Life and death have always been topical matters for the humanity. While each person may consider his or her own mortality at some point in life, terminally ill patients begin to look at the matter from a different perspective. Some of such patients become desperate enough to resort to suicide. Assisted dying poses an array of ethical issues for nursing practitioners, as its very concept creates an ethical dilemma. The purpose of this paper is to examine physician-assisted suicide in terms of its contradiction with nursing ethical principles.
Ethical Principles in Relation to Assisted Suicide
Ethical decision-making is a crucial part of medical practice, but sometimes it causes ethical dilemmas. The latter occurs when a medical practitioner faces a decision that is not obvious because neither of the alternatives is fully satisfactory. Nurses are an integral element of the healthcare system, and they take an active part in treatment. Therefore, if the ethical dilemma implies nurses’ participation, they should be allowed to partake in the decision-making process. When considering the options, medical practitioners usually follow a set of ethical principles that serve to determine the further course of action. These principles were introduced in order to ensure that all patients receive fair and optimal amount of care. Moreover, according to the ethical principles, any treatment should perceive the fundamental goal of medicine, i.e., improving the patient’s condition and overall doing what is best for them.
The exact list of ethical principles varies depending on the research, but several of them are considered to be the crucial ones. Autonomy recognizes a person’s right to make a choice without external pressure and, in fact, encompasses all areas of society, including healthcare. According to Pope et al. (2016), autonomy “is a moral principle and the foundation of many social and political systems” (para. 8). As far as nursing is concerned, this principle dictates the necessity of treating each patient as an autonomous individual capable of making a choice. Even though doctors and nurses have a better knowledge of medicine, the patient has the right to be presented with all the options and to have a vote in decision-making. However, Pope et al. (2016) note that autonomy entails not participation per se but rather the opportunity to participate upon the patient’s will. Therefore, pro-assisted suicide people portray the matter as the ultimate manifestation of a patient’s autonomy (Sulmasy & Mueller, 2017). Nevertheless, those who stand against the matter at hand argue that, while patient autonomy is important, it is not absolute and should exist in balance with other principles.
As a matter of fact, the list of such principles extends beyond autonomy and comprises other points. Beneficence is another critical component of ethical decision-making in nursing, as it refers to the classic dogma of maximizing benefit, while minimizing harm (Pope et al., 2016). According to Pope et al. (2016), this concept implies “that it is the healthcare professional who is best able to identify potential harm and benefit” (para. 5). Therefore, it is a nurse’s obligation to remain mindful of the patient’s condition and to pursue the most beneficial path in terms of the treatment outcome. However, as mentioned above, every individual has an inherent right to be autonomous, i.e., partake in the decision-making process. Assisted suicide proponents state that everyone deserves to determine his or her fate and, once the disease becomes unbearable, assisted suicide or even euthanasia is more beneficial than continuing treatment (Lehto et al., 2016). On the other hand, the public might see nurses and doctors’ active participation in ending a patient’s life as a betrayal of the primary purpose of medicine, i.e., saving people.
In general, there are two stances regarding assisted suicide, and it is extremely difficult to prove either one right, considering the colossal ethic dilemmas that the issue poses for medical practitioners. Notwithstanding the controversy, Vogelstein (2017) writes that the American Nurses Association prohibits nurses’ participation in assisted dying in euthanasia, as it violates the organization’s Code of Ethics. However, one may argue that, according to the Code article in question, a nurse “may not act with the sole intent to end life” (Vogelstein, 2017, para. 9). This not entirely applicable in the case of assisted suicide, as a nursing practitioner’s intention might be to alleviate the pain and end the suffering of a consenting patient. In fact, pain is the key factor contributing to a patient’s decision to end their life. According to Frey and Hans (2016), family members of terminally ill patients demonstrate a higher support rate for assisted dying and euthanasia in case of severe physical pain rather than depression. This research shows that physical factors are crucial in taking the drastic decision to end a patient’s life.
All in all, physician-assisted suicide remains a debatable issue across the globe, which includes the United States healthcare system. The very concept of assistant dying causes a series of ethical dilemmas for nurses, who are not allowed to participate in assisted suicide by the ANA Ethics Code. Existing ethical principles serve to guide medical practitioners through difficult decision-making process, but they are interpreted differently by people who take opposing stances regarding the matter. Therefore, the debates around the ethical side of physician-assisted suicide continue, while it is a nurse’s duty to follow active regulations in their line of duty.
Frey, L. M., & Hans, J. D. (2016). Attitudes toward assisted suicide: Does family context matter? Archives of Suicide Research, 20(2), 250–264. Web.
Lehto, R. N., Olsend, D. P., & Chan, R. R. (2016). When a patient discusses assisted dying: Nursing practice implications. Journal of Hospice & Palliative Nursing, 18(3), 184–191. Web.
Sulmasy, L. S., & Mueller, P. S. (2017). Ethics and the legalization of physician-assisted suicide: An American College of Physicians position paper. Annals of Internal Medicine, 167(8), 576–578. Web.
Vogelstein, E. (2017). Evaluating the American Nurses Association’s arguments against nurse participation in assisted suicide. Nursing Ethics, 26(1), 124–133. Web.
Pope, B., Hough, M. C., & Chase, S. (2016). Ethics in community nursing. Online Journal of Health Ethics, 12(2). Web.