature, etc.
Ethical decisions are not easy because there is no ‘right’ answer. Nurses are often on the front lines of these difficult, emotionally charged situations. Understanding ethical principles and being active on ethical committees can help each nurse to understand why he or she comes to certain conclusions and respect those who come to conclusions that are different.
Susan Allison-Dean, MSN RN is a nurse who retired from traditional practice in 1999, after working 13 years as a Wound, Ostomy, Continence Clinical Nurse Specialist. She has authored several clinical and horticulture articles and was a contributing author to the bestselling book, Touched By A Nurse. She is passionate about the sea and loves exploring tropical islands. She extends this passion by doing volunteer work benefitting dolphins and whales. Sue splits her time between Armonk, New York and Cary, North Carolina, with her husband and English bulldog, Bubba. Check out her website here.
And please check out Susan’s two books! Woo hoo! Go nurse authors! Clicking on the image will take you to Amazon to learn more.