First, a current event about a robot to help with assisted suicide. ???
http://www.iflscience.org/japan-engineers-design-robotic-bear-to-aid-in-assisted-suicide/
Which reading (Rachels, Callahan, or Brock) was most persuasive to you on the topic of euthanasia? Why?
Identify the least persuasive argument and try to give it a good defense, but trying to convince your classmates of its merit.
I found that Daniel Callahan's topic of euthanasia was the most persuasive for me. He states that the disease a person suffers and is dying from should be the cause of death. Although withholding treatment might result in death, it is more the disease that caused death. In active euthanasia, a deliberate act will cause death such as an injection. As he stated though sometimes the two intercept as in a case of brain death and turning off life sustaining machines.
ReplyDeleteThe least persuasive to me was Dan Brocks topic of active euthanasia. He argues that autonomy and well-being are the two ethical considerations. I feel the patient has the right to make their own decisions regarding life and death, but physicians should play no part in it except to educate the patient on all aspects. There are many misconceptions about Hospice and Palliative care. People are innately fearful of dying. I just do not feel they should seek assistance with dying from their physician. Lets get back to the practice of taking the time to sit down and listen to their concerns. Their fears generally stem from misconception.
Your right Cindy, sometimes Patients and their families just need to talk, vent their fears and know that someone genuinely cares. That is what the Dr.s leave to the nurses. Giving time just to be heard can be so helpful.
DeleteHow true Cindy. People do fear dying I think more than death itself. It makes me wonder why very few of us feel comfortable with our loved ones seeing us in a vulnerable situation, even if the reasons we are there were out of our control, and even if we are handling the vulnerability with grace and courage.
DeleteDaniel Callahan was the most persuasive for me as well. I like how he distinguishes the subtle differences between passive and active euthanasia as "equally dead by our omissions as well as our commissions". He really places the cause of death on the underlying disease itself and not the individual facilitating the death. This would help to absolve the guilt one might feel in assisting such death. I lean toward the side of passive euthanasia, I feel he describes the medical view well, that we have had the "historical role of curing and comforting". It goes against our grain to kill intentionally, though this argument has persuaded me to think about different aspects of active euthanasia more than before. Dan W. Brock's argument was the least persuasive for me on euthanasia. He really only talks of euthanasia as the patient's choice to decide. While I do believe the patients should have an active say in their care and end of life decision, it seems that these decisions, in a lot of cases, are being made by families whose loved ones are so ill they are no longer able to make a decision for themselves.I think the most difficult part of the whole topic of euthanasia is the guilt families feel over making this decision and it would be much easier if the patient made the decision for themselves. In order for this to be a more convincing argument, he should address both sides of the patient's circumstances. If he could break it up in stages of the patients illness and their frame of mind during those times, then the decision could be made at which time the patient is no longer competent to make a decision for themselves. Hopefully by that time, with this tool, the family will already know their loved ones wishes to implement them.
ReplyDeleteI understand the thought of absolving guilt in assisting with the death and dying process. I never thought about it that way and I never felt guilty about it. I have assisted with removing ventilators, fluids and dialysis machines and allowing the disease process to run its course and never put any ethical value on it because of the disease process itself. Now I have a better understanding of this reasoning. Definitely food for ethical thought.
DeleteThe reading that I found most persuasive in the topic of Euthanasia was from Callahan. He believes that active euthanasia is against the role of the physician and the physicians true role is to cure or comfort his patient and never to kill them.
ReplyDeleteThe reading that I found least persuasive in the topic of Euthanasia was Rachels. Rachels believed that when death was the only way to escape horrific pain then Euthanasia was justified. I disagree with him completely! A patient should be kept as comfortable as possible but not to the point of delivering a fatal dose of medication.
I think Rachels is questionable also but he did make some valid points. By prolonging life to we prolong suffering and decrease quality of life. He states that why is it permissible in some cases to withold treatment and allow a patient to die but it is never permissible to actively kill someone. After expierencing my grandmother agonizing death over 1 week it is hard to dispute him in his argument that active euthanasia is better that passive. I know that everybody wants as much time with their loved ones once they make that decision to stop treatment but watching someone suffer even though you are giving them pain medicine is also hard.
DeleteI completely agree Sarah. I also did not like Rachels view with escaping horrific pain was to give fatal doses of medications. Keeping a patient comfortable is the most important thing in caring for a terminally ill patient.
DeleteI am very much in the minority in my agreement with Dan Brock. I see Callahan's point of view, however , prolonged death from a disease is difficult for everyone, and how can we be sure that the person suffering from the affliction or disease is comfortable while the dying process completes? We assume that by giving pain medications and anxiolytics that our loved ones aren't indeed suffering, but can we be sure ? By giving the terminally ill the right to choose , we are handing THEM the right to make their own decision in regards to their quality of life and if they so choose to end it , I think the physician is giving them the support they need by helping them to do so.
