Question

PK, a competent, middle-aged woman diagnosed with a terminal illness feels that she cannot go on. The patient, receiving hospice care lives in her home with her spouse and one adult child. For the last couple of weeks, she has been talking to the community based hospice RN about the demands she is putting on her family, her physical suffering, and the mental stress on all of them. Now PK indicates she is considering ending it all. She asks the RN to help hasten her death. Consider the HPNA Position Statements to assist with this assignment.

Initial Discussion Post:

Consider the legal and ethical implications of this situation, a potential request for euthanasia and/or assisted suicide by:
   1. Identifying the RN’s legal responsibilities in such a situation.
   2. Identifying how the RN can best interact with this patient and meet their legal responsibilities.
   3. Identifying whom the RN would discuss this with, to develop a team intervention plan.

Answer 1

A patient with terminal illness demands for a euthanasia induces an ethical dilemmas among health care members. Euthanasia is simply mercy killing. Many of the countries legalised passive euthanasia.

1.Legal responsibilities of RN

• It should be the responsibility of the nurse to render everything possible to provide support to the patient. Every terminally ill patients have the right to get expert medical care and support. It should be rendered
• The demand of the patient should be forwarder to the ethics Committee of the hospital and seek opining on this.
• Responsibility to discuss with health care team and other Social activists etc
• Explain the patient along with family members the details of euthanasia act and the procedure to be followed.
• The patient and their request to euthanasia must be examined.
• And make a detailed report on the findings and need of euthanasia. The nurse must be thoroughly awared if all the legal provisions and formalities associated with it, and should be well communicated with patient and relatives.

2.How RN can best interact with the patient and meet their legal responsibilities? ​

​​​​​​It is really an ethical dilemmatic situation for the nurse to hear such a request from a patient. But it must be well dealt with. It is highly sensitive matter to deal with utmost care.

• The interaction with patient and relatives is very important to meet the situation and nurse have to do the possible things to alleviate the suffering of patient
• Before taking a take on this, the nurse should encourage the patient to ventilate their feelings and make her or his maximum relief
• ​​​​​Take a detailed medical examination and seek information on her exact physical status at present and give whatever possible to alleviate her grief and make them feel better.
• ​Conduct family- medical team- patient interaction sessions to make them calm and relaxed.
• In depth explanation on the procedure and it's associated legal matters.

3.Identify whom the RN would discuss this with, to develop a team intervention plan

​​This is highly sensitive situation to deal. The expert opinions should be collected from as much as sources to develop a effective intervention.

• The nurse must first consult with the physician, who treat the patient and check whether any treatment options are still available before such a drastic move.
• Then should be notified with ethical committee of the hospital that such a demand was raised and to take appropriate procedure to follow up
• Detailed discussion should be arranged with department of palliative medicine to meet the patient suffering and make them feel better at terminally ill stage atleast physically. Eg. Advanced pain management techniques
• Seek a group discussion including all health care members to deal the situation effectively.
• Seek expert opinion on this or discuss with legal luminaries and be thoroughly awared the whole procedure and legal responsibilities associated with it.
• Setting a discussion session with doctors or other professionals who already associated with procedures of euthanasia in the past and seek expert opinion

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