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'We may have to discuss planning their death'


It is with a heavy heart that I am reflecting on what is being discussed both in the press and media about assisted suicide.

I fear for what my fellow nurses may have to face in the not to distant future. For the first time in the history of nursing in Britain, we may have to deal with the reality of discussing with patients the option of planning their own death. With this discussion, for many nurses, will come a feeling of sadness, sadness that they were not able to address the issues that the patient had to face when deciding whether or not to do this act.

While others; MP’s; religious leader’s; even celebrities, publically voice their stance, we watch silently in the background, fearful of the divide that this has the potential to create among the nursing workforce. The divide will be between those nurses who either support or reject this act, and yet, both decisions will be made out of a belief in what unites us as nurses: compassion to help ease the suffering of those in our care.

The constitution of the NHS published in January 2009, states ‘we, the NHS, respond with humanity and kindness to each persons’ pain, distress, anxiety or need’. 2009 may be the year in which the Constitution was published, but, it is actions which we as nurses, have been striving to achieve from that first day of becoming a nurse.

Many nurses like myself, will remember the time that the word ‘cancer’ was said in a hushed voice because of what it most often meant: suffering and death. At that time there was little in the way of analgesia to help, Brompton Cocktail being the one most often available.

Look how we have progressed since then: the word ‘cancer’ does not mean the end of hope for many now; we have Pain Team Services to refer to for controlling pain; there are Care Pathways in place including end of life pathways which also encompass care of friends and relatives; we also have Hospices available.

How did those services come about: did we as nurses, through our own experiences, not help create these services and pathways? How did we know that these services were required - we knew from being at the patients bedside, trying to ease suffering; we knew from trying to comfort patients when the fear of what was to come caused anguish; we knew from trying to support relatives in coming to terms with the suffering witnessed, and in doing so, helped to prevent future generations from having fear instilled in them by stories told.

In the ‘big scheme of things,’ the services described are still in their infancy, yet have already brought comfort, eased distress and controlled pain for a new generation.

With this foremost in our minds, I hope that, even silently in the background, we are given the chance to address the issues that lead a person to decide that their life needs ending. Most of all, I hope that we do this united in our compassion for those in our care.

About the author

Monica Mcaleer RGN. Theatre Nurse, ENT Theatres, Nottingham University Hospitals, Queens Medical Campus.


Readers' comments (8)

  • I do not disagree that we should 'ease the suffering' of those in our care, but who are we to dictate to others how to end their lives.

    Do we want to return the days of a paternalistic service where 'we know best'?

    If, (and I hope it is a long time coming - if at all!) I decide that my quality of life is of such poor quality that I do not want to go on, then that is a decision for me and not you.

    We keep spouting on about patient choice, why should this be denied when making probably the hardest decision of them all. surely it is better to have the conversation and ensure that people are aware of ALL the options?

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  • Thank you for being frank enough to write this article, however I am surprised that assisted suicide in the UK is being talked about as almost a fait accompli. We are a long way from that, and I will make my views plain by saying that I hope we never get to that point.
    If your concern is that we are not trying hard enough to advance palliative care services, then I will share responsibility for that with the rest of the nursing workforce. But if that is the case it does not follow that assisted suicide should be legalised as an alternative.
    I do not believe that any of us, people or nurses, are meant to have the authority or responsibility for ending someone's life and I don't think we can cope with it.
    Thank you,

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  • I wish we would discuss planning a patients death more often, then we wouldn't find ourselves in horrible situations with the medical staff, patient and family all unable to reconcile their best intentions.

    The two issues of assisted suicide and effective palliative care should not be confused as by the writer of this article and other speakers.

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  • I also hope that we will never see assisted suicide legalised, but I do think we need to find the means to discuss the possibility of this happening. If we don't have these discussions then I belive there is a real risk we will be 'standing silently in the background' as others decide that this leagalisation goes ahead.
    I think that if a patient feels that they wish to plan to end their life then we have a duty of care to find out what thoughts are behind that decision. A patient wanting to end their life is not something that we should just accept as a 'patients choice' without finding out if the reason behind this choice is something that we could address.

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  • Monica, would you say that you come at this issue from a religious perspective?

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  • No, I wouldn't say that I come at this issue from a religious perspective. I feel very strongly that as human beings it is not the natural order of things to want to end your life and therefore something is inflencing that decission. When I say influencing I refer to fear. As nurses should we try to find out what that fear is? I think we should.

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  • I am interestedin the comment about a religious perspective. Is there a problem if Monica was coming from this view point.

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  • Not a problem but understandably, religious backgrounds will often lead people to have particular viewpoints that will influence how they feel about this issue. Many commentators don't feel the need to include this in their discussion and yet it seems clear that there is a divide on this issue between the pious and the non pious.

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