NUR131 Research Foundations for Health Practice

Normally nurses are not directly involved in the final stage of execution of euthanasia, they are mainly present in the process which starts when the patient request for assisted dying and ends with offering support to the patient’s relatives and other health care givers (Nia, Lehto, Ebadi, & Peyrovi, 2016). It is very important for the nurses to be aware of their role during the process. The Role that Nurse Julie played while assisting Rex on his journey to assisted dying can be categorized into three phases;

Nurse Julie played a very vital role of assessing Rex. She was determined to assess the underlying motive for requesting euthanasia and the prevailing factors that contribute to the decision (Terkamo-Moisio, et al., 2017). This gave her a perfect opportunity to establish whether Rex’s suffering was relievable and could provide alternative care plan for the patient to avoid undignified death.  For instance, after they visited Doctor Farmer at the hospital for the first time, Julie offered to provide palliative care to Rex as he waited on the line for euthanasia (De Lima, et al., 2017). During this time the nurse examined the physical condition of the patient to determine severity of the illness.

Consent and dignity

The nurse ensured that Rex fully understood the process of euthanasia and its implications. She made sure the patient was not pressurized into submitting to the decision of euthanasia and that his rights and dignity were well protected (Green, et al., 2020). Nurse Julie felt that Doctor Farmer was more eager to test her machine for assisted death as opposed to take care of Rex. Even Rex confessed that he felt that the Doctor wanted him dead. Nurse Julie upheld and protected the dignity of Rex, she did not equate him to some specimen for testing functionality of a machine. But rather as a patient who needed care and deserved better life. The nurse ensured that there was a mutual consent before they could proceed to the euthanasia (Lee, Kim, Kim, & Kim,, 2019). She acted as the advocator for the patient, providing information about his condition and the patient’s readiness for the assisted-dying. Nurse Julie adopted heartfelt communication and active listening skills to identify the patient’s needs and preparedness to die.

Preparation

The nurse helps the patient to get ready for euthanasia by relieving them from anxiety (Blaschke, Schofield, Taylor,, & Ugalde, 2019). For example Nurse Julie guided Rex through light body exercises and meditation. On the last evening before the patient was set for euthanasia, they both spent time by the sea exercising and watching the sun set. This improved mental health of Rex and consciousness of his decisions. On the day of executing assisted dying, the nurse was present to offer emotional support to the patient. And explain to him the procedure and also to prepare the medication that is to be used during the euthanasia.

The difference between the Role of Nurse Julie and Doctor Farmer

The role that Doctor Farmer played while trying to assist Rex on his journey to assisted dying was more entangled in legal battles. There are several legislation requirements that need to be met before euthanasia can be administered to any patient (Hewitt, et al., 2020). After designing a new machine for assisted dying, Doctor Farmer was tasked to collect enough signatures as required by the local authority before its use would be legalized in the Northern Territory, Darwin. The doctor advocated for the legalization of the euthanasia as alternative of care for patient suffering from terminal illness. Her center of focus was not just caring for Rex but rather for other future patients too (White & Willmott, 2018). Doctor Farmer worked closely with other healthcare providers and legal authorities to provide conducive environment and tools for assisted dying.

There is a distinctive difference in the role of Doctor Farmer to nurse Julie. Doctor Farmer is more interested in the continuity of care for the patient. Unlike Julie, Farmer is not interested in developing a close relationship with Rex. She designs the machine for euthanasia and prescribes the medication to be used in the execution of euthanasia (Munday & Poon, 2020). She is viewed as the head of the health care plan for the patient. This is difference between the doctor and the nurse is known as the difference in code of conduct. The nurse on the other hand administers the medication prescribed by the doctor and maintains a close relationship with the patient. As their responsibility is to promote health and alleviate suffering.

Registered Nurse Scope of Practice

The scope of practice of a registered Nurse in euthanasia is well established under the Victorian Legislation. A registered Nurse with conscientious objection to euthanasia is accorded the right to deny the patient information about euthanasia or decline to participate in the request and assessment process of assisted dying (O’Connor, et al., 2018). There is no offence when a registered health practitioner with a conscientious objection refuse to supply or dispense medication meant for voluntary assisted dying. The nurse enjoys of the freedom of choosing not be present at the time when the euthanasia is being executed.

