Assisted Suicide Earnestine Blancher Dr.

Wendy Whitner Health care Policy, Law and Ethnic-HSA 515 June 12, 2011

1. Explain how the Patient Bill of Rights applies to this case. Nurse Nancy is violating the Patient Bill of Rights because Mrs. Jones did not make her own decision to end her life as a form of treatment. Mrs. Jones has the right to be involved in every aspect of treatment and can refuse treatment at any time. The patient is expecting reasonable continuity of care even though she might die. The patients doctor is supposed to inform Mrs. Jones if her condition is worsening and if she needs to seek different treatment options. Nurse Nancy did not ask the patient if she wanted to die, she just assumed because the patient is very ill that she may want to end her life. 2. Identify and explain at least three ethical considerations. Ethically it is a nurses job to help the doctor preserve a patients life. However, Nurse Nancy is the one that is with Mrs. Jones more and sees the drastic effect that the cancer has taken on her. Nurse Nancy has compassion for Mrs. Jones and knows that she is suffering from cancer, so to alleviate the pain she wants to help her end her life. Nurse Nancy needs to ask Mrs. Jones if she wants to die early because of her status as a single mom. In the event that Mrs. Jones does want Nurse Nancy to help her end her life she will need to make preparations for the care of child. Secondly, is it right for nurse Nancy to try and play GOD and end Mrs. Jones life? How does she know that she wont get better? There may be new treatment that Mrs. Jones can try to help her live a few more years for her childs sake. There is a difference between passive and active killing and what nurse Nancy wants to do is considered active killing. Passive killing is a patient refusing treatment that leads to them dying and active is Nurse Nancy assisting in giving the patient and overdose of a narcotic to kill herself. Morally it is wrong to assist a patient in killing themselves. (Showalter, 2008).

Finally, there is a potential for abuse by patients that want assisted suicide. Some patients might consider this option as a way to end their life if they are depressed, lacking access to care and support. Medical expenses for terminally ill patients can be expensive, especially depending on the treatment options that the patient chooses. Burden family members and patients may choose assisted suicide as a cost-containment strategy. This is why assisted suicide needs to remain illegal because people will be using the hospital as a place to go to die and not get help(Showalter, 2008). 3. Identify and explain at least three legal considerations. Currently in the 2009 article, Oregon and Washington are the only states where assisted suicide is legal; other states have considered assisted suicide a crime. In November 1994, Oregon voters approved a law to let physicians give a lethal dose of medication to terminally ill patients. Also, Washington State has the same law that went into effect on March 5th, 2009. In this case, Nurse Nancy is a third party administering a narcotic to end Mrs. Jones life, this is a crime. Euthanasia is illegal in all states including Oregon and Washington. However, if Nurse Nancy was supplying Mrs. Jones with the medication and she was to administer it to herself then she would not be charged with a crime. Secondly, if Mrs. Jones did not inform Nurse Nancy that she wants to die and she kills her, Nurse Nancy can be charged with a crime of murder. Especially if there is evidence that the patient was competent and wanted to live. The patient is a single mom and may not want to die with no one to care of her child. Also, she would cause her manager and the facility to be liable for any negligence on her part due to the respondent superior law. The doctrine of respondent superior is also called the master-servant relationship. That

is, an employer can be liable for the negligence of an employee, who injures someone as a result of their employment, even though the employer did nothing wrong (Showalter, 2008,p.67). The last legal consideration is, if Mrs. Jones informed the nurse that she wanted to commit suicide, and then she would not be criminally liable. A health care provider cannot be held liable for honoring a competent adults wishes to forgo treatment or withdraw from ongoing treatment, even when the decision will lead to death (Showalter, 2008,p.257). However, Nurse Nancy would need to inform her manager so that a written acknowledgement of refusal can be placed in Mrs. Jones medical records. This written consent releases the medical staff from liability. 4. Identify and explain at least three business considerations. Cancer centers are known to help patients overcome cancer by encouraging and empowering each patient to be part of the healing process. The National Cancer Institute (NCI) article states, patient and the medical staff are supposed to work together on treatment plans that can improve the quality of life for a patient. Also, cancer centers offer support groups to patients that need to share personal experiences, these support groups help patients want to live and provide information about treatment options. The cancer center would be known in the community as a place that helps people die rather than helping them live. The NCI article states, if the medical staff determined that Mrs. Jones cancer could no longer be controlled, medical testing and cancer treatment normally stops, however, patient care continues. The medical staff is supposed to make Mrs. Jones feel comfortable by giving her medication to control the pain but not to try and kill her. If Mrs. Jones

decides herself to stop eating and taking medications to commit suicide this in no way will make the facility or its staff liable. It is the cancer centers mission at all times to operate in the best interest of the patient and assisting a patient in dying is not one of them. The third business consideration is, if the manager of the cancer center needs to improve the work environment for their nursing staff. In this case the nurse is frustrated and burnt out and may need some time away from patient care. Since, there was an increase in terminally ill patients coming to the center there should have been mandatory counseling for the nurses. I think the manager at the center did not do enough to help Nurse Nancy with her current work environment and emotional attachment to Mrs. Jones. As a manager it is your job to provide good working conditions for your employees and quality patient care. The cancer center is a business and if they continue making their nurses unhappy this could affect the quality of care that they give patients and hurt their reputation. 5. Explain what the manager should do in this situation and why. As the manager I would tell Nurse Nancy it is mandatory for her to seek counseling and to take a few days off to separate herself from the situation. Nurse Nancy has become emotionally attached to Mrs. Jones so, it is best that she takes this time off. Also, I would assign a new nurse to Mrs. Jones because if Nurse Nancy kills her, the hospital, Nurse Nancy, doctor and I could all be liable for her negligence charges. I am curious to know if Mrs. Jones ever mentioned committing suicide to Nurse Nancy, so I am going to recommend that she seeks counseling as well to deal with her own personal feelings. When Nurse Nancy returns I am going to inform her if she visits Mrs. Jones she will be

terminated immediately. Mrs. Jones will also be informed that Nurse Nancy is not allowed to be around her or to administer any medication to her.

References Physician-Assisted Suicide. University of Washington School of Medicine. (2008,April). Retrieved June 9, 2011, from http://depts.washington.edu/bioethx/topics/pas.html Physician-Aid-in-Dying. University of Washington School of Medicine. (2009, April). Retrieved June 9, 2011, from http://depts.washington.edu/bioethx/topics/pad.html NCI Mission Statement. National Cancer Institute. Retrieved September 1, 2010, from http://www.cancer.gov/aboutnci/overview/mission Showalter, J. S. (2008).The law of Healthcare Administration (5th ed.). Chicago: Health Administration Press.