DeleteAs a nurse and choosing to push that next dose of morphine when a patients respiration rate is already very low isn't that similar to administering a lethal dose. We all know that after administering that there is a very likely chance it will induce death by suppressing their already compromised respiratory status.
DeleteWell put Shelley... I didn't look at it in that aspect but you are right!
DeleteCallahan’s perspective of euthanasia was the most persuasive to me. I agree that people loose site of the reality of the disease process and cannot control the “outer world”. He explains that physicians are obligated to provide care for the overall welfare of the patient, struggle against the disease and do not want to use authority to end their patients life. His perspective emphasized that physicians are not “miracle workers”, and cannot always control the underling disease. Callahan concluded that euthanasia should not be defined by an act of killing someone but a way to care for the patient, address their wishes and not the disease.
ReplyDeleteI disagree with Brock’s prospective of euthanasia. Brock believes that a physician should not euthanize a patient because it is not compatible or the “moral center” for a physician. Brock described patients have a right to share their desire and values but the physician will be the “guiding power” to decide what is best for the patient. His perspective reminds me how medicine use to be, where the physician was often viewed as a “symbol of god”, and had “all the right answers”. Many may disagree but I would define a physician behavior that thinks he/she can listen to my wished but makes the final decision about my life should be define as narcissism. A person with an inflated sense of their own importance, a deep need to be praised, and a lack of empathy for others.
Jodi you are funny and I agree that some dr's do need to be praised and have a lack of empathy and that they do not do what the patient or family wants because they don't want to be the deciding factor. I have talked to older nurses and they have talked about how dr's used to be. They had to stand up when they came into the room, given up their chairs, etc. I feel like most dr's now value the nurse, family and patients opinions.
DeleteI agree! I feel blessed with the doctors we interact with in today's society! They respect the patient, family, and our input as a nurse. They often seek guidance from the multidisciplinary team, the patient, or their family members if the patient is unable to verbalize their needs.
DeleteThis comment has been removed by the author.
ReplyDeleteI disagree with Brocks view. I don't think the dr. should have any say in the person's decision to end of life care. The most important person making the decision should be the patients and the family members. The dr should only be there to give advice and to help guide them in their final decisions about how they want to handle the patients end of life care.
ReplyDeleteI liked Callahan's perception on euthansia. He says that the dr's should be there to help the overall well being of the person. Callahan states that just because we pull life support or artificial feeding from a person doesn't mean that we actively killed them. The disease itself was incapacitating him so the disease is the ultimate reason for his death. He states that allowing someone to die from a disease we can not cure and that we did not cause we are allowing the disease to casue the death. Where as if we inject something we are actively killing them and not the disease.
All these theorists brought up some good and bad points. I dont' think until we are personally put into the situation of making the choice of active or passive euthanasia we can fully grasp these concepts, We only have opionions on what we think we might do.
I agree that this decision would be extremely hard and we could not make a final decision until we are presented with this situation. I understand that physician has a duty to fulfill to care for their patient. This doesn't mean to "save their physical presence" but to agree upon a plan of care that the patient and/or their family members to agree upon. The physicians should not act as a political candidate and debate what is "morally right" with the "consequences of society" but to focus on the individuals wishes. I've been blessed so far in my life where I have not been presented with this scenario but I truly believe in my heart even though it would be tough, I would advocate for my loved one's wishes.
DeleteCallahan was the most persuasive for me. Callahan tries to look at allowing someone to stop treatments and die because of the progression of the disease. It is moral to allow someone to die from disease progression but not at the hands of someone else(injections).
ReplyDeleteBrock is the least persuasive for me. As is stated assisting someone to die even though the have a terminal illness and want to die is wrong. A physician is to do know harm. He can assist in comfort care but should not assist in suicide which is what it would be if he would help a patient end their life early.
I agree Donna that a person should have the right to stop treatment due to the progression of the disease. Stopping should be thier choice. But on the other side if the person wants to end it all because the pain is to much to take and they don't want to contuine they should have the choice to end their life with a helping hand of an injection. The end result is the same death.
DeleteI felt most persuaded by Callahan and his ideas to allow natural death. Physicians should assist in comfort and overall well-being of the patient. The patient should not die because of lethal injections because of a terminal diagnosis. I agree in his argument that naturally some dies by disease not by someone's physical cause of death to another.
ReplyDeleteI felt least persuaded by Brock's argument on euthanasia. He only seems to address the fact that a patient has the right to decide on active euthanasia, and that the physician can assist in decision making. I don't believe in active euthanasia at all. The patient should only be kept comfortable while allowing natural death. Physicians should be available for support and information to the patient and family, not participating in killing patients.
