https://www.nlm.nih.gov/medlineplus/suicide.html
http://www.nejm.org/doi/full/10.1056/NEJMclde1302615
http://onlinelibrary.wiley.com/doi/10.1111/sltb.12188/abstract
http://www.preventsuicide.us/hopeline-new/pern.html
Lack of Trust in the Health-Care System After Losing a Child to Suicide
A Nationwide Population Survey
Rossana PettersenRelated information
1Stockholm
Centre for Psychiatric Research and Education, Department of Clinical
Neuroscience, Karolinska Institute, Stockholm, Sweden
2Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
, Pernilla OmerovRelated information2Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
1Stockholm
Centre for Psychiatric Research and Education, Department of Clinical
Neuroscience, Karolinska Institute, Stockholm, Sweden
2Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
, Gunnar SteineckRelated information2Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
2Division
of Clinical Cancer Epidemiology, Department of
Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
3Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
, David TitelmanRelated information3Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
4National Center for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institute, Stockholm, Sweden
, Atle DyregrovRelated information
5Center for Crisis Psychology, Bergen, Norway
, Tommy NybergRelated information
2Division
of Clinical Cancer Epidemiology, Department of
Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
, and Ullakarin NybergRelated information
1Stockholm
Centre for Psychiatric Research and Education, Department of Clinical
Neuroscience, Karolinska Institute, Stockholm, Sweden
2Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
2Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
Abstract
Abstract. Background:
Lack of trust in the health-care system after
losing a child to suicide may prevent bereaved parents from seeking
professional treatment when needed, thus diminishing
their chances of recovery. Aims: This is
the first large study to aim at evaluating the
incidence of lack of trust in the health-care system and associated
variables in suicide-bereaved parents. Method:
This nationwide population-based survey included 569
parents who lost a child to suicide 2-5 years
earlier and a matched comparison group of 326 nonbereaved
parents. Using a study-specific questionnaire, we asked bereaved
and nonbereaved parents if they trusted the
health-care system and measured psychological and
background variables. Results: Prevalence of lack of trust in
the health-care system differed between the bereaved
(46.5%) and the nonbereaved parents (18.3%), giving a
relative risk of 2.5 (95% CI = 2.0-3.3). After
multivariable modeling, high scores of depression,
living in big cities, and being single were identified as variables
associated with lack of trust in suicide-bereaved
parents. Conclusion: Suicide-bereaved
parents show lack of trust in the health-care
system. We present possible effect modifiers that may be
considered in professional interventions aiming at influencing
suicide-bereaved parents' level of trust.
Keywords: suicide survivor, bereavement, trust, health care, distrust'
http://rnjournal.com/journal-of-nursing/euthanasia-assisted-suicide-and-nursing
Journal of Nursing
Euthanasia, Assisted Suicide, and Nursing
Brooke Butler
Euthanasia and assisted suicide are serious ethical issues within the medical community. These particular issues have been debated for a very long time in the United States. According to ProConorg assisted suicide became illegal in 1828 and bills to legalize euthanasia were overruled in Ohio in 1906 (proconorg, 2013). In more recent years assisted suicide and euthanasia have jumped back into the spot light due to a man named Jack Kevorkian. Kevorkian assisted many in dying and was convicted of second degree murder in Michigan (pbsorg, 2013).
Merriam-Webster defines euthanasia as “the act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for reason of mercy (Merriam-Webster, 2013). Assisted suicide is defined as “suicide committed by someone with assistance from another person” such as a physician (Merriam-Webster, 2013). Another term related to this subject is aid-in-dying. According to Compassion & Choices org aid-in-dying is not assisted suicide. The definition provided is “aid-in-dying is an end-of –life care option in which mentally competent, terminally ill adults request their physician provide a prescription for medication that the patients can, if they choose, self-administer to bring about a peaceful death” (Compassion & Choices, 2013).
Euthanasia is illegal in the United States at this time. However, physician assisted suicide is currently legal in four states. These states include Oregon, Washington, Montana, and Vermont. Oregon was the first state to make physician assisted suicide legal in 1997 with the Oregon Death with Dignity Act. The Death with Dignity Act “allows terminally ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose (Oregon gov, 2013).
Typically, the order for lethal medications to end a patient’s life occurs in an outpatient setting (Oregon gov, 2013). The administration of the medication usually happens in the patient’s home surrounded by loved ones. With that being said, many of the patients that would request physician assisted suicide are terminally ill and receive some form of home care. Hospice is an example of home care that this type of patient may utilize.
