ASSISTED SUICIDE Whitney Ayers LEARNING OBJECTIVES 1. Upon completion of this seminar you should be able to define and differentiate between the terms euthanasia, and physician-assisted suicide. 2. Describe the laws and ethics regarding assisted suicide and the controversies surrounding the
issue. 3. Identify two of the criteria that must be meet in order for someone to qualify for assisted suicide. 4. Identify and discuss ANA and QSEN quality and standards as they relate to assisted suicide. WHY IS THIS IMPORTANT ? Aging population Patient Education Quality of life Ethics
Laws HOW TO DIE IN OREGON http://www.youtube.com/watch?v=Srdo5UYyTiU THEORY BASE HILDEGARD PEPLAU INTERPERSON
AL RELATIONS THEORY INTERPERSONAL RELATIONS THEORY ROLES OF A NURSE Stranger Teacher Resource Person Counselor
Surrogate Leader Assessment Orientation Data collection and analysis [continuous]
Non continuous data collection May not be a felt need Felt need
Define needs Nursing diagnosis Planning Mutually set goals Implementation
Plans initiated towards achievement of mutually set goals May be accomplished by patient , nurse or family Evaluation Identification
Interdependent goal setting Exploitation Patient actively seeking and drawing help Patient initiated
Resolution Based on mutually expected behaviors May led to termination and initiation of
new plans Occurs after other phases are completed successfully Leads to termination a ELISABETH KUBLER-ROSS STAGE
THEORY THE FIVE STAGES OF GRIEF http://www.youtube.com/watch?v=oIbdOyhxp18 ASSESSMENT OF THE HEALTH CARE ENVIRONMENT POLICY IN OREGON
According to the laws of the state of Oregon, a patient requesting a prescription for a lethal medication must be.. 1. 2. 3. 4. An adult Capable of taking medication A resident of the state of Oregon
Has been determined by 2 physicians to be suffering from a terminal illness 5. Voluntarily expresses a wish to die 6. Makes written request for medication that will end life POLICY IN MICHIGAN A person who knows that an individual intends to kill themselves, and does anything with the intent to assist the
individual in killing themselves is guilty of criminal assistance to the killing of an individual, a felony punishable by imprisonment for not more than 5 years or a fine of not more than $10,000.00, or both. ASSUMPTIONS A SS U M P T I O N S
Decrease healthcare costs Easy way out Depression C O M PA R E D T O. . Abortion Animal Euthanasia Killing babies
with diseases SCENARIO Brea is a 28 year old nurse on a medical surgical floor. This is her second day back from a 12 week maternity leave. Two of her co-workers have called in sick, leaving the floor under staffed. All employees are stressed and are just trying to keep up. Brea has 5 patients until someone can come in to cover the open shifts. One of her patients is actively dying and is consuming a lot of her time. No one has time to help her. Opal is an 87 year old patient who was diagnosed with terminal liver cancer 3 weeks ago. When her children came to visit they found her in agony and she begged them to just put her out of her misery so she could
be out of pain. Earlier in the shift the cleaning person unknowingly unplugged the patients PCA and the battery was dead. Brea was so busy with her dying patient that she missed two doses of Opals pain medication. Opals call light was answered but the nurse was so busy she forgot to tell Brea that she was requesting pain medication. ROOT CAUSE ANALYSIS Equipme nt PCA
Nurs 3 days back from e maternity leave Lack of training Staff
Overworked with 5 pt unplugged Defective back-up battery for PCA Poor communication 2 callins
Actively Dying pt Environme nt Pt. in pain INFERENCES AND
IMPLICATION S LACK OF TRAINING Nurses lack of knowledge about assisted suicide Lack of EOL training Poor patient education High potential for misinformation Unnecessary patient anxiety
RELIGIOUS/WORLD VIEWS Nurses form bonds with patients Attitudes may be influences by personal feelings Negative impact of the nurse-patient relationship Loss of patient trust
LACK OF END-OF-LIFE PLANNING Less than 1/3 of Americans have a plan for endof-life Even patients with chronic conditions Hard to talk about RISKS
Ethical conflict Inappropriate acute hospitalization Unwanted interventions Family burden RECOMMENDATION FOR QUALITY AND SAFETY IMPROVEMENTS QSEN COMPETENCIES A N A S TA N D A R D S
EDUCATION EVIDENCE-BASED PRACTICE ETHICS PATIENT-CENTERED CARE physical comfort and emotional support QUALITY IMPROVEMENT Explain the importance of variation and measurement in assessing quality of care
INFORMATICS Identify essential information that must be available in a common database to support patient care REFERENCES American Nurses Association. (2010). Nursing scope and standards of practice. In .Silver Spring, MD: American Nurses Association Clymin, J., Jablonski, A., Jacobson, D., & Feldt, K. (2012). Washington state death with dignity act: A survey of nurses knowledge and implications for practice part 2. Journal of Hospice and Palliative Care, 14(2), 141-148. http://dx.doi.org/10.1097/NJH.0b013e31823cc77a
Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., ... Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3), 122-131. Darr, K. (n.d). Physician-assisted suicide: legal and ethical considerations . Journal of Health Law, 40(1). Retrieved from http://www.healthlawyers.org/Publications/Journal/Documents/Vol%2040%20Issue%201/ Physician-Assisted%20Suicide-%20Legal%20and%20Ethical%20Considerations.pdf Gielen, J., Branden, S., & Broeckaert, B. (2009). Religion and nurses attitudes to euthanasia and physician assisted suicide. Nursing Ethics, 16(3), 303-318. http://dx.doi.org/10.1177/0969733009102692 Humphry, D. (2005). Tread Carefully When You Help to Die. Retrieved from http://www.assistedsuicide.org/suicide_laws.html McLeod-Sordjian, R. (2014). Death preparedness: A concept analysis. Journal of Advanced Nursing , 70(5), 1008-1019. http://dx.doi.org/10.1111/jan.12252 Merritt, M., & Procter, N. (2010). Conceptualizing the functional role of mental heath-liasion nurse in
multi-morbidity, Using Peplaus Nursing Theory. Contemporary Nursing, 34(2), 158-166. http://dx.doi.org/ 10.5172/conu.2010.34.2.158 Patricelli, K. (2014). Stages of Grief Models: Kubler-Ross. Retrieved from http://www.amhc.org/58-griefbereavement-issues/article/8444-stage-of-grief-models-kubler-ross ProCon. (2012). Michigan Laws on Assisted Suicide. Retrieved from http://euthanasia.procon.org/view.resource.php?resourceID=5076 Robley, L. R. (2009). Reigniting the debate over assisted suicide. Nursing: Critical Care, 15-17. Retrieved from www.nursing2009criticalcare.com TIME !! NUMBER ONE
What are the stages (1-5) in Elisabeth Kubler-Rosss stage theory? NUMBER TWO According to Hildegard Peplau, what are two roles of the nurse?
NUMBER THREE If a person is charged with assistance to the killing of an individual in Michigan, what is the maximum number of years they can spend in prison? NUMBER FOUR
What is three months from today? NUMBER FIVE In Oregon, what are two things that must be accomplished in order for someone to qualify for assisted
NUMBER SIX What was the name of the documentary I showed? NUMBER SEVEN What is one assumption of assisted suicide?
NUMBER EIGHT Name one risk of having no end-oflife planning? NUMBER NINE What was the name of the patient in my root cause analysis?
NUMBER TEN What is the major difference between euthanasia and assisted suicide?
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