Euthanasia and Nursing Practice

This research examines the moral, ethical, and legal aspects of euthanasia, especially as they have an impact on nursing practice. The research will set forth the historical and moral context in which the issue has emerged then discuss legal, philosophical, social, and practical elements that figure into what has become a feature of discourse of medical care in general and nursing practice in particular.

One of the most notorious news stories of 1976 centered on New Jersey, where Karen Ann Quinlan's physicians disconnected artificial life-sustaining equipment from her body. For nearly three years, Karen's parents had sought permission to have the equipment turned off. Drama and conflict had surrounded the case, partly because Karen had been in her photogenic twenties, partly because the Quinlans were fighting the full weight and authority of the hospital that as a matter of custom, practice, and prevailing social policy refused to allow withdrawal of life support, characterized as passive euthanasia. But by the time comatose Karen Ann Quinlan died in 1985, if the withdrawal of artificial life support was not an ordinary hospital protocol, it was nonetheless a more usual practice in hospitals around the country.

In 1976, California's Natural Death Act legalized use of the living will. By 1977, the year after the Quinlan decision, "fifty bills were introduced in thirty-eight states, and in Arkansas, California, Idaho, Nevada, New Mexico, North Carolina, Oregon, and Texas, the

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91). The competence and will of the patient are basic to the argument for assisted suicide, reply advocates of personal autonomy and informed consent. Humphry & Wickett say, for example, that the Nazi program is mischaracterized as euthanasia and more properly referred to after the German form as lebensunwerten Leben, meaning life not worthy of life (1986). They continue: There is no record of the Nazis assisting in a suicide or killing anyone suffering intolerably from a fatal illness. Quite the contrary, every killing was unexpected by the victim and involuntary (Humphry & Wickett, 1986, p. 23). Less easy to answer are the objections of such health-care-delivery veterans as Elisabeth Kubler-Ross, whom Humphry and Wickett cite to the effect that assisted-suicide advocates are really in favor of "putting themselves out of their own misery--the agony of seeing a loved one suffer" (1986, p. 296). Caught in the middle of this debate are nurses, who may experience the fine line between "assisted suicide, a morally objectionable means or intent (killing) [as] the treatment used to achieve a morally permissible end (pain relief)" (Cain and Hammes, 1994, p. 161). It is an indubitable fact for those who know the subculture of the hea

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