Medical Assistance in Dying

The choice for nursing context is Medical Assistance in Dying (MAID). In February 2015, the Supreme Court of Canada changed the law to permit registered Physician-assisted death under specific circumstances. Some of the circumstances that the law highlighted to the effect of the law are if a person consents to terminate their lives and if they have underlying medical conditions that cause suffering (Health Canada, 2020). However, for one to be eligible for this process, an individual must meet some requirements. Some of the requirements are; be a Canadian citizen, be eighteen years and above, have a critical medical condition, be out of voluntary need and not external pressures, and give informed reasons for the decision (Downie & Chandler, 2017). Additionally, a legal process is required to be followed by both the patient and the nurse.

Some of the health issues that may force one to seek medical assistance in dying are serious mental illness or physical disabilities. Such conditions may cause suffering such that a person wishes to die. Another issue is advanced states of illness that are declining and cannot be reversed for the better. Some patients who are in their final stages of cancer, for instance, may opt for this option. The third issue is a mental illness where a person suffers mentally due to stress or depression (Robinson, 2013).

This context is relevant because it will help people who at their lowest point of life and suffering but are unable to commit suicide. Such people may seek assistance from physicians and be guided on how to professionally and legally end their lives. It is also essential for nurses who have eligibility for performing this action. They will understand under what terms to assist patients, how they are supposed to behave ethically, and the legal process to follow.

Nursing Role

To guide Medical assistance in dying practice, nurses are expected to have seven core-values and responsibilities in their work (Smith, 2018).

They are expected to be compassionate and provide safety for their patients. They should be updated on the current laws and under which jurisdictions to work for the patients’ safety. They should also provide enough knowledge to patients as a way of being compassionate such as options for medical support.

Another value is promoting the health and well-being of patients. Instead of merely offering death solutions, nurses can show patients that there could be good health if they stopped thinking about death. Showing them that it is possible to recover their illness and continue with their healthy lives is crucial.

Respecting patients’ decisions is critical in the MAID context. What the patients say reflects their feelings and nurses ought to respect that. Nurses should not impose their views or discriminate against patients’ decisions. Additionally, nurses must provide full information on health that patients request.

Providing dignity for patients: Patients who wish to die should be provided with a dignified death without insults. Whether their beliefs are different from the nurses’, the nurses should respect that and provide an equally respectful death. The patients should also feel comfortable in their decisions, and this can only be brought into effect by nurses.

Maintaining the patients’ privacy and confidentiality is another crucial value nurses should possess. What the patients say, their causes of illness or the reasons why they need to die should remain private between the nurses and the patient or family members. When private information of patients spread to the public, the patients may develop other health conditions like stress and depression.

Provision of justice to patients who request for MAID is also vital. Nurses do not need to exaggerate ways of dying or judging, demeaning, and stigmatizing their patients. If they do so, they could be depriving the patients of their rights. They should remain neutral and make fair decisions for the patients to choose from.

The last value is being accountable. They are responsible for working according to the laws and guidelines of the practice. They have an obligation to consult their employers in cases where making decisions is hard. Also, they are accountable for attending to patients who need help in dying.

In the course of their work when assisting patients, nurses face ethical issues. They get torn between respecting the patients’ decisions of ending lives or act as an ethical human being who is not expected to end a life knowingly. Two ethical issues are evident in this context.

Suffering and death is an ethical issue that puts nurses in confusion. Nurses who do not believe in ending lives may view MAID as a good chance to cure patients’ suffering instead of aiding them to die. While the law talks of a nurse respecting patients’ decisions, this may pose a threat to the nurses. Perceptions of nurses can make them aid the patients or fail to aid them even though it is their obligation. Perceptions may be driven by moral, social, philosophical, and faith-based beliefs (Ulrich & Grady, 2018). Therefore, nurses who conceive aiding in death as harm may opt not to help the patients. This, therefore, remains to be an ethical issue facing nurses.

Patient’s autonomy and nurses’ concern is another ethical issue. Although everybody has the right to choose what happens to their bodies, ethically, nurses face a lot of challenges. Nurses worry whether patients seeking MAID are aware of other options such as palliative care. Others worry about the well-being of people in society and how MAID can influence other people like the old or disabled to need death assistance. Some nurses argue that patients’ autonomy is not enough to decide for a MAID rather, both the patients’ and physician’s autonomy counts (Petropanagos, n.d). They say that nurses have the right to practice their autonomy despite the law talking about considering the freedom of patients.

The major disconnect between the current roles and what I think could work better is the scope of practice limitations for nurses. The law has not given nurses a chance for practicing their ethical beliefs. Even though patients’ decisions are important and should be respected, because nurses too are human beings with human interest, they should be allowed to air their views. The main idea is the goal of medicine which is not to end lives but save lives. Nurses who are empathetic and ethically dignified have a role in achieving this goal. Therefore, if they are given a chance also to consider their ethics than merely patients’ decisions, then lives could be saved. They could do so by informing patients of other ways to save their lives and not just agreeing to end lives because the law says so. Also, so as not to reach that point of seeking MAID, patients should be advised to seek medical help at the early stages of their illness. This could save their lives and save nurses’ ethical dignity.

Conclusion

I am interested in the MAID area of nursing. The reason being I agree with nurses helping patients to die, but it should be done after extensive research. It is not pleasing to just decide to end someone’s life because the law says so. As a nurse, I am interested in saving lives and not ending them. Therefore, in such a situation, I would first consider why a patient wants to die and possible solutions to offer. Even if the patient is suffering and they are convinced to end their lives, ethically, and religiously, it is unwise to help die. However, this context raises a debate in which medical practitioners ought to make informed moves to MAID. Some of the areas the debate should cover are; whether it is ethical, whether the patients are in suffering and critical conditions, and whether the reasons patients give are sound.

I want to work in this area (MAID) as a registered nurse. One major reason is to save the lives of patients who end their lives without sound reasons or conditions by offering possible solutions. Another reason is to drive campaigns of encouraging patients to seek medical help before reaching to the point of seeking medical assistance in dying. I believe the campaigns could save many lives and in turn, save nurses from the guilt that comes along with aiding the death of a human being.

References

Downie, J., & Chandler, J. A. (2017). Interpreting Canada’s medical assistance in dying legislation. SSRN Electronic Journal. DOI:10.2139/ssrn.2976521

Health Canada. (2020, July 24). Medical assistance in dying. Retrieved from https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html

Petropanagos, A. (n.d.). The Royal College of Physicians and Surgeons of Canada: Providing medical assistance in dying (MAiD). Retrieved from https://www.royalcollege.ca/rcsite/bioethics/cases/section-5/providing-medical-assistance-dying-e

Robinson, G. (2013). Assisted dying in Canada. Canadian Medical Association Journal, 185(5), 418-418. DOI:10.1503/cmaj.113-2107

Smith, D. H. (2018). Regarding medical assistance in dying and mental health: A legal, ethical, and clinical analysis. The Canadian Journal of Psychiatry, 63(8), 571-571. DOI:10.1177/0706743718775935

Ulrich, C. M., & Grady, C. (2018). Moral distress in the health professions. Springer.