Some time ago, I found myself in a position where I am working against death. I fought hard and was even more aggressive than the family members of the patients themselves, but in the end, they came up to me, and told me, that they would want to sign a DNR contract. My patient was 16 years old who got in a tragic accident. We’ve been taking care of him for almost 10 months in the ICU and the chances of getting him back were very slim. The family gave up. My initial reaction? I said nothing, of course. That is not my position to say anything. But I swear, it hurts like hell to say nothing at that particular moment when all I really wanted was for them to keep going.
With dying patients, it is inevitable that the loved ones of the patient be given the option to sign a “Do Not Resuscitate” agreement. But as part of the team of lifesavers, choosing death when you have the capacity to save someone is a contradiction. And I am not even speaking about euthanasia, where we generally assist in the suicide of someone else, or in elective abortion, or in choosing whether to save the mother or the infant. These things can happen to any one of us, where we are caught up in the orbit of these people who gave their consent to choose death, and in one way or another, it will change your views with your profession.
The argument that euthanasia and DNR are unjustifiable for the people who are pro-life is generally correct, but for the most part, having the option to end the suffering is more humane especially when there are no more options left. Everything is about the advocacy of ending pain and suffering, both for the patient and their significant others.
“Will you pull the plug for me?”
Having a conviction on this issue is a must, especially if you are a nurse. This is no longer a dilemma whether passive (DNR) and active euthanasia is legal or not, but it is more of justification if the dictates of our beliefs and moral values in the context of euthanasia are making us ethical nurses.
Medical institutions all around the world share and differ in their stand mainly because of the involvement of the various religious doctrine all pointing out that killing is a sin. Pulling the plug and being part of the team who are advocates of euthanasia seems like being cast as murderers. This issue could lead us to feel like we are on a pendulum, swinging back and forth as we could not meet a cut and dry mentality whether deliberately taking away someone’s life is no more short of saving the dignity of the dying. I have met a lot of patients who were bedridden and attached to mechanical ventilators for more than a year, unresponsive. Are we really saving them? Or are we adding to their suffering?
I guess the real question to consider here is this: Do we have the right as a professional nurse to have the option to deny participation as witnesses in the signing of the DNR or euthanasia contract? Or better yet, is it a contradiction to our advocacy of pro-life if we agreed to the instructions of the family of the dying to stop life support?
“Let the patient die.”
The gravity of that statement is truly extreme. We have to consider a lot of things as to why the patient or the significant other decided to turn off life support. They might be financially incapacitated or just emotionally drained from the hopelessness of the situation.
To the general population, life is sacred. Giving up on life devalues that sacredness. Death is also terrifying which is why as much as possible, we prevent it to happen.
We are all at war for a miracle to happen in our reality, but what if we are waiting in vain? As nurses, we are closer to seeing the flat fact that life is a cycle. When there is death, there is life. When we choose death, we give way to life. All we can do is accept the fundamental truth that death is inevitable and that we agreed to choose death so that the life of the ones left behind can continue.