The Other Side

Though I do believe that those suffering from a terminal illness should have the right to die, I do agree with a few of this articles points on what could potentially happen in assisted suicide were legalized.

Many of the disorders leading people to suicide are treatable, such as depression, alcoholism, and stress. If suicide were legal, it would give those suffering from this problems and easier out.

An attempt at suicide is often a challenge to see if anyone out there really cares. Indeed, seeking physician assistance in a suicide, rather than just acting to kill oneself, may well be a manifestation of precisely that challenge. If society creates a "right to suicide" and legalizes "physician-assisted suicide," the message perceived by a suicide attempter is not likely to be, "We respect your wishes," but rather, "we don't care if you live or die."

Reference:

Balch, Burke, Randall O'Bannon. "Why We Shouldn't Legalize Assisting Suicide."
National Right to Life. 15 March 2007. html>.

Natural vs. Unnatural Death

Life, though a precious gift, does ultimately end in death. It’s with common knowledge and acceptance that any living, breathing organism will die. Death can occur in two general forms, natural or unnatural.

A natural cause of death is loosely defined as an unpredictable or extreme act of nature caused without human intervention or agency (Natural, par.1). Deaths from old age or a sudden heart attack are examples of a natural death.

An unnatural cause of death is defined as death not describable as death by natural causes. This would include such events as homicide, suicide, or accident (Unnatural, par. 1).

It's important to define both natural and unnatural causes of death when discussing medical ethics because most people would want to die of natural causes. Unfortuantly being taken off life support would fall under an unnatural cause of death because it does involve human interference. This lays the foundation for my counter claim paper. I believe it will easier to write if I follow the above arguement.

Involvement of Nurses in Physician Assisted Dying

Death is often preceded by medical end-of-life decisions. Much of the research pertaining to this topic often focuses on the physician's role in assisted dying. There is not much information about the role of other health care workers, especially that of nurses.

A study performed by a group or doctors and nurses, centered around reporting the actual involvement of nurses in medical end-of-life decisions. The research investigated how often nurses were consulted by physicians in the decision making process preceding end-of-life decisions and how often nurses participate in administering lethal drugs in end-of-life decisions.

The study found that physicians consulted at least one nurse in 52% of end-of-life decisions cases occurring in institutions, compared with 21.4% of such cases at home. Nurses administered lethal drugs in 58.8% of euthanasia cases occurring in institutions and 17.2% at home. For cases in which life was ended without the patients request because the patient was too ill to do so, the percentages were 82.7% in institutions and 25.2% for cases occurring at home. In institutions, nurses mostly administered drugs without the attendance of a physician who had prescribed the drugs.

These findings were very surprising to me. I would have thought that nurses would have been more involved in euthanasia cases occurring at home, rather than the hospitals because nurses are often more involved in the home health care setting. The journal article is obviously much longer and detailed, the above facts and figures are just the gist of it.

Reference:

Bilsen, Johan, Robert Vander Stichele, Freddy Mortier, and Luc Deliens. "Involvement of Nurses in Physician-assisted Dying." Journal of Advanced Nursing. 47.6 (2004): 583-591.

Miracle in Medicine

As I was routinely signing into my Yahoo account, a very interesting (but short) news story caught my eye on Yahoo's homepage.

Christy Lilly spent the last seven years of her life in a persistent vegetative state after suffering from a heart attack and stroke. Her mother had been taking care of Ms. Lilly at her home in Colorado Springs, Colorado. Miraculously, Ms. Lilly awoke from her vegetative state for three days this week. She spoke to the local television station and was able to see her twelve year old daughter before slipping back into a vegetative state. Her neurologist is baffled and has no explanation for Ms. Lilly's brief awareness. It was reported that Ms. Lilly had awakened four other times for shorter moments in the past.

While I'm definitely going to research this particular topic a bit more, I thought it would bring an interesting twist to my previous blogs.

Reference:

"Woman in Vegetative State Awakes, Slips." Yahoo! News. 7 Mar. 2007. 8 Mar 2007.
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An Important Case in the Field Medical Ethics

Never has the American public’s consciousness regarding life sustaining methods and the importance of advanced directives been so heightened as with the recent Terri Shiavo case. Terri Shiavo had suffered extensive brain damage in 1990 when she collapsed due to cardiac and respiratory failure possibly related to extensive dieting. She remained comatose for two and a half months and upon awakening regained a normal sleep wake cycle, yet did not respond to stimulus and was unaware of her environment. One year later, after many tests and attempts at rehabilitation she was diagnosed as being in a persistent vegetative state (PVS) (Wikipedia).

Terri, like other patients in PVS, exhibited many behaviors that could be construed as arising from partial consciousness. Grinding teeth, swallowing, smiling, shedding tears, grunting, moaning, and screaming without any external stimulus are common behaviors seen in patients in PVS (Persistent). Unable to acknowledge the need to eat or ability to be fed, Terri received a percutaneous endoscopic gastrostomy (PEG) feeding tube. The peg tube is surgically placed into the stomach through the abdominal wall, which allows the patient to be fed and hydrated. Terri was receiving the necessities of life, and could have essentially lived the average life span, yet with little quality or enjoyment.

References:
“Persistent Vegetative State.” Wikipedia, the Free Encyclopedia. 19 February 2007.
20 February 2007. http://en.wikipedia.org/wiki/Persistent_vegetative_state.
“Terri Schiavo.” Wikipedia, the Free Encyclopedia. 20 February 2007. 20 February 2007.
http://en.wikipedia.org/w/index.php?title=Terri_Schiavo&oldid=109672072.

Photo: Terri, before and after accident; obtained at: http://www.lldf.org/2_up_lg.jpg

Another Bloggers Insight

After many failed attempts at finding a blog that was even relatively close to my subject, I came across a blog posted by a gentlemen named, Derek Humphry. Mr. Humphry is the founder of ERGO- Euthanasia Research and Guidance Organization. He is a journalist that has published two bestselling books; one in the UK, and one in the US. "Final Exit" (a #1 selling book in the US) explains methods, approaches, and the means of voluntary euthanasia, physician-assisted suicide, and self-deliverance (rational suicide).

The particular entry I found interesting was dated January 19, 2006. Humphry defines different terms regarding euthanasia. He defines the following terms:
assisted suicide as helping a person to end his or her life by request to end suffering. Physician-assisted suicide is a medical doctor helping a patient to die by use of prescribing a lethal overdose of a drug. He describes the term euthanasia as a broad, generic term meaning "help with a good death." He defines a few other interesting terms.

Mr. Humphry's blog was interesting, yet incredibly biased. Which isn't surprising considering he wrote multiple books supporting euthanasia. I'm not so sure I'd reference his blog in my final paper, although one of his books may be interesting to check out. The particular blog that I referenced he lists as archival, from that blog is a link to his newly updated blog, which appears very insightful...http://blog.assistedsuicide.org/.

Reference:
Humphry, Derek. Euthanasia, Assisted Suicide, Right-to-Die, Final Exit, Hemlock Society
Founder Weblog. 25 February 2006. 1 March 2007.
<http://self-deliverance.blogspot.com/>.

Original picture obtained at:http://www.amazon.com/gp/reader/0385336535/ref=sib_dp_pt/103-6309303-4690248#reader-link