Oregon law states that only physicians are allowed to assist in suicide. However, many other healthcare professionals and volunteers are involved with the patients care (Oregon gov, 2013). Nurses often spend a great deal of time with their patients and families in and out of the hospital setting. According to ohsu.edu patients often ask their nurses about assisted suicide (Dunn, P., Reagan, B., Tolle, S., & Foreman, S., 2008).
The art of nursing is a caring for people in every way possible. These people include the patient and their families. Nurses are strictly prohibited to directly participate in assisted suicide. The American Nurses Association (ANA) concluded in April of 2013 that participation by nurses in assisted suicide and euthanasia is strictly prohibited (ANA Position Statement, 2013, p. 9). However, nurses are expected to provide quality and compassionate end of life care for all patients.
According to Robley “ nurses in Oregon, and now Washington, don’t assist with suicide, but care for patients who elect assisted suicide in the same way they care for all patients, with dignity and compassion” (Robley, 2011, p. 15). Many nurses choose to work with patients who are at the end of their lives. Often these are home health care and hospice nurses. Nurses who work in any of the four states where physician assisted suicide is legal need to take time to consider their personal values and beliefs about being involved in the care of a patient who chooses this form of care. Nurses in Oregon are allowed to refuse to provide care for a patient who chooses physician assisted suicide, as with all healthcare professionals (Dunn et al, 2008). The nurse who chooses to continue to provide care to this patient population should provide compassionate care to the patient and the family during the dying process.
Nurses should be aware that this is a current ethical issue within healthcare. It is important to understand what euthanasia and assisted suicide are because four states have legalized these forms of care. Equally important, nurses need to know what type of care and actions are legal for nurses to assist with or provide for this patient population. As stated by the ANA, “participation by nurses in assisted suicide and euthanasia is strictly prohibited” (ANA Position Statement, 2013, p. 9).
References
ANA Position Statement, (2013). Euthanasia, assisted suicide, and aid in dying. Retrieved on 8/15/13 from httpwwwnursingworldorg
Assisted suicide, (n.d.) Merriam-Webster Online. Merriam-Webster. Retrieved on 8/15/13 from wwwmerriam-webstercom
Compassion & Choices, (2013). Nurses talking points. Retrieved on 9/5/13 from wwwcompassionandchoicesorg
Dunn, P., Reagan, B., Tolle, S., & Foreman, S., (2008). The Oregon death with dignity act: A guidebook for healthcare professionals. Retrieved on 8/15/13 from wwwohsuedu
Euthanasia, (n.d.). Merriam-Webster Online. Merriam-Webster. Retrieved on 8/15/13 from wwwmerriam-webstercom
Euthanasia, (2013). State to state guide to physician assisted suicide. Retrieved on 8/15/13 from wwwproconorg
Frontline, (2013). Chronology of Dr. Jack Kevorkian’s life and assisted suicide campaign. Retrieved on 9/6/2013 from www.pbsorg
Oregon Health Authority, (n.d.). Death with dignity act. Retireved on 9//6/2013 from wwwpublichealthoregongov
Robley, L. R., (2009). Reigniting the debate over assisted suicide. Nursing 2009 Critical Care, p15-17. Retrieved on 9/6/13 from lippincott’snursingcentercom
http://www.psychiatrictimes.com/suicide/bullying-and-suicide
http://rnjournal.com/journal-of-nursing/euthanasia-assisted-suicide-and-nursing
Euthanasia, Assisted Suicide, and Nursing
Brooke Butler RN, BSN bludwig1981@hotmail.comEuthanasia, Assisted Suicide, and Nursing
Brooke Butler
Euthanasia and assisted suicide are serious ethical issues within the medical community. These particular issues have been debated for a very long time in the United States. According to ProConorg assisted suicide became illegal in 1828 and bills to legalize euthanasia were overruled in Ohio in 1906 (proconorg, 2013). In more recent years assisted suicide and euthanasia have jumped back into the spot light due to a man named Jack Kevorkian. Kevorkian assisted many in dying and was convicted of second degree murder in Michigan (pbsorg, 2013).
Merriam-Webster defines euthanasia as “the act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for reason of mercy (Merriam-Webster, 2013). Assisted suicide is defined as “suicide committed by someone with assistance from another person” such as a physician (Merriam-Webster, 2013). Another term related to this subject is aid-in-dying. According to Compassion & Choices org aid-in-dying is not assisted suicide. The definition provided is “aid-in-dying is an end-of –life care option in which mentally competent, terminally ill adults request their physician provide a prescription for medication that the patients can, if they choose, self-administer to bring about a peaceful death” (Compassion & Choices, 2013).
Euthanasia is illegal in the United States at this time. However, physician assisted suicide is currently legal in four states. These states include Oregon, Washington, Montana, and Vermont. Oregon was the first state to make physician assisted suicide legal in 1997 with the Oregon Death with Dignity Act. The Death with Dignity Act “allows terminally ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose (Oregon gov, 2013).
Typically, the order for lethal medications to end a patient’s life occurs in an outpatient setting (Oregon gov, 2013). The administration of the medication usually happens in the patient’s home surrounded by loved ones. With that being said, many of the patients that would request physician assisted suicide are terminally ill and receive some form of home care. Hospice is an example of home care that this type of patient may utilize.
Oregon law states that only physicians are allowed to assist in suicide. However, many other healthcare professionals and volunteers are involved with the patients care (Oregon gov, 2013). Nurses often spend a great deal of time with their patients and families in and out of the hospital setting. According to ohsu.edu patients often ask their nurses about assisted suicide (Dunn, P., Reagan, B., Tolle, S., & Foreman, S., 2008).
The art of nursing is a caring for people in every way possible. These people include the patient and their families. Nurses are strictly prohibited to directly participate in assisted suicide. The American Nurses Association (ANA) concluded in April of 2013 that participation by nurses in assisted suicide and euthanasia is strictly prohibited (ANA Position Statement, 2013, p. 9). However, nurses are expected to provide quality and compassionate end of life care for all patients.
According to Robley “ nurses in Oregon, and now Washington, don’t assist with suicide, but care for patients who elect assisted suicide in the same way they care for all patients, with dignity and compassion” (Robley, 2011, p. 15). Many nurses choose to work with patients who are at the end of their lives. Often these are home health care and hospice nurses. Nurses who work in any of the four states where physician assisted suicide is legal need to take time to consider their personal values and beliefs about being involved in the care of a patient who chooses this form of care. Nurses in Oregon are allowed to refuse to provide care for a patient who chooses physician assisted suicide, as with all healthcare professionals (Dunn et al, 2008). The nurse who chooses to continue to provide care to this patient population should provide compassionate care to the patient and the family during the dying process.
Nurses should be aware that this is a current ethical issue within healthcare. It is important to understand what euthanasia and assisted suicide are because four states have legalized these forms of care. Equally important, nurses need to know what type of care and actions are legal for nurses to assist with or provide for this patient population. As stated by the ANA, “participation by nurses in assisted suicide and euthanasia is strictly prohibited” (ANA Position Statement, 2013, p. 9).
References
ANA Position Statement, (2013). Euthanasia, assisted suicide, and aid in dying. Retrieved on 8/15/13 from httpwwwnursingworldorg
Assisted suicide, (n.d.) Merriam-Webster Online. Merriam-Webster. Retrieved on 8/15/13 from wwwmerriam-webstercom
Compassion & Choices, (2013). Nurses talking points. Retrieved on 9/5/13 from wwwcompassionandchoicesorg
Dunn, P., Reagan, B., Tolle, S., & Foreman, S., (2008). The Oregon death with dignity act: A guidebook for healthcare professionals. Retrieved on 8/15/13 from wwwohsuedu
Euthanasia, (n.d.). Merriam-Webster Online. Merriam-Webster. Retrieved on 8/15/13 from wwwmerriam-webstercom
Euthanasia, (2013). State to state guide to physician assisted suicide. Retrieved on 8/15/13 from wwwproconorg
Frontline, (2013). Chronology of Dr. Jack Kevorkian’s life and assisted suicide campaign. Retrieved on 9/6/2013 from www.pbsorg
Oregon Health Authority, (n.d.). Death with dignity act. Retireved on 9//6/2013 from wwwpublichealthoregongov
Robley, L. R., (2009). Reigniting the debate over assisted suicide. Nursing 2009 Critical Care, p15-17. Retrieved on 9/6/13 from lippincott’snursingcentercom
http://www.psychiatrictimes.com/suicide/bullying-and-suicide
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http://www.nejm.org/doi/full/10.1056/NEJMsa1213398
http://nsrf.ie/wp-content/uploads/journals/2015/Mergl%20et%20al%202015.pdf
http://nsrf.ie/publications/journal-articles/#2015
http://www.nejm.org/doi/full/10.1056/NEJMsa1213398
http://nsrf.ie/wp-content/uploads/journals/2015/Mergl%20et%20al%202015.pdf
http://nsrf.ie/publications/journal-articles/#2015
