Wednesday, January 26, 2011

Vermont nurse - offers a vision of caring rather than assisted suicide

Vermont Governor Peter Shumlin has made the legalization of assisted suicide in Vermont a priority for his government.

In response to Shumlin, Lynne Caulfield, a registered nurse from Dummerston Vermont wrote an inspiring letter that was published in the Rutland Herald paper on January 23, 2011. Caufield made several valid points and she referred to her own personal experience in the death of her husband.

Caufield first stated:
It is hard to believe that with all the pressing budget issues facing the 2011 Legislature, Gov. Peter Shumlin has made doctor-prescribed death one of his first priorities.

Funded with money outside of Vermont, the proponents of doctor-prescribed death have targeted Vermont as their next victim. It is a sad day when human beings want to help other human beings to die rather than extending compassionate and respectful care to ease suffering and pain. It is especially disturbing that health care professionals are being called upon to assist patients to die rather than live.

She then brings home her point by writing about the ethical code that she follows as a registered nurse. She stated:
As part of the Florence Nightingale pledge, nurses have sworn an oath to “abstain from whatever is deleterious … to not knowingly administer any harmful drug.” The pledge also says, “With loyalty I will endeavor to aid the physician in his work and devote myself to the welfare of those committed to my care.”

Doctors and nurses are expected to exercise beneficence, which is to “do good,” and non-maleficence, which is to “do no harm.” We have pledged to care, not destroy. To expect a doctor to prescribe a lethal dose of barbiturates is the ultimate violation of non-maleficence.

Death is permanent and irreversible. Doctor-prescribed death should not be legalized in Vermont, because it is not needed. The legalization of doctor-prescribed death could lead to potential abuse and is not without complications.

You’ve heard it said, “Nothing is certain in life except death and taxes.” (Some add housework!)... With the advancements in the medical treatment of pain and palliative care, we should assist the chronically ill and dying with compassionate care to make each day comfortable, valuable and precious
She then opened her life to us by telling us about her personal family experience.
My husband, Jack, was diagnosed with pancreatic cancer in December 2002. Prognosis for patients with pancreatic cancer is often poor. He was treated aggressively with chemotherapy and radiation. In September 2003, he was told the cancer had metastasized to his liver and that there was no hope. He was devastated by the news since he wanted more time to spend with his family and our five children in particular.

If the option of doctor-prescribed death was available to someone in this situation, one might resort to this drastic step with no recourse.

In my husband’s situation, the doctors were horribly mistaken. The cancer had not spread. Jack finished treatment and surgery. He lived two more years before receiving another diagnosis that the cancer had returned. Again, the doctors said he would be gone before Christmas, yet Jack lived until February and was able to savor more time with his family. He had wanted to write a letter to each of the children, and he was able to accomplish his desire. If he had listened to the doctors and chosen a doctor-prescribed lethal dose, he would have lost much precious time. We were present when he breathed his last breath. He was peaceful and comfortable.

Caufield then explained the reality of people dying by lethal dose. She stated:
Doctor-prescribed death is not a pretty picture. The doctor has to prescribe a lethal dose of barbiturates, which usually means 90 pills. The patient takes the pills home. Can you imagine swallowing 90 pills at once? A spoonful of sugar might have worked for Mary Poppins, but not for those patients who have trouble swallowing. There is no doctor present, no medical assistance. They are on their own.

The side effects from this lethal dose are multiplied times 90. Some of the side effects include gastrointestinal distress such as nausea and vomiting. Another complication is failure to die. It doesn’t always work, and then whom do you call? In the Netherlands, if one fails to die from the oral overdose, it is legal to give a lethal injection. Is this what we want for our fellow Vermonters?

She ended her letter by challenging society to care for the other.
One more important aspect that would be missing if doctor-prescribed death were to be legalized is that rich privilege we have to care for those we love. In our me-first society where we want everything disposable and convenient, caring for the chronically ill, the disabled and the dying is not something we are comfortable with or have time for.

Granted, it isn’t easy to care for your dying loved one. It isn’t convenient or quick, but it is an awesome privilege and a rich experience. My mother died last April after a long battle with breast cancer. She died peacefully at home surrounded with love and music. Each day was a gift as we cared for her and sought to help her experience those things that brought her joy.

We are called as human beings to care for one another deeply. It is one of the richest of human experiences. We don’t need doctor-prescribed death in Vermont; we just need to extend loving care to one another.

Thank you Lynne Caulfield for sharing with us your caring experience.

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