domingo, 17 de septiembre de 2017

American Nurses Association endorses VSED

American Nurses Association endorses VSED

Bioedge

American Nurses Association endorses VSED
     
Many patients require artificial nutrition and hydration (ANH) at the end of life. But what should medical staff do when a patient seeks to hasten death by having ANH withdrawn? Despite the ethical complexities of the situation, medical guidelines are vague and, in some cases, non-existent.
But the American Nurses Association has issued a new position statement that categorically endorses “voluntary stopping of eating and drinking” (VSED). In the statement, the ANA asserts that “VSED at the end of life is used to hasten death, and is a reflection of autonomy and the patient’s desire for control.” According to the Association, a patient’s decision to begin VSED should be respected by the nurses, as “patients who are at the end of life likely have reasons for stopping nutrition and hydration”. The Statement continues:
“[Reasons for VSED may include] physiologic causes that lead to loss of appetite and/or the inability to eat. Some people who choose VSED may not be imminently dying. Psychological, spiritual or existential suffering, as well as physical suffering, can lead to patient requests for hastened death.”
Nurses are instructed to continue “to ensure the provision of high quality care, minimizing discomfort and promoting dignity”.

Oxford University bioethicist Julian Savulescu penned a controversial article in 2013 that proposed VSED as an “ethical and legal alternative” to euthanasia in jurisdictions where euthanasia is still prohibited. The ANA guidelines are an endorsement of this suggestion.
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Sunday, September 17, 2017



For better or worse, this week’s newsletter seems largely dedicated to topics revolving around euthanasia. Belgium’s system is finally getting the close critical scrutiny it deserves in a new collection of essays from Cambridge University Press.



Coincidentally, the doyen of euthanasia there, Dr Wim Distelmans, has just released statistics about child euthanasia. “Nothing to see here; please move along,” seems to be his message. In three years, only two children have been euthanised. Perhaps that is an index of how normal euthanasia has become in his country.



Assisted dying is a hot topic, too, in Australia, in the states of Victoria and New South Wales. BioEdge has organised a free forum on NSW’s Voluntary Assisted Dying Bill on this coming Thursday in Sydney. It will be held at Parliament House, on Macquarie Street, from 9.30am to 12.30pm. A number of medical and legal experts will be discussing the possibility of legal euthanasia in New South Wales. For more details, please check our Facebook page.





Michael Cook

Editor

BioEdge
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American Nurses Association endorses VSED

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