This legislation prohibits any Registered Nurse from initiating the process of assisted dying either by introducing a discussion about voluntary assisted dying with the patient or directly suggesting to the patient to consider voluntary assisted dying as an alternative care plan (Beardsley, Brown, & Sandroussi, 2018).in retrospect the Victorian legislation permits the registered nurse to provide full detailed information about euthanasia upon request by the patient. Violation of any of the provisions is considered unprofessional conduct within the meaning of the legislation.

Voluntary Assisted Dying Act of 2017 of the Victorian legislation requires that the registered nurse should either accept or reject the patient’s request for assisted dying within 7 days after officially receiving the request from the patient. While rejecting the request the nurse should clearly state the reasons that informs their decision (Gilbert & Boag, 2019).  The nurse may reject the request for assisted dying based on the following grounds; the registered nurse has a conscientious objection to voluntary euthanasia or the registered nurse anticipates that they will not be available to perform the duties of coordinating for purposes of assisted dying. The registered nurse is permitted to assess the patient to determine their eligibility to voluntary assisted euthanasia under the provisions of the legislation.

If this Victorian legislation had been effective during the movie Nurse Julie would have been compliant to care for Rex. She has not acquired a conscientious objection to voluntary euthanasia. The minimum qualification requirement for a coordinating nurse in euthanasia is to be a vocationally registered practitioner and also to partner with a specialist medical colleague like Doctor Farmer.  Nurse Julie is a registered nurse and has been providing her care services for at least a period of six years. And it is evident in the movie that she aware of her role as nurse. She competently bridges the relationship between rex and Doctor Farmer.

Ethical Considerations

There is need for a more elaborate and candid discussion about nursing ethics in light to voluntary assisted dying and with regards to the prevailing governing laws (Rutherford, ). A practicing nurse under the Victorian Legislation is guaranteed the rights to apply for practitioner administration permit. This document gives the registered nurse power to administer sufficient dose of the prescribed substance to end the life of the patient in the presence of a witness. This is against the spirit of code of conduct of nurses that advocate for nurses to promote health and restore life. It controversial when a registered nurse personally ends the life of a patient. At this point its nit easy to determine if the nurse still uphold the dignity of the patient.

Assisted dying has not been perceived as the professional mandate of nurses. Their role is well established and they are never expected to directly get involved in ending a patient’s life.  Nurses are encouraged to conduct more vigorous research on how they can improve palliative care to patients to improve their quality of life.  Life is divine and pain and suffering is not sufficient reason to end someone else life even with their permission (Blaschke, Schofield, Taylor,, & Ugalde, 2019). The law under Victorian Legislation contradicts the morality of the general society that life should be safeguarded.

Watching the movie and writing this assessment has provided me with an opportunity to examine the topic of assisted dying.  The movie is about Rex who is a taxi driver who is probably is in his 70s and is a resident of Broken Hill. He has been diagnosed with cancer and the doctor projected his remaining lifespan not to exceed three months (Munday & Poon, 2020). I have scrutinized the role of doctors and nurses in assisted dying and how these roles differ. I have identified possible ethical issues that are linked to voluntary assisted-dying.

Feelings

Originally before I watched this movie and had the opportunity to complete this assignment, I bluntly felt that killing or ending life of another person is cruel. I felt that life is dive and a sacred gift from God and no one is entitled to end it for whatever reason (Lee, Kim, Kim, & Kim,, 2019). While watching the movie I resonated with the pain and frustration Rex was going through. Although I still preserved my belief that life was sacred. I felt that euthanasia was the right option for the patient as long as he voluntarily agreed to it.

Evaluation

Doing this assignment was not much complicated as the tutor made fundamental resources for the assignment available. The link to watching the movie and reviewing the Victorian Legislation were provided (Nia, Lehto, Ebadi, & Peyrovi, 2016). This acted as a good motivation to tackle the assignment. However, it was relatively difficult to find materials that had relevant information about the role of nurses in voluntary euthanasia.

Analysis

The reason why doing this assignment was not much complicated for me is because I find the topic of euthanasia intriguing and I was excited to learn more information in relation to this topic. The tutorial materials came handy in giving me a clear framework of how to handle this assignment. Many scholars have previously discussed this topic even though a few have analyzed the role of nurses in voluntary euthanasia. Generally there is adequate learning material about euthanasia.  I think it is advisable to read wider on the given topic before resuming the work on the given subject. Proper planning is helpful in finishing assignment with the required deadline.

Conclusion

I learnt that voluntary euthanasia is an alternative care plan for the patients who have been diagnosed with terminal illness and the specialized physician have predicted that they have less than three months to live. Patients should be given the right to choose their preferable care plan (De Lima, et al., 2017). However the health care practitioners should not initiate the discussion of voluntary euthanasia with the patients. The role of a doctor and nurse differ due to their professional codes of conduct.

In my future endeavor I plan to be more open minded and willing to learn. And not just form personal rigid conclusion about an issue without a detailed examination of the matter. As the future nurse I will continue to learn more about the various roles of nurses and their ethical code of conduct.

References

1. Beardsley, C., Brown, K., & Sandroussi. (2018). Euthanasia and surgeons: an overview of the Victorian Voluntary Assisted Dying Act 2017 and its relevance to surgical practice in Australia. ANZ journal of surgery,, 88(12), 956-958.

2.Blaschke, S. M., Schofield, P., Taylor,, K., & Ugalde, A. (2019). Common dedication to facilitating good dying experiences: Qualitative study of end-of-life care professionals’ attitudes towards voluntary assisted dying. Palliative medicine, 33(6), 562-569.

3.De Lima, L., Woodruff, R., Pettus, K., Downing, J., Buitrago, R., Munyoro, E., & Radbruch, L. (2017). International association for hospice and palliative care position statement: euthanasia and physician-assisted suicide. Journal of palliative medicine, 20(1), 8-14.

4.Gilbert, J., & Boag, J. (2019). ‘To die, to sleep’–assisted dying legislation in Victoria: A case study. Nursing ethics, 26(7), 1976-1982.

5.Green, G., Reicher, S., Herman, M., Raspaolo, A., Spero, T., & Blau, A. (2020). Attitudes toward euthanasia—dual view: Nursing students and nurses. Death studies,, 23(3), 1-8.

6.Hewitt, J., White, Del Villar, K., Willmott, L., Greaves, L. L., & Meehan, R. (2020). Voluntary assisted dying in Victoria: Why knowing the law matters to nurses. Nursing Ethics,, 30(5), 123-124.

7.Lee, H. J., Kim, J. S., Kim, H., & Kim,, C. T. (2019). The awareness of medical department students about euthanasia. The Korean Journal of Emergency Medical Services, 23(1), 165-178.

8.Munday, T., & Poon, P. (2020). "Geriatricians’ attitudes towards voluntary assisted dying: A survey of Australian and New Zealand Society for Geriatric Medicine members.". Australasian journal on ageing, 39(2), e40-e48.

9.Nia, H. S., Lehto, R. H., Ebadi, A., & Peyrovi, H. (2016). Death anxiety among nurses and health care professionals: A review article. International journal of community based nursing and midwifery, 4(1), 2.

10.O’Connor, M. M., Hunt, R. W., Gardner, J., Draper, M., Maddocks, I., Malowney, T., & Owler, B. K. (2018). Documenting the process of developing the Victorian voluntary assisted dying legislation. Australian Health Review, 42(6), 621-626.

11.Rutherford, , J. (n.d.). The role of the medical profession in Victorian assisted dying law reform. Journal of law and medicine, 23(4), 246-264.

12.Terkamo-Moisio, A., Kvist, T., Kangasniemi, M., Laitila, T., Ryynänen, O. P., & Pietilä, A. M. (2017). Nurses’ attitudes towards euthanasia in conflict with professional ethical guidelines. Nursing ethics, 24(1), 70-86.

13.White, B., & Willmott, L. (2018). Future of assisted dying reform in Australia. Australian Health Review, 42(6), 616-620.

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