I think that patients have the right to decide about their treatment. I even believe that in some terminal cases they have the right to decide to die. The biggest problem lies on how their choice to die will be carried through. I don't think any physician should be "killing" people because I know I wouldn't want to be the one to do it. I think the best alternative is like you said promoting comfort so the patient can die peacefully with dignity.
DeleteI can agree on some aspects but I also think that; If a person is really wanting to comment suicide, they will find a way to do it with or without a doctors help. If one of my love ones requested active euthanasia over withholding treatment I would support them in it, only after speaking with all members of the health care team and maybe a psychologist.
DeleteI felt that Callahan was also the most persuasive for me. Allowing the patients to be able to decide whether they want to stop their treatments due to the severe progression of their disease is in my mind the right thing to do. You are following the patients decisions. It is not moral to actively try to end a patients life through stopping care such as tube feedings, and fluids if patient is unable to eat or drink without a DNR order. I did not feel persuaded by Brock. A doctor should not ever be a deciding factor in the decision for the patient to live of die. This decision is solely on the patient and or the patients POA. The doctors role is to provide care where needed and support the patients wishes.
ReplyDeleteI agree with you allowing a patient to decide to stop treatment is the right thing to do. If the disease has progressed in a way that has changed their life forever and they can no longer live the way they want the patient should have the choice of how they which to continue. Even if that means death.
DeleteThe most persuasive reading for me was Callahan's. I liked his concept with separating self with the external world. An item in the external world is disease and its process. This allows death to occur based on the outcome of the disease even though we discontinued the tube feedings and removed the ventilator. It wasn't the acts themselves that caused the death but the terminal disease process.
ReplyDeleteThe one reading that was least persuasive to me was Brock. It wasn't that he thought active euthanasia was OK it was that there was no moral worth with regards to life in his reading. I get the autonomy and self well being and life becoming a burden, but where is the moral obligation to life's worth. I think he could have been a little more persuasive if that topic was addressed. I have seen people suffer along with their families and I've had a family member of a dying Patient tell me "we treat our pets better than this, we would never let them suffer as we do our mom", so I understand how much hurt it takes to be wanting active euthanasia. I don't condone it but I understand it.
The most persuasive reading for me was Dan Brock's. I liked the point he kept pointing out that one has the right to self- determined. People should have the right to explore what they want in the end. If one thinks their life has changed so much from a disease and in thier is no cure for it, why shouldn't they have the right to say enough is enough. If they feel the burdens of life is to great to carry on and thier life has changed forever with no self worth let them make the choice.
ReplyDeleteCallahan was the most persuasive for me. I believe that a disease process is one that we cannot control in late stages and if death is eminent then it's our duty to promote comfort for that patient until passing. On the other hand I kind of agree with parts of Brock's too because if a patient is making the decision they are done with suffering and they want to end their life. Why should we stand between them and that decision? They will have no quality of life while being in a bed getting morphine every hour. I think the morphine will keep them from suffering and they will die in peace. I think the real issue is who is actually going to administer a lethal dose of medication if one is allowed to decide that route.
ReplyDeleteDan Brock was the most persuasive for me, especially with his statement that individual self - determination and individual well - being should be the driving force in our decisions regarding end of life care. He stated people should be able to make their own decisions based on their own set of values or conceptions of a good life. Take For instance, Brittany Maynard , who, diagnosed with terminal brain cancer at the age of 29, moved to Oregon to take advantage of the state's assisted suicide laws. She was exercising her right to make her own decisions about the way her life would end. Giving the physicians the ability to make those decisions doesn't mean they will abuse it . The Oregon law if very thorough , and I don't feel that any physician presented with a case such as this would abuse that power. They, just as nurses, were taught that life is precious and the ability to heal and make a life better is a privilege. But in those instances that healing is no longer a possibility and a life has been determined as no longer within the patient's perception of a good life, then this allows them with the assistance of their physician to end the suffering on their own terms.
ReplyDeleteI found Callahan the most persuasive. He states that ending the life of another with an injection is directly killing. The injection is what causes death. If a person dies from an incurable disease then the disease caused the death. He also talks about the action of withdrawing care such as a respirator. We may physically turn the respirator off but it is the disease process requiring the respirator that causes the death. He goes further to talk about the role of physician and that it is important to make sure that it remain one whose goal is to comfort and cure rather than kill.
ReplyDeleteI found Brock the least persuasive. He talks about patients having the option to choose active euthanasia and that competency needs to be determined. Brock goes on further to state that patients’ will have greater trust in their physician if the physician will provide active euthanasia when they request. I do not think that physicians should have that power and do not believe that the trust in physicians will be greater.
Brock was the most persuasive for me. I personally believe in assisted suicide for the terminally ill. If a person is oriented and understands their diagnosis/prognosis and wants to end their life that should be an option. I can understand the moral and ethical part of the physician if he actually would give a lethal injection to end a life. I agree that would be hard to do. But I think giving a prescription of a combination of lethal pills for the patient to take when they decide the time is right is acceptable. Medical technology and interventions have come along way and people are living longer. But longer is not necessarily better.
ReplyDeleteI totally agree with you Tricia! I believe if a person wants to end their own life, they will find away to do it with out without help. Having medical personal assisted with the euthanasia process will prevent any farther suffering of the terminal ill patient if they are not successful when trying to suicide themselves.
DeleteIf a person is in sound mind and has decided that they don't want to suffer and have there family watch them slowly leave this world then I believe they should have a reliable, safe way to die.
DeleteFor me, Brock was the most persuasive. I agree with assisted suicide. I know myself I would never want to be lying in a bed, fragile unable to speak and my family be waiting for my last breath. I believe nobody wants to spend their last days suffering before they die. I would like my family to be able to remember me how I am now. I liked how Brock talked about self- determined. I don't know if I agree with his statement about trusting doctors more if they offer active euthanasia though, but what if a patient requested euthanasia and had to see a specialist for this request and not their PCP, very similar to palliative care doctors.
ReplyDeleteI found Callahan was the least persuasive for me. I do agree with having a disease process be the end of a person's life but I do not believe in making a person who is in their right mind suffer if their quality of life is very low. If a person is in their right mind and able to make their own choices, they should have the right to not suffer in the very end stage of their life.
I am on the same page as you, Beth. I feel the exact same. I would not want my children to see me in any other way than I am right now. I watched my Dad die from cancer, and I remember him before he got sick too, but I also remember him withering away to nothing and being in so much pain. I don't think I could stand for my kids to see me that way.
DeleteJames Rachels view on active and passive euthanasia was highly persuasive. The examples he used to argue his opinion were very compelling. I do believe that active euthanasia can be more humane than passive. I can understand why some people would choose this path rather than experience the deterioration that would come before death from an incurable disease. I did have a middle aged man diagnosed with lung cancer and mets to his bones to brain talk to me about dying not too long ago. He was very upset about being newly incontinent and worried about being a burden on his wife. After a long conversation he asked if there was just a pill he could take because he was ready for it. All I could tell him is I wish it was an option for him. He had came to terms with death but was truly struggling with the road he was going to have to travel to get there.
ReplyDeleteCallahan was the least persuasive to me. He has his three perspectives and everyone can fall into at least one of those. Allowing to die is the disease process taking a person's life. Assisting someone with the dying process is killing.
I agree Beth. I don't think our patients' can fit so neatly into categories. Like many theories or perspectives, it seems a blend would most accurately describe how most of us view this subject.
DeleteI liked Rachels view on active euthanasia as well. I also can understand why patients want this. I would not want my family to see my decline physically and mentally. This puts a huge emotional strain on the family. I would not want to be a burden either if it came to the point I was unable to care for myself.
ReplyDeleteI have to say I found Rachel had the most persuasive argument about euthanasia. For me, it helps to look at the end result of each action. I whole-heartedly agree with Rachel when he states that stopping life-saving actions is in itself, an action. If that were where things ended, this whole topic would be easier to think about. But as we know, once a patient and physician decide that treatments aimed at curing or stopping progression of a disease process should be ceased, many times that is where our (the nurse) most difficult work begins.
ReplyDeleteWhen such a decision is made, there are times the patient is not far from death, maybe days or weeks. There are also times when a patient may have months to live. In either situation there are measures taken to optimize comfort. Those measures may include anti-emetics, pain medication, emotional and possibly financial counseling or pastoral care. It should also include family involvement if at all possible. These are all actions and if applied with the patient and family as the focal point can allow the patient to feel as though they still have some control.
If I understood his thought process, that at the point that the decision to stop treatment, giving a lethal injection may be okay because it spares agony for the patient, I do not agree. Except in extreme cases, I feel like there is usually a period of time when not only the patient, but all those involved in their care may benefit. How else would we have any knowledge of hospice care or any insight into the process of grieving the patient goes through as they die or even the actual process of how the body shuts down as it dies? That being said, I do not think keeping a patient alive for the sake of learning is any more right than a lethal injection.
I have the most disagreements with Brock’s point of view. I feel there is this fine line between keeping the patient comfortable and administering a lethal injection. In my heart I cannot make myself believe it is morally acceptable to end a life. Yet, I have been the one to give that last dose of pain medication. Watching my mother deteriorate during the process of Alzheimer’s was excruciating. She did not physically decline until the last 3 months after a fall caused a broken hip. I knew the end would come soon. My parents had discussed their wishes with each other at length prior to her mental decline. She had a DNR. I would have considered it outright murder if her physician or my father would have “ended her suffering” by lethal injection when she broke her hip. As a family we learned much from each other during the last months and I as a nurse learned much about how I could improve the care I give.