Editor’s Note: The account in question was conveyed to the Euthanasia Prevention Coalition by a nurse who requested to remain anonymous. In order to ensure the privacy rights of those involved, the nurse changed all names. – Alex Schadenberg
It is commonly asserted that euthanasia represents a compassionate and dignified manner of passing away. Those in favour of euthanasia argue that everyone should have the option to end their life if they are suffering. They claim that a life with suffering is not a life worth living. However, this is not what I have observed. It is evident that the subject of Medical Aid in Dying (MAID) is shrouded in a veil of secrecy and taboo, with the full extent of its implications remaining largely unspoken. I have observed the indirect consequences of euthanasia, which can complicate the grieving process. It is my intention to inform the general public of the impact that MAID has on healthcare professionals. As a palliative care nurse, I am in a position to offer a first-hand account of the impact of MAID on healthcare professionals.
One shift, I was assigned to care for a patient named Laura, who was scheduled for euthanasia later that day. Laura had been diagnosed with terminal metastatic breast cancer, but exhibited no symptoms that could be considered particularly challenging. However, she informed me that she was weary of life and that the prospect of living longer than her current condition warranted was more distressing to her than the alternative of death. Laura had selected music to be played in the background during her passing, and had designated which loved ones she wished to be present at the time of her death.
The event was scheduled to commence at 18:00. The patient was observed to be alert and oriented, and had signed a waiver stating that, in the event that she was no longer deemed to be of sound mind at the time of the MAID provision, she would be euthanised regardless. She believed that she had absolute control. In the hours preceding the scheduled time of 6 pm, Laura experienced a sudden and unexpected grand mal seizure. Despite the administration of a sedating anticonvulsant in large doses, the patient continued to experience seizures. The time of the provision arrived, and the patient was confused and groggy from the sedating medication. She was unable to confirm her wishes for euthanasia or say goodbye to her family members. Despite her best efforts, she was unable to articulate her thoughts and feelings. At 6 pm, Laura was euthanised in accordance with the waiver she had signed. This was the outcome she had desired, yet the family emerged from her room in a state of distress, their eyes wide with disbelief. The family members expressed their distress and frustration, stating that the situation should never have occurred in the first place. The family was unable to achieve closure. The manner of Laura’s passing was neither dignified nor peaceful. The individual in question was killed in the middle of an attempt to communicate.
The manner of death was particularly distressing. Had Laura chosen to die naturally, it is possible that she would have survived for a further two weeks. It is possible that she would have required additional sedatives and spent a longer period of time asleep. However, we would have ensured her comfort. Her family could have been present to observe and appreciate any conscious moments and verbal communication she might have made. As her nurse, I would have attempted to alleviate any restlessness, have taken steps to prevent any seizures, observed any furrowed brows and administered pain medication. It would have been possible for me to explain the dying process to Laura’s family, to discuss the changes that were occurring in her breathing and circulation, and to accompany them in their grief as she grew closer to death. Instead, her demise was abrupt and distressing, and the family departed the premises immediately, lacking the necessary support to navigate the subsequent grieving process.
The death of a family member is a traumatic event for any family, but in this case, the family was additionally affected by the circumstances surrounding the death. In accordance with the MAID protocol, a nurse is present in the room throughout the procedure, along with the MAID provider, who administers the lethal medication. As a conscientious objector to euthanasia, I was not required to be present during the procedure. Instead, my colleague volunteered to assume this role. Following the termination of Laura’s life, this colleague departed the room in a state of distress, exhibiting signs of emotional distress that had never been observed in the context of a natural death of a patient.
I am aware of numerous other nurses who have undergone a comparable experience. Although they had no religious or moral objections to MAID, after witnessing it firsthand, they swore to never be in the room again while it happened. The nurses were profoundly unsettled, and their conscience compelled them to acknowledge that the intentional termination of a life, regardless of the circumstances, is morally reprehensible.
The consequences of Laura’s euthanasia extended beyond her immediate family and staff to other patients on the palliative care unit. Mark, who was situated in a bed in the hallway, informed me that he had observed an incident that he found disagreeable and that he wished to discuss.
Mark proceeded to inform me that he had observed Laura entering her room in her wheelchair, accompanied by an unidentified visitor. Subsequently, Mark observed staff and family members entering the room, after which he observed the family exiting the room, weeping. He observed the removal of a stretcher from the room, covered by a black sheet, which led him to conclude that Laura had died.
Mark observed his family in a state of distress, a situation that evoked memories of his own wife’s demise. He was profoundly distressed by the sudden transition from Laura’s active and engaged state to her subsequent demise. He acknowledged that he was also fearful of dying suddenly. Due to confidentiality, I had refrained from discussing Laura. However, as a patient in the hallway, Mark was able to observe and hear a great deal. Both Mark and Laura were able to move around independently, and over the past few days, they had engaged in conversation in the patient lounge on occasion. The death of Laura evoked a multitude of complex emotions and distress in Mark, and I found myself at a loss as to how to provide him with the requisite support.
The death of Laura was a particularly challenging experience for me. Prior to her demise, it was challenging to engage with her in a conventional manner. I found myself continually monitoring the clock, counting down the days, hours, and minutes until her scheduled demise. I experienced an uncomfortable moment when I introduced the scheduled laxative she received each morning, along with her other medications. She responded, “Really?” “I am dying today. Does it matter if I am constipated?” Every interaction with her was imbued with the weight of her impending death. I was driven to the point of desperation, to the extent that I felt the urge to scream out, “Don’t do it!” “Your life has intrinsic value.” However, I refrained from expressing my thoughts and instead provided her with support. I then returned home, experiencing a sense of moral distress, questioning whether I had spoken my mind and whether it would have made a difference. I was motivated to tear up the waiver she had signed and to appeal to the doctor administering the lethal dose not to proceed. Upon the patient’s demise and the conclusion of my shift, I returned home with a profound sense of sadness and helplessness regarding the circumstances that had transpired.
The objective of palliative care is to alleviate suffering and provide support to patients and their families until the natural end of life, without hastening or prolonging death. It is regrettable that in the case of Laura, we were compelled to deviate from our own philosophical stance.
When euthanasia was first legalised in Canada, palliative units and hospices were exempt from having to provide MAID on site for valid reasons. The entire unit is affected when death is chosen before it is appropriate to do so. It is possible that those staff members who are accustomed to witnessing natural death on a regular basis may experience the impact of this more acutely than others. We are aware of the contrast between the two types of death, and we are aware that a natural death does not have to be frightening or painful. In the event that a patient, such as Laura, experiences a grand mal seizure, we are adept at adjusting our approach to accommodate the evolving circumstances, thereby ensuring her comfort.
Allowing death to occur naturally provides families with the opportunity to form strong bonds and to fully appreciate the time they have with their loved ones. It is possible that patients may believe that choosing MAID relieves their family of the burden of waiting for their death or of witnessing suffering. In reality, however, it results in the loss of time and closure, and replaces a natural process with an unsettling conclusion. From my observations, those who have lost a loved one to euthanasia appear to experience greater difficulties in their grieving process than those who have lost a loved one to natural causes.
The case of Laura serves to illustrate a reality of euthanasia that is not often discussed in public. Moreover, although this was merely one example, it is not an isolated incident. There are numerous additional cases that could be presented, and the consequences of euthanasia are felt throughout society, even in instances where the procedure is carried out as planned. The objective of sharing this story is to facilitate a greater understanding of the complex and often distressing reality of euthanasia. It is hoped that this understanding will lead to a shift in attitudes and perceptions, both emotionally and intellectually.
As a palliative care nurse, I offer this account of my experience.
Daniel Miller is responsible for nearly all of National Right to Life News' political writing.
With the election of Donald Trump to the U.S. presidency, Daniel Miller developed a deep obsession with U.S. politics that has never let go of the political scientist. Whether it's the election of Joe Biden, the midterm elections in Congress, the abortion rights debate in the Supreme Court or the mudslinging in the primaries - Daniel Miller is happy to stay up late for you.
Daniel was born and raised in New York. After living in China, working for a news agency and another stint at a major news network, he now lives in Arizona with his two daughters.
