The nurse voice in the voluntary euthanasia debate

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South Australian nurse Sandy Bradley writes about the voluntary euthanasia debate and nurses’ role in that. She says ‘Not being able to discuss voluntary euthanasia to address individual concerns about this issue frustrates me as a nurse … Australian nurses, in general, remain quiet on this issue … Whichever way you feel about VE, it is important to make your voice heard from a nursing perspective – not a personal perspective.’ Also included on the blog is a video of nurses speaking about assisted dying and a podcast by Andrew Denton. Read on…

The voluntary euthanasia (VE) debate has come into the spotlight again after a VE Bill was tabled in the South Australian Parliament a few months ago.

Since 2013, there have been VE Bills or reports tabled in New South Wales, Victoria, Tasmania and the Commonwealth. In addition to this, Andrew Denton and The Wheeler Centre have produced a number of podcasts on all aspects of the VE debate – both pro and con – to understand whether VE is truly an option for the Australian public and if so, how it may occur.

the-shift-500NSWNMA Professional Day Keynote Speaker Andrew Denton talks about dying with dignity in this podcast Better Off Dead.

The ANMF Federal Office has a position statement on VE which supports a nurse to respect a person’s right to self-determination, identification of quality of life and compassion for those who suffer. The statement acknowledges that assisted dying is currently an illegal act and that nurses are obliged by law and professional codes to operate within those boundaries of the law. However, the ANMF position statement also states that its role is to “participate in the broader public debate as an appropriate organisation to ensure that the nursing and midwifery voice is heard”.

I participate as a nurse in this debate through my research on advance care directives (Bradley, 2015) and by holding community forums and seminars on the new South Australian Advance Care Directive (SA ACD) form.

The average age of people attending the forums is 65+. They are knowledgeable, articulate and have been contemplating completion of this document for their own satisfaction as well as to support family members who may be called upon in a time of need. Participants in these forums have been generous in sharing their concerns and experiences and inevitably someone will raise the issue of voluntary euthanasia.  I tell them that in the new SA ACD form, the Act specifically says that healthcare professionals cannot respond to a request for VE, as VE is currently an illegal act.

Not being able to discuss voluntary euthanasia to address individual concerns about this issue frustrates me as a nurse. I feel I am constrained in discussing the topic to any great extent because it remains an illegal act, yet as a nurse I am bound by a code of ethics and professional practice which supports the very tenets underpinning the choice of VE.

So what to do?

I am a member of the SA Nurses Supporting Choices in Dying group. The group’s convenor Susie Byrne and I have written articles about the group and VE in general for the ANMJ (Bradley, 2008, 2010, 2011; Byrne, 2013). The ANMF leadership has also written on this subject (Levett, 2013) as well as Australia’s recognised nursing ethicist, Professor Megan-Jane Johnstone (2014).  Nevertheless, Australian nurses, in general, remain quiet on this issue.

Whichever way you feel about VE, it is important to make your voice heard from a nursing perspective – not a personal perspective.

Do you believe, as a nurse, that a person should have the right to determine the manner and time of their death if they are at the end of their life?  If not why not? If so why?

More importantly, and I think this is where nurses get stuck, how do you think this might play out in your professional practice? Would you be prepared to discuss VE with a person who has put this in their Advance Care Directive? Would you be prepared to assist in the act of administering VE should it be made legal? From a nursing point of view, what are the pros and cons of this for your practice?

Your voice on this issue is critical. Families and carers who feel the need to discuss concerns around voluntary euthanasia should be able to do so with us. The ANMF position statement gives us the support to do so: “Where a person expresses a wish for assistance with dying, nurses should be educationally prepared to discuss the legal and medical parameters of this request as well as other options available to the person or seek the assistance of knowledgeable healthcare professionals”.

To voice your nursing perspective on this issue, visit the SA Nurses Supporting Choices in Dying Facebook page, write to Susie Byrne at sanursessupportingchoicesindying@hotmail.com or write to the ANMF Federal Office at anmfcanberra@anmf.org.au. Nurse-led practice is the future and we need to be prepared for it in all aspects of our care.

This story was first published in the ANMJ, June 2016.

4 COMMENTS

  1. […] Nurses and midwives are on the frontline every day, working with patients and their families and providing treatment, care and emotional support. You witness more than anyone else the damage, harm and trauma that is taking place in the absence of legislation. [See our recent article on The Nurse voice in the voluntary euthanasia debate.] […]

  2. Whilst I do understand that some people may wish to end their own lives, I have to say that as a nurse (who also happens to work in palliative care) I really struggle with any idea of taking someone’s life or supporting someone to take their own life. Conversations I have had with other colleagues have been similar. My concern is that there is no conversation about what is this going to be like for health professionals who choose to assist in this and that asking someone to end our life is a great responsibility. This is a very emotive issue, with many points of view. But I wonder if we are really covering all bases in what we are discussing as a community.

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