Coalition Voices: Not a Compassionate Choice

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Our new blog forum, Coalition Voices, features thoughts and personal stories from members of the Maryland Against Physician Assisted Suicide Coalition. In this week’s installment, Sandi Nettina, a Nurse Practitioner in Maryland, talks about the treatment process for patients at the end of their lives, and the dangers PAS poses to healthy healing.

Please join Sandi Nettina and the growing list of other healthcare professionals against physician-assisted suicide by signing up for our coalition Care Without Harm: Maryland Healthcare Professionals Against PAS.

Coalition Voices: Not a Compassionate Choice

By Sandi Nettina

Proponents of the movement to legalize physician-assisted suicide (PAS) continue to state that it’s needed for those people suffering with terminal illness at the end of their lives. That belief could not be further from the truth. 

Maybe some in the medical community bear some degree of fault for making people believe that we can cure anything and that life isn’t as valuable when living with chronic and serious illnesses. 

Perhaps we have also led the public to believe that any form of treatment should be tried, no matter how many side effects and how little chance there is for survival. We are all about helping to cure or control disease, until we can’t anymore.  I find it interesting when I hear stories of a patient’s care team nowhere to be found at the moment when they are most needed.  The end of life is the most important time to serve our patients when feelings of isolation and abandonment can often lead the terminally ill to harbor thoughts of suicide. And with end-of-life resources such as hospice and palliative care, we can be very effective.

If our entire health care system was more focused on patients rather than diseases and caring for them as human beings, we would eliminate the desire for PAS.

As a provider of palliative care and primary care, I draw on my recent experience dealing with elderly and home bound patients, as well as patients of all ages in all stages of health in many settings over my career. In my 40 years of nursing, 30 of those years prescribing medicine and treatment as a nurse practitioner, there have only been a handful of patients who have ever expressed feelings of suicide. But when I referred them to counselling, they were able to put those thoughts aside and have meaningful interactions with their loved ones until natural death. 

I firmly believe it is malpractice not to evaluate and treat someone that has suicidal thoughts. Counselling is very effective and suffering can be reduced and quality of life increased through human caring. What lesson do we want to teach future generations? We DO NOT want them to think it’s OK to end their life because they have to rely on others for care, that a diagnosis of less than 6 months to live means that time is not valuable, or that it is OK to commit suicide if that’s their choice.

There must be more discussion surrounding symptom management and palliative care, as well as approaches that offer help with pain, physical care, and psychological and spiritual care. We must also include support for the family as part of treatment. This goes beyond hospice to include a focus on quality of life and individualizing the approach for all people with chronic and serious illnesses. “Caring” for all people, especially vulnerable populations such as the elderly and the disabled should include education about the natural progression of their illness, prognosis, and treatment risks versus benefits.

The fabric of our very humanity is about interacting and caring for each other. Physician-assisted suicide goes against this very basic tenet. Marylanders understand this and that is why we defeated PAS legislation in this state for the past several years. Physician-assisted suicide is wrong and it should not be legal, anywhere.

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