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A human choice?

Posted Jun 30 2009 5:54pm

euthanasia I had a job a little while back that made me question some things but also re-affirmed a strong belief I have….that of allowing euthanasia in this country.

Now, I know that some people hold strong views on this subject (me included), but in this day of pointing fingers at bloggers etc, let me re-state that this is just my own personal opinion. We are all allowed to have views and opinions on things and it just so happened that what I experienced made me think about all of this stuff again.

I was crewed on a 2 person ambulance and we were sent to a local hospital to transfer a female patient from one ward, to a local hospice for palliative care. The information on the MDT told us that she was a DNR (do not resuscitate) patient but then also informed us that she was on ’suicide watch’!

I looked at my mate and we both thought the same thing….If she is dying anyway, why go to the extremes of having someone watch a patient 24hrs a day to ensure that she doesn’t do anything to shorten or end her life?

I know its not as simple as that, and that in the eyes of the law, the hospital and the staff on the ward would be responsible for the patients well being whilst in their care and therefore would be indirectly culpable for allowing the patient to commit suicide.

We arrived on the ward and were met by the nurse in charge who proceeded to tell me that the patient (lets call her Val) had tried a number of times over the last 3 days to hang herself or choke herself with various cords, oxygen tubing, belts etc. She was now being sent to a palliative care unit for continuation of her care.

The nurses had drawn up a number of sedatives and managed to persuade Val to take them ‘to make her journey more comfortable’

We moved her onto the trolley and off into the ambulance.

It doesn’t take a doctor to understand her rationale for wanting to die.

She was fed up with the pain that she had, and she never got any significant relief. She was dying anyway, and she didn’t want to go through a painful drawn out death. She wanted some control back in her life, she was sick of being a patient and wanted to decide herself, what her fate was and when she was going to die. She had been told there was no further treatment for her and she knew that it was unlikely that she was going to get back home again. The only family she had was a brother who lived further down the country and couldn’t get up to see her due to his own ill health.

But……she was on suicide watch. She had a security guard sitting outside he door, constantly watching her. No one was going to give her any chance to finish what she had tried a number of times over the days before.

Whilst we were in the vehicle the sedation quickly took hold off her and she became disorientated and started pulling at the sheets covering her. Her eyes were open but there didn’t seem to be any one there. Her breathing became a little wheezy and her oxygen saturations dropped from 91% to 84%so I started a salbutamol neb to try and ease any discomfort that she may be having. I know she was DNR, but trying to maintain patient comfort is seperate from performing heroic measures to maintain life.

All the way to the hospital, I was thinking that this was far from a dignified and peaceful death. No doubt the hospice where she was going would be able to palliate her symptoms far better than an acute medical ward, but ultimately, its just delaying the inevitable.

When I was a nurse, I started my career in an oncology (cancer) ward, and also worked in a local hospice. I have the upmost respect for what nurses in the cancer specialities can do and I know that there is a movement against euthanasia and for good palliation and control of symptoms to allow patients to have a peaceful death. BUT……it isn’t always possible. Despite everyones best efforts, not all death can be peaceful. I have seen a number of patients apparently struggle right up to their last breath. Surely there has to be a better way for these patients and their families.

I would hate to see a member of my family go through an end of life event like that. I don’t see it as a cop-out to seek euthanasia as I think it takes a great deal of courage and support to make the decision to end your own life.

We don’t let animals suffer like this do we?

As for Val, I hope that she does find peace and I hope her remaining days are not filled with further attempts to end her life. It just doesn’t seem right or fair.

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