According to the American Medical Association (AMA), physician-assisted suicide (PAS) is defined when “a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act.” A variety of terms have historically been used to describe an event when a physician uses lethal medications on a terminally ill patient for the purpose of easing their suffering. The term “physician-assisted suicide” was conceptualized to accurately reflect the relationship between the doctor and patient while denoting the etymological roots of suicide as “auto-killing” or “self-killing.” After years of courtroom and political battles, California, Colorado, the District of Columbia, Montana, Oregon, Vermont, and Washington are the only U.S. states that currently allow PAS as a result of the Death With Dignity Act enacted in 1997. As of January 1, 2019, Hawai’i will be added to that list.

Public Policy

The perception of PAS is a highly controversial topic within the nursing profession because it centers on the decision of terminating a human life to ease physical and emotional agony. For centuries, issues related to PAS have been zealously debated, with neither advocates nor opponents gaining much ground. Currently, those who favor PAS view the process as a peaceful and painless death while those who oppose it believe that the consequence of any form of suicide will ultimately result in irreparable legal and ethical ramifications. With recent societal and technological advancements in science and medicine, choices involving both life and death have become much more complicated in recent years. As a result of this worldwide controversy in health care, many nurses nationwide are now forced to deal with this ethical dilemma head on.

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Risks and Benefits

Like many controversial topics in contemporary society, there are numerous risks and benefits nurses must be familiar with when it comes to justifying PAS. Those who support PAS argue that people should have the right to choose the timing and manner of their death in the event of an adverse clinical aftermath. Proponents of PAS strongly believe that allowing a patient to needlessly suffer can cause additional pain and distress, which can ultimately eliminate whatever shred of dignity the patient may possess. As a result of this realization, many proponents believe that PAS can provide patients with a unique treatment alternative to their incessant agony.

Despite the urgings of proponents however, many opponents argue that the sanctity of human life should be continually honored and respected in spite of physical or emotional discomfort. The argument contends that only God Himself has the authority to give and take life, and that individuals should not be allowed to take any life, including their own.

Lastly, the potential for PAS is tremendously high in vulnerable populations because of their lack of access to quality health care. Since PAS may become a cost-containment strategy that can lead to serious litigation if not performed properly, opponents strongly forbid PAS to stop these abuses from occurring.

The Impact of Nursing in Physician-Assisted Suicide

PAS is an exceptionally controversial issue because it encompasses both legal and medical ramifications centered on the individual’s unique moral and ethical principles. With the ever-expanding ability to both prolong and end life, nurses must not only remain cognizant but also prepared for any and all repercussions associated with life and death situations.

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Mental Health Is a Global Issue
Jonathan V. Llamas, DNP, RN-BC, PMHNP-BC, PHN
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