“Hospice nurses are often worried that someone who willingly hastens his own death is really committing suicide,” Judith Schwarz says impatiently. She is a registered nurse herself, who has done a qualitative study on what it’s like for nurses to be asked by patients for assistance in dying.
Schwartz, who also works for CompassionandChoices.org, has spent a lot of time at the bedsides of the terminally ill. She knows, for example, that when a dying patient says, “This is going on too long. I can’t stand this much longer,” the person may be actually saying any number of things: perhaps he’s in the kind of pain which may well be alleviated with better or a higher dosage of medication. Or perhaps the pain is intractable and excruciating, and nothing can lessen it.
There are also patients with what Schwarz calls “existential issues,” meaning the dying person, finding her body in complete revolt, believes life no longer has any true meaning.
Obviously, she adds, the interpretation by gifted professionals of what a patient is really implying or begging for is vital. Not everyone who mentions the possibility of hastening her own death really means it. But, she also says, “I would argue that someone who has thought about this a long time is not acting out of untreated depression. And yet in most hospices, if a patient says, ‘I want to die!’ they send in a social worker SWAT Team.”
Schwarz wrote an article this past summer for the American Journal of Nursing on the subject of voluntarily stopping eating and drinking — an option she believes should be offered if a suffering and terminally ill patient is requesting how to accomplish a hastened death. But she knows that for most hospice nurses even discussing such an option is a taboo subject. And there, she says, is where hospices are failing some of their patients.
“The hospice nurse should say, ‘If you want to stop eating and drinking — really drinking is the important part — you will die in 15 days, usually. At most, a month. Eventually you will slip into a coma and you will die peacefully.”
But those are the very words most patients who make such requests never get to hear. If any readers out there have thoughts on the subject, I would like to read them.
i wholeheartedly agree with you.