The Role of Nurses When Patients Decide to End Their Lives

Some hospitals and hospices have policies that forbid nurses to be part of the process or even to discuss end-of-life options.

New York Times

Emilie Le Beau Lucchesi

When Ben Wald, 75, was dying of cancer in 2012, he wanted to use Oregon’s Death with Dignity Act to receive a prescription for a lethal medication that would end his life. His hospice nurse, Linda, was part of the discussion and provided both information and support, said his wife, Pam Wald, of Kings Valley, Ore.

His colon cancer had spread to his lungs, and his weight dropped from 180 to 118 pounds. He struggled to speak or eat.

When he was ready to end his life, the couple wanted Linda with them, but the hospice organization she worked for did not allow it, Mrs. Wald said. The organization allowed other hospice workers, such as social workers and massage therapists, to be present, but not the doctors or nurses it employed. . . [Full text]

Physician-Assisted Suicide and the Perils of Empirical Ethical Research

JAMA Netw Open. 2019;2(8):e198628. doi:10.1001/jamanetworkopen.2019.8628

Daniel P. Sulmasy

Al Rabadi et al1 compare statistics on physician-assisted suicide (PAS) available from public databases for the states of Washington and Oregon and find similar profiles and trends, which is unsurprising given the similarity of the laws and demographic characteristics of these states. Among the unanswered questions are what such a study can contribute to medical ethics (about PAS or any other ethical controversy) and what the limits are of such work.

Cautions

First, it should be noted that the medical literature is, in general, favorably disposed toward the empirical and the new. Although this predilection is often advantageous for scientific progress, it introduces a problematic bias when applied to ethical questions. The appeal of the study by Al Rabadi et al1 is that it is empirical, and by comparing data from 2 states for the first time, it can be considered novel. Because there are new reports each year and the practice of PAS is legal in only a few states, descriptive reports about PAS are published frequently. This means, however, that articles defending the ethical status quo (ie, against PAS) tend to be shut out of the medical literature because they are not reporting anything new and, therefore, cannot have any data. The result is an impression of growing acceptance of PAS, but it really represents an artifact of a scientific bias. . . . [Full text]

19 State Attorneys General Declare Opposition to HHS’ Proposed Conscientious Objection Rule

New York Law Journal

Kristen Rasmu

A U.S. Department of Health and Human Services proposed rule that would more vigorously protect health care providers’ ability to deny coverage in certain circumstances because of moral or religious beliefs should be withdrawn, according to a coalition of state attorneys general.

The proposed rule would strengthen the enforcement of existing regulations that allow providers to invoke conscientious objections as a basis for refusing to provide care that involves certain medical issues, including abortion, sterilization, assisted suicide and others. It also would allow individual providers to object to informing patients about their medical options or referring them to providers of those options. . . [Full Text]

Prevailing culture hard on religious liberty

Policy hits conscience; believers often classified as bigots

Catholic Sentinel

Ed Langlois

Oregon tends to lead the pack in causes favored by some wings of the political left — legal abortion, assisted suicide, gay marriage, recreational marijuana.

Some fear that next on the progressive docket could be tax exemption for churches and the right of church agencies to operate according to their ancient beliefs, especially in the dignity of life and marriage.

‘Striking change’

“There has been a striking change just in the last 10 or even just five years,” says Bishop Liam Cary of the Diocese of Baker in central and eastern Oregon.

Bishop Cary cites demographics. Among the fastest-growing groups in Oregon is the population without religious affiliation. That means they have no personal interest in protecting religious freedom. In their minds, personal choice trumps religious liberty, the bishop says.

Also new is the government’s willingness to use policy to try to force people to act against conscience. . . [Full text]

    

Dying Dutch: Euthanasia Spreads Across Europe

Newsweek

Winston Ross

In one of the last photographs my family took of my grandmother, she looks as if she’s been in a fistfight. Jean Bass Tinsley is lying in a hospital bed in Athens, Georgia, wearing a turquoise button-up shirt and staring blankly at the camera. A bandage obscures her fractured skull, along with the bridge of her bloodied nose. She is 91 years old.

My grandmother essentially did this to herself. In June 2013, she fell out of her wheelchair headfirst, after ignoring her caregivers’ warnings not to get out of bed without help. Earlier that year, she’d broken both of her hips, in separate falls. Before that, her pelvis-all while trying to do what for most of her life she’d managed just fine on her own: walk.

In her last year, dementia crept into my grandmother’s mind. The staff at her long-term-care facility plotted ways to protect her from herself. It’s against the law in Georgia to restrain patients in such facilities, so they lowered her bed to the floor and put a pad down next to it. They even installed an alarm that went off if she left her mattress. My grandmother disabled the alarm, moved the pad and freed herself, repeatedly. In the end, she was both too weak and too strong. [